{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:06:48Z","timestamp":1791565608943,"version":"4.3.4"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>South Africa lacks services to detect and address alcohol use during pregnancy, particularly outside of health-care facilities. This study aimed to explore pregnant women and healthcare providers\u2019 perceptions of the acceptability, feasibility and appeal of a community-based counselling programme for pregnant women with alcohol problems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty-eight in-depth interviews with pregnant women who drink, Community Health Workers (CHWs) and antenatal service providers were conducted. Transcribed interviews were analyzed thematically using a combined deductive and inductive approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women reported feeling uncomfortable seeking help for their alcohol use at antenatal clinics, limiting usefulness of current support services. All stakeholders perceived a community-based intervention to be acceptable and feasible as it could be integrated with other CHW-delivered services. Participants thought an intervention should facilitate early linkage to antenatal services and should include partners or family members. The feasibility of an intervention may depend on the relationship between CHWs and clinic-based antenatal staff, and their relationships with pregnant women. Clinic and community challenges to implementation were raised. Clinic-level challenges included shortage of space, staff capacity, high number of pregnant women, long waiting times, financial burden of having to travel to a clinic, lack of comfort and privacy and staff attitudes. Community-level challenges included crime, lack of privacy, lack of attention given competing interests in the home, fear due to abuse, and stigma and discrimination from other community members. Suggestions for overcoming these challenges were provided.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Findings provide essential information to facilitate the adaptation of a community-based alcohol counselling programme for greater acceptability, feasibility and cultural appropriateness for the South African context. Intensive training, supervision and support is required to ensure the programme is delivered as planned.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2023.1203835","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T11:25:00Z","timestamp":1688642700000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Community-based counselling programme for pregnant women with alcohol problems in Cape Town, South Africa: a qualitative study of the views of pregnant women and healthcare professionals"],"prefix":"10.3389","volume":"14","author":[{"given":"Petal","family":"Petersen Williams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodilee","family":"Erasmus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronwyn","family":"Myers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijit","family":"Nadkarni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela C.","family":"Fuhr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"860","DOI":"10.3109\/14767058.2011.587559","article-title":"Heavy prenatal alcohol exposure and risk of stillbirth and preterm delivery","volume":"25","author":"Cornman-Homonoff","year":"2012","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1111\/j.1530-0277.2011.01513.x","article-title":"Association of moderate alcohol use and binge drinking during pregnancy with neonatal health","volume":"35","author":"Meyer-Leu","year":"2011","journal-title":"Alcohol Clin Exp Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1111\/acer.13566","article-title":"Effect of hazardous alcohol use during pregnancy on growth outcomes at birth: findings from a south African cohort study","volume":"42","author":"Myers","year":"2018","journal-title":"Alcohol Clin Exp Res"},{"key":"ref4","first-page":"57","article-title":"Overview of fetal alcohol spectrum disorders for mental health professionals","volume":"12","author":"Clarke","year":"2003","journal-title":"Can Child Adolesc Psychiatr Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1001\/jamapediatrics.2017.1919","article-title":"Global prevalence of fetal alcohol Spectrum disorder among children and youth: a systematic review and Meta-analysis","volume":"171","author":"Lange","year":"2017","journal-title":"JAMA Pediatr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"522","DOI":"10.3390\/ijerph14050522","article-title":"Replication of high fetal alcohol Spectrum disorders prevalence rates, child characteristics, and maternal risk factors in a second sample of rural communities in South Africa","volume":"14","author":"May","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.drugalcdep.2006.11.007","article-title":"The epidemiology of fetal alcohol syndrome and partial FAS in a south African community","volume":"88","author":"May","year":"2007","journal-title":"Drug Alcohol Depend"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1111\/acer.12033","article-title":"Approaching the prevalence of the full spectrum of fetal alcohol spectrum disorders in a south African population-based study. 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