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Randomized Controlled Trial
. 2015 Jul;39(7):1219-26.
doi: 10.1111/acer.12747. Epub 2015 May 22.

Computer-Delivered Screening and Brief Intervention for Alcohol Use in Pregnancy: A Pilot Randomized Trial

Steven J Ondersma  1 , Jessica R Beatty  1 , Dace S Svikis  2   3 , Ronald C Strickler  4 , Golfo K Tzilos  5 , Grace Chang  6 , George W Divine  4 , Andrew R Taylor  4 , Robert J Sokol  7
Affiliations
Randomized Controlled Trial

Computer-Delivered Screening and Brief Intervention for Alcohol Use in Pregnancy: A Pilot Randomized Trial

Steven J Ondersma et al. Alcohol Clin Exp Res. 2015 Jul.

Abstract

Background: Although screening and brief intervention (SBI) for unhealthy alcohol use has demonstrated efficacy in some trials, its implementation has been limited. Technology-delivered approaches are a promising alternative, particularly during pregnancy when the importance of alcohol use is amplified. The present trial evaluated the feasibility and acceptability of an interactive, empathic, video-enhanced, and computer-delivered SBI (e-SBI) plus 3 tailored mailings, and estimated intervention effects.

Methods: We recruited 48 pregnant women who screened positive for alcohol risk at an urban prenatal care clinic. Participants were randomly assigned to the e-SBI plus mailings or to a control session on infant nutrition, and were re-evaluated during their postpartum hospitalization. The primary outcome was 90-day period prevalence abstinence as measured by timeline follow-back interview.

Results: Participants rated the intervention as easy to use and helpful (4.7 to 5.0 on a 5-point scale). Blinded follow-up evaluation at childbirth revealed medium-size intervention effects on 90-day period prevalence abstinence (OR = 3.4); similarly, intervention effects on a combined healthy pregnancy outcome variable (live birth, normal birthweight, and no neonatal intensive care unit stay) were also of moderate magnitude in favor of e-SBI participants (OR = 3.3). As expected in this intentionally underpowered pilot trial, these effects were nonsignificant (p = 0.19 and 0.09, respectively).

Conclusions: This pilot trial demonstrated the acceptability and preliminary efficacy of e-SBI plus tailored mailings for alcohol use in pregnancy. These findings mirror the promising results of other trials using a similar approach and should be confirmed in a fully powered trial.

Keywords: Brief Intervention; Fetal Alcohol Spectrum Disorder; Pregnancy; Randomized Trial; Technology.

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Figures

Figure 1
Figure 1
Participant Flow
Figure 2
Figure 2
Intervention Flow, with Self-Selection into Major Branches
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