Increasing accurate self-report in surveys of pregnancy alcohol use

Background: pregnancy alcohol research relies on self-reports of alcohol consumption. Reporting bias may contribute to ambiguous and conflicting findings on fetal effects of low to moderate pregnancy alcohol exposure. Objective: this study aimed to identify the determinants which would enable women to provide accurate data in surveys of alcohol use in pregnancy. Design and participants: six focus groups were held with a total of 26 pregnant women and new mothers. Participants reviewed a set of alcohol survey questions followed by a guided discussion. Transcripts were analysed using inductive content analysis. Setting: public hospital antenatal clinics and Mother & Child Health Centres, Melbourne, Victoria, Australia. Findings: women's emotional responses were generally favourable, although the potential for anxiety and fear of judgement was acknowledged. Barriers to accurate self report were recall, complexity and use of subjective language. Facilitators were appropriate drink choices, occasional drinking options and contextualising of questions. Confidentiality and survey method, including a preference for methods other than lace to face, were also important factors. Key conclusions and implications for practice: questions embedded in clear context may reduce anxiety around questions about alcohol use in pregnancy. Methods using shorter recall periods, a list of drinks choices, measures of special occasion drinking and minimising complex and subjective language will increase accurate self report. A setting perceived as confidential and anonymous may reduce a desire to provide socially acceptable answers. (C) 2014 Elsevier Ltd. All rights reserved.