{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T03:31:12Z","timestamp":1782444672299,"version":"3.54.5"},"reference-count":59,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Due to the risks it poses to a child\u2019s health, drinking alcohol during pregnancy is a serious problem that the public health sector is struggling to deal with. The reasons why women who do not have alcohol problems do not give up drinking alcohol completely during pregnancy are still poorly understood. And the knowledge available about them does not translate into communication strategies in Poland. The analysis of standards and examples of good practice allows to formulate proposals for improving the quality and effectiveness of social campaigns addressed to the general population and women of childbearing age in order to reduce the risk associated with the prenatal exposure to alcohol.<\/jats:p>","DOI":"10.3390\/ijerph19084552","type":"journal-article","created":{"date-parts":[[2022,4,10]],"date-time":"2022-04-10T06:02:54Z","timestamp":1649570574000},"page":"4552","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Is Public Health Response to the Phenomenon of Alcohol Use during Pregnancy Adequate to the Polish Women\u2019s Needs?"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7981-3885","authenticated-orcid":false,"given":"Katarzyna","family":"Okulicz-Kozaryn","sequence":"first","affiliation":[{"name":"Institute of Mother and Child, 01-211 Warsaw, Poland"},{"name":"National Centre for Prevention of Addictions, 02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1037\/0033-2909.84.5.888","article-title":"Attitude-Behavior Relations: A Theoretical Analysis and Review of Empirical Research","volume":"84","author":"Ajzen","year":"1977","journal-title":"Psychol. Bull."},{"key":"ref_2","first-page":"45","article-title":"Social Cognitive Theory of Moral Thought and Action","volume":"Volume 1","author":"Kurtines","year":"1991","journal-title":"Handbook of Moral Behavior and Development"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"190","DOI":"10.15288\/jsa.2001.62.190","article-title":"Drinking to Cope, Emotional Distress and Alcohol Use and Abuse: A Ten-Year Model","volume":"62","author":"Holahan","year":"2001","journal-title":"J. Stud. Alcohol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1080\/1067828X.2017.1305932","article-title":"Contextual Factors That Influence Alcohol Use Behaviors","volume":"26","author":"Dearfield","year":"2017","journal-title":"J. Child Adolesc. Subst. Abus."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Obeid, S., Akel, M., Haddad, C., Fares, K., Sacre, H., Salameh, P., and Hallit, S. (2020). Factors Associated with Alcohol Use Disorder: The Role of Depression, Anxiety, Stress, Alexithymia and Work Fatigue- a Population Study in Lebanon. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-8345-1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1111\/add.14534","article-title":"Neighborhood Density of Alcohol Outlets Moderates Genetic and Environmental Influences on Alcohol Problems","volume":"114","author":"Slutske","year":"2018","journal-title":"Addiction"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1001\/jamapediatrics.2017.1919","article-title":"Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth","volume":"171","author":"Lange","year":"2017","journal-title":"JAMA Pediatr."},{"key":"ref_8","first-page":"10","article-title":"Animal Research: Charting the Course for FAS","volume":"18","author":"Becker","year":"1994","journal-title":"Alcohol Health Res. World."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/S0140-6736(15)01345-8","article-title":"Comorbidity of Fetal Alcohol Spectrum Disorder: A Systematic Review and Meta-Analysis","volume":"387","author":"Shield","year":"2016","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/acer.13305","article-title":"Prenatal Alcohol Consumption Between Conception and Recognition of Pregnancy","volume":"41","author":"McCormack","year":"2017","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Muggli, E., O\u2019Leary, C., Donath, S., Orsini, F., Forster, D., Anderson, P.J., Lewis, S., Nagle, C., Craig, J.M., and Elliott, E. (2016). \u201cDid You Ever Drink more?\u201d A Detailed Description of Pregnant Women\u2019s Drinking Patterns. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-3354-9"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.15585\/mmwr.mm7101a2","article-title":"Alcohol Consumption and Binge Drinking During Pregnancy Among Adults Aged 18\u201349 Years\u2014United States, 2018\u20132020","volume":"71","author":"Gosdin","year":"2022","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e290","DOI":"10.1016\/S2214-109X(17)30021-9","article-title":"Estimation of National, Regional, and Global Prevalence of Alcohol Use During Pregnancy and Fetal Alcohol Syndrome: A Systematic Review and Meta-Analysis","volume":"5","author":"Popova","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_14","unstructured":"Moskalewicz, J., Room, R., and Thom, B. (2016). Opinions on and Attitudes towards Alcohol. Comparative Monitoring of Alcohol Epidemiology across the EU, European Union. Available online: https:\/\/www.rarha.eu\/Resources\/Deliverables\/Pages\/details.aspx?itemId=7&lista=Work%20Package%204&bkUrl=\/Resources\/Deliverables\/."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s13011-020-00269-3","article-title":"Alcohol Consumption and Its Associated Factors Among Pregnant Women in Sub-Saharan Africa: A Systematic Review and Meta-analysis\u2019 As Given in the Submission System","volume":"15","author":"Addila","year":"2020","journal-title":"Subst. Abus. Treat. Prev. Policy"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Addila, A.E., Azale, T., Gete, Y.K., and Yitayal, M. (2021). Determinants of Hazardous Alcohol Use Among Pregnant Women Attending Antenatal Care at Public Health Facilities in Gondar Town, Northwest Ethiopia: A Nested Case-Control Study. PLoS ONE, 16.","DOI":"10.1186\/s13011-021-00401-x"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.ntt.2003.07.002","article-title":"Risk Factors for Alcohol Use During Pregnancy in a Multistate Area","volume":"25","author":"Leonardson","year":"2003","journal-title":"Neurotoxicology Teratol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5820\/aian.1702.2011.1","article-title":"Socioeconomic Status, Psychological Distress, and Other Maternal Risk Factors for Fetal Alcohol Spectrum Disorders Among American Indians of the Northern Plains","volume":"17","author":"Lewis","year":"2011","journal-title":"Am. Indian Alsk. Nativ. Ment. Health Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1111\/acer.14612","article-title":"Partner Influence as a Factor in Maternal Alcohol Consumption and Depressive Symptoms, and Maternal Effects on Infant Neurodevelopmental Outcomes","volume":"45","author":"Petrenko","year":"2021","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.amepre.2020.05.017","article-title":"Trends in Alcohol Use Among Pregnant Women in the U.S., 2011\u20132018","volume":"59","author":"Denny","year":"2020","journal-title":"Am. J. Prev. Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lyall, V., Wolfson, L., Reid, N., Poole, N., Moritz, K., Egert, S., Browne, A., and Askew, D. (2021). \u201cThe Problem Is That We Hear a Bit of Everything\u2026\u201d A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18073445"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Raymond, N., Beer, C., Glazebrook, C., and Sayal, K. (2009). Pregnant women\u2019s Attitudes towards Alcohol Consumption. BMC Public Health, 9.","DOI":"10.1186\/1471-2458-9-175"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1016\/j.midw.2012.11.014","article-title":"A Qualitative Investigation of Alcohol Use Advice During Pregnancy: Experiences of Dutch Midwives, Pregnant Women and Their Partners","volume":"29","author":"Hoving","year":"2013","journal-title":"Midwifery"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/j.1465-3362.2009.00136.x","article-title":"What Women in France Say about Alcohol Abstinence During Pregnancy","volume":"29","author":"Toutain","year":"2009","journal-title":"Drug Alcohol Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1080\/13698575.2013.863851","article-title":"\u2018I Don\u2019t Think It\u2019s Risky, but\u2026\u2019: Pregnant women\u2019s Risk Perceptions of Maternal Drinking and Smoking","volume":"16","author":"Hammer","year":"2013","journal-title":"Health Risk Soc."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Grant, A., Morgan, M., Mannay, D., and Gallagher, D. (2019). Understanding Health Behaviour in Pregnancy and Infant Feeding in-Tentions in Low-Income Women from the UK through Qualitative Visual Methods and Application to the COM-B (Capability, Opportunity, Motivation-Behaviour) Model. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-018-2156-8"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1111\/dar.12973","article-title":"Pregnancy as a Transition: First-time Expectant couples\u2032 Experience with Alcohol Consumption","volume":"38","author":"Gouilhers","year":"2019","journal-title":"Drug Alcohol Rev."},{"key":"ref_28","first-page":"533","article-title":"Exploring Practices and Perceptions of Alcohol Use During Pregnancy in England and Sweden through a Cross-Cultural Lens","volume":"28","author":"Hughes","year":"2017","journal-title":"Eur. J. Public Health"},{"key":"ref_29","unstructured":"Goli\u0144ska, J. (2019). Spo\u017cywanie Alkoholu W Trakcie Ci\u0105\u017cy\u2014Eksploracja Postaw\/Raport Z Projektu jako\u015bciowego [Consuming Alcohol During Pregnancy\u2014Attitudes Exploration\/Report on the Qualitative Project], 4P Research Mix Sp. z.o.o.. Unpublished Report Available from PARPA."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s40817-016-0025-9","article-title":"Prevention and Intervention for FASD in Poland","volume":"3","author":"Terlikowska","year":"2017","journal-title":"J. Pediatr. Neuropsychol."},{"key":"ref_31","unstructured":"United Nations Office on Drugs and Crime and the World Health Organization (2018). International Standards on Drug Use Prevention, United Nations Office on Drugs and Crime and the World Health Organization. [2nd ed.]. Licence: CC BY-NC-SA 3.0 IGO."},{"key":"ref_32","first-page":"E13","article-title":"Increasing FASD Knowledge by a Targeted Media Campaign: Outcome Determined by Message Frequency","volume":"3","author":"Mengel","year":"2005","journal-title":"JFAS Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1080\/15205436.2015.1063666","article-title":"Reading Lasswell\u2019s Model of Communication Backward: Three Scholarly Misconceptions","volume":"18","author":"Sapienza","year":"2015","journal-title":"Mass Commun. Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1037\/0003-066X.47.9.1102","article-title":"In Search of How People Change: Applications to Addictive Behaviors","volume":"47","author":"Prochaska","year":"1992","journal-title":"Am. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"The Project CHOICES Intervention Research Group (2003). Reducing the Risk of Alcohol-Exposed Pregnancies: A Study of a Motivational Intervention in Community Settings. Pediatrics, 111, 1131\u20131135.","DOI":"10.1542\/peds.111.S1.1131"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jsat.2005.06.003","article-title":"Reducing Alcohol Exposed Pregnancy Risk in College Women: Initial Outcomes of a Clinical Trial of a Motivational Intervention","volume":"29","author":"Ingersoll","year":"2005","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s10865-010-9308-2","article-title":"Motivational Interviewing + Feedback Intervention to Reduce Alcohol-Exposed Pregnancy Risk Among College Binge Drinkers: Determinants and Patterns of Response","volume":"34","author":"Ceperich","year":"2011","journal-title":"J. Behav. Med."},{"key":"ref_38","unstructured":"Bryant, J., and Zillmann, D. (2002). Exemplification Theory of Media Influence. Media Effects: Advances in Theory and Research, LEA. [2nd ed.]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S221","DOI":"10.1111\/j.1460-2466.2006.00291.x","article-title":"Exemplification Effects in the Promotion of Safety and Health","volume":"56","author":"Zillmann","year":"2006","journal-title":"J. Commun."},{"key":"ref_40","first-page":"590","article-title":"Exemplification Effects: Responses to Perceptions of Risk","volume":"20","author":"Spence","year":"2015","journal-title":"J. Risk Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"263","DOI":"10.2307\/1914185","article-title":"Prospect Theory: An Analysis of Decision under Risk","volume":"47","author":"Kahneman","year":"1979","journal-title":"Econometrica"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1037\/0033-2909.121.1.3","article-title":"Shaping Perceptions to Motivate Healthy Behavior: The Role of Message Framing","volume":"121","author":"Rothman","year":"1997","journal-title":"Psychol. Bull."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S202","DOI":"10.1111\/j.1460-2466.2006.00290.x","article-title":"The Strategic Use of Gain- and Loss-Framed Messages to Promote Healthy Behavior: How Theory Can Inform Practice","volume":"56","author":"Rothman","year":"2006","journal-title":"J. Commun."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1080\/10410236.2010.521910","article-title":"Communicating the Risks of Fetal Alcohol Spectrum Disorder: Effects of Message Framing and Exemplification","volume":"25","author":"Yu","year":"2010","journal-title":"Health Commun."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"France, K.E., Donovan, R.J., Bower, C., Elliott, E.J., Payne, J.M., D\u2019Antoine, H., and Bartu, A.E. (2014). Messages That Increase Women\u2019s Intentions to Abstain from Alcohol During Pregnancy: Results from Quantitative Testing of Advertising Concepts. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-30"},{"key":"ref_46","first-page":"2333393617707663","article-title":"\u201cNo Alcohol Is Recommended, But...\u201d: Health Care Students\u2019 Attitudes About Alcohol Consumption During Pregnancy","volume":"4","author":"Coons","year":"2017","journal-title":"Glob. Qual. Nurs. Res."},{"key":"ref_47","first-page":"756","article-title":"A Survey of Obstetrician\u2013Gynecologists on Their Patients\u2019 Alcohol Use During Pregnancy","volume":"95","author":"Diekman","year":"2000","journal-title":"Obstet. Gynecol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1177\/0308575915598931","article-title":"Knowledge and Opinions of Professional Groups Concerning FASD in the UK","volume":"39","author":"Mukherjee","year":"2015","journal-title":"Adopt. Foster."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Lewis, S.J., Zuccolo, L., Davey Smith, G., Macleod, J., Rodriguez, S., Draper, E.S., Barrow, M., Alati, R., and Gray, R. (2012). Fetal Alcohol Exposure and IQ at Age 8: Evidence from a Population-Based Birth-Cohort Study. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0049407"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1111\/jcpp.12486","article-title":"Moderate Alcohol Drinking in Pregnancy Increases Risk for children\u2019s Persistent Conduct Problems: Causal Effects in a Mendelian Randomisation Study","volume":"57","author":"Murray","year":"2015","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.3389\/fimmu.2018.01107","article-title":"Lifelong Impacts of Moderate Prenatal Alcohol Exposure on Neuroimmune Function","volume":"9","author":"Noor","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e20182399","DOI":"10.1542\/peds.2018-2399","article-title":"Patterns of Prenatal Alcohol Use That Predict Infant Growth and Development","volume":"143","author":"Bandoli","year":"2019","journal-title":"Pediatrics"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1136\/jech.2009.103002","article-title":"Light Drinking During Pregnancy: Still No Increased Risk for Socioemotional Difficulties or Cognitive Deficits at 5 Years of Age?","volume":"66","author":"Kelly","year":"2010","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.drugalcdep.2019.01.007","article-title":"Prenatal Alcohol Exposure and Offspring Mental Health: A Systematic Review","volume":"197","author":"Easey","year":"2019","journal-title":"Drug Alcohol Depend."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1258\/jrsm.2011.110180","article-title":"The Answer Is 17 Years, What Is the Question: Understanding Time Lags in Translational Research","volume":"104","author":"Morris","year":"2011","journal-title":"J. R. Soc. Med."},{"key":"ref_56","unstructured":"World Health Organization (2018). Global Status Report on Alcohol and Health 2018, Licence: CC BY-NC-SA 3.0."},{"key":"ref_57","unstructured":"IGO (2019). The SAFER Technical Package: Five Areas of Intervention at National and Subnational Levels, Licence: CC BY-NC-SA 3.0 IGO."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1080\/16066359.2020.1773445","article-title":"Reconceptualising the Study of Alcohol Policy Decision-Making: The Contribution of Political Science","volume":"29","author":"Lesch","year":"2021","journal-title":"Addict. Res. Theory"},{"key":"ref_59","first-page":"6","article-title":"Polska Polityka Wobec Alkoholu Na Tle Innych kraj\u00f3w Europejskich","volume":"9","year":"2017","journal-title":"\u015awiat Probl."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/8\/4552\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:51:09Z","timestamp":1760136669000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/8\/4552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,9]]},"references-count":59,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["ijerph19084552"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19084552","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,9]]}}}