A novel prenatal alcohol use risk perception model: feedback from a Delphi process

Understanding prenatal alcohol exposure (PAE) risk perception is important for the communication and prevention of alcohol use during pregnancy. A previous systematic review has explored the dimensions and influencing factors of women's PAE risk perceptions, leading to the construction of Pregnancy Alcohol Use Risk Perception (PARP) conceptual model. This study aims to refine the PARP model using a Delphi process. A total of 37 international experts participated, 17 completed all three online surveys between May 2022 and December 2022. The online survey consisted of Likert-scale and free-text responses on the usefulness and clarity of the components and the design of the PARP model. Likert-scale responses were analysed using descriptive statistics. Free-text responses were analysed using a reflexive thematic analysis approach. The model was amended following participants' responses. Four characteristics underpinned the revised model-relevance-to-self and the negotiations of risks, inter-relatedness of affect with the cognitive processing of risk, contextual influences of individual, sociocultural and institutional/political/organizational rendering a socioecological perspective to PAE risks perception and the dynamic characteristics of PAE risk perception. The acknowledgement of PAE risk perceptions and the contextual influences can support development of targeted and tailored messages and health education materials.