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Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

ABSTRACT: Alcohol exposed pregnancy (AEP) is a leading cause of preventable birth defects. While randomized controlled trials (RCTs) have shown that multi-session motivational interviewing-based interventions reduce AEP risk, a one-session intervention could facilitate broader implementation. The purposes of this study were to: (1) test a one-session motivational AEP prevention intervention for community women and (2) compare outcomes to previous RCTs. Participants at risk for AEP (N=217) were randomized to motivational interviewing+assessment feedback (EARLY), informational video, or informational brochure conditions. Outcomes were drinks per drinking day (DDD), ineffective contraception rate, and AEP risk at 3 and 6 months. All interventions were associated with decreased DDD, ineffective contraception rate, and AEP risk. Participants who received EARLY had larger absolute risk reductions in ineffective contraception and AEP risk, but not DDD. Effect sizes were compared to previous RCTs. The one-session EARLY intervention had less powerful effects than multi-session AEP prevention interventions among community women, but may provide a new option in a continuum of preventive care.

SUBMITTER: Ingersoll KS

PROVIDER: S-EPMC3678761 | biostudies-literature | 2013 Apr

REPOSITORIES: biostudies-literature

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Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

Ingersoll Karen S KS Ceperich Sherry D SD Hettema Jennifer E JE Farrell-Carnahan Leah L Penberthy J Kim JK

Journal of substance abuse treatment 20121126 4

Alcohol exposed pregnancy (AEP) is a leading cause of preventable birth defects. While randomized controlled trials (RCTs) have shown that multi-session motivational interviewing-based interventions reduce AEP risk, a one-session intervention could facilitate broader implementation. The purposes of this study were to: (1) test a one-session motivational AEP prevention intervention for community women and (2) compare outcomes to previous RCTs. Participants at risk for AEP (N=217) were randomized ...[more]

PMID: 23192220

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Project description:AimTo test the effectiveness of a motivational interviewing (MI) intervention using the mobile phone among adults with alcohol use problems.DesignA randomized clinical trial of mobile MI and standard in-person MI with 1- and 6-month follow-up, including a 1-month waitlist control followed by mobile MI.SettingA primary health center in rural Kenya.ParticipantsThree hundred adults screening positive for alcohol use problems were randomized and received immediate mobile MI (n = 89), in-person MI (n = 65) or delayed mobile MI (n = 76) for waiting-list controls 1 month after no treatment, with 70 unable to be reached for intervention.Intervention and comparatorOne MI session was provided either immediately by mobile phone, in-person at the health center or delayed by 1 month and then provided by mobile phone.MeasurementsAlcohol use problems were repeatedly assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the shorter AUDIT-C. The primary outcome was difference in alcohol score 1 month after no intervention for waiting-list control versus 1 month after MI for mobile MI. The secondary outcomes were difference in alcohol score for in-person MI versus mobile MI one and 6 months after MI.FindingsFor our primary outcome, average AUDIT-C scores were nearly three points higher (difference = 2.88, 95% confidence interval = 2.11, 3.66) for waiting-list controls after 1 month of no intervention versus mobile MI 1 month after intervention. Results for secondary outcomes supported the null hypothesis of no difference between in-person and mobile MI at 1 month (Bayes factor = 0.22), but were inconclusive at 6 months (Bayes factor = 0.41).ConclusionMobile phone-based motivational interviewing may be an effective treatment for alcohol use problems among adults visiting primary care in Kenya. Providing mobile motivational interviewing may help clinicians in rural areas to reach patients needing treatment for alcohol use problems.

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Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

Publications

Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

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