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drinking and reducing unintended pregnancies by encouraging contraception use.
• Some of the women in the program once consumed an entire bottle of hard liquor, the equivalent of about 17 drinks, in one day. Others opted for a 40 oz. malt liquor, the equivalent of about five drinks. A few drank while previously pregnant.
• "A lot of it when they're young, it's kind of the norm and when they're hanging around with their friends and that's what everybody is doing," said Florence Janis, a counselor in Rapid City with Project CHOICES. "When they get older, the issues that come out ....what we see is underneath is a lot of pain. There's been rape, been beatings, nobody available, abandonment, a lot of grief. And they don't realize when they're drinking what they're doing."
• The Oglala Sioux Tribe estimates that one in four children born on its reservation suffers from fetal alcohol syndrome or fetal alcohol spectrum disorder. Children with fetal alcohol syndrome are often hyperactive and have difficulty paying attention. They also can have learning difficulties, abnormal facial features and suffer from a low body weight, among other symptoms.
• Project CHOICES has been used among other high-risk populations of women, but the Oglala Sioux Tribe is the first Native American community to take part in the program, said Jessica Hanson, an assistant scientist for the Center for Health Outcomes and Prevention Research at Sanford Research.
• Sanford is working with the Pine Ridge Tribal Health Administration and the Rosebud Tribal Health Administration on a study that they hope will lead to an expansion of the program to other communities with large Native American populations. They have received more than $800,000 in funding from the National Institutes of Health for the effort.
• In Rapid City, Janis works with Native American women from ages 18 to 44 to try to change their risky behaviors through a technique called motivational interviewing. Counselors talk to the women to identify reasons why they might want to change their behavior and allow them to come to decisions to change on their own.
• The women also keep journals of their risky drinking behaviors. Looking back over the journals, they can see their at-risk behaviors, and those who aren't ready to stop drinking can get birth control, said Susan Pourier, coordinator for Project CHOICES on the Pine Ridge Indian Reservation.
• "It's more feasible to get our women educated on prevention whether than take care of an FAS baby. Education, prevention is the key," Pourier said. Each woman receives a $25 gift card as an incentive to participate.
• The Oglala Sioux Tribe has struggled for years with alcoholism among its members. It filed a $500 million lawsuit earlier this year against several beer makers and

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