# Leverage Points for Equitable Systemic Change to Reduce Alcohol Exposed Pregnancy

> **NIH NIH P20** · SANFORD RESEARCH/USD · 2020 · $305,431

## Abstract

Continued trends of alcohol exposed pregnancy (AEP) indicate a great need for higher quality AEP-reduction
programs, particularly those that address AEP health disparities within at-risk populations and communities, such
as American Indian (AI) women. These programs do not account for the broad constellation of factors pertinent
to AEP, in particular, the role of intimate partner violence (IPV), which forms a syndemic association with two
other AEP indicators (alcohol use and unplanned pregnancy). System dynamics methods are effective strategies
for understanding of how AEP and this syndemic are nested within a broader system of interpersonal,
intrapersonal, and institutional factors. This method is especially beneficial for addressing the current AEPrelated health disparities within AI communities, especially when adding how equity and inequity can impact the
system. Community-based system dynamic models allow practitioners and policymakers to determine the best
system areas for implementing policies and programs that will produce the biggest changes in AEP. The current
proposal uses community-based approaches to develop equity-informed AEP system models for AI women
within a small metro area in western South Dakota. The goals of this project are to build qualitative and
quantitative system dynamic models that that represent the AEP system in partnership with our highly
collaborative community-researcher team. We will parametrize and validate these models utilizing a variety of
community data sources. The proposed research is significant as it accounts for the often-ignored underlying
matrix of contributors which maintain community levels of AEP and AEP health disparities. This project serves
as a valuable extension of the PI’s current COBRE grant, and provides her with a strong foundation for utilizing
this research in future grants as an independent researcher. This project is innovative due to the integration of
system simulation and community-based approaches to address complexity, of this issue, and the deliberate
attention to health inequity as a contributor to disparity. The close working partnership between researchers and
the communities of interest are together a powerful collaborative to facilitate project success and meaningful
contributions to community health. Findings from this study provide critical information about the broad system
underlying AEP and AEP health disparities, as well as a clear mechanism for developing a strategic blueprint for
systematic change within AI communities.

## Key facts

- **NIH application ID:** 10151815
- **Project number:** 3P20GM121341-04S1
- **Recipient organization:** SANFORD RESEARCH/USD
- **Principal Investigator:** JILL M WEIMER
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $305,431
- **Award type:** 3
- **Project period:** 2017-07-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10151815

## Citation

> US National Institutes of Health, RePORTER application 10151815, Leverage Points for Equitable Systemic Change to Reduce Alcohol Exposed Pregnancy (3P20GM121341-04S1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10151815. Licensed CC0.

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