A Novel Integration Effort to Reduce the Risk for Alcohol-Exposed Pregnancy among Women Attending Urban STD Clinics

Hutton, Heidi E.; Chander, Geetanjali; Green, Patricia P.; Hutsell, Catherine A.; Weingarten, Kimberly; Peterson, Karen L.

doi:10.1177/00333549141291s109

Cited by 15 publications

(15 citation statements)

References 21 publications

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“…Similarly, a study that utilized both in-person and telephone-based adaptations of CHOICES interventions with women at clinics and college campuses in Wisconsin found that risk of AEP was significantly reduced, mostly due to improved contraception with minor reductions in alcohol use (Wilton et al, 2013). Women in two urban communities (Baltimore and Denver) who received the 2-session version of CHOICES also lowered their AEP risk at significant rates, and were more likely than our study to change both behaviors, finding similar results to the original CHOICES study (Hutton et al, 2014). …”

Section: Discussionsupporting

confidence: 76%

Impact of the CHOICES Intervention in Preventing Alcohol‐Exposed Pregnancies in American Indian Women

Hanson

Nelson

Jensen

et al. 2017

Alcoholism Clin & Exp Res

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Background Fetal Alcohol Spectrum Disorders (FASD) comprise a continuum of lifelong outcomes in those born prenatally exposed to alcohol. Although studies have shown no differences in rates by race, FASD is of particular concern for American Indian communities. One tribally-run prevention program is the Oglala Sioux Tribe (OST) CHOICES Program, which is modeled after the evidence-based CHOICES program that was focused on preconceptional prevention of alcohol-exposed pregnancy (AEP) by reducing risky drinking in women at-risk for pregnancy and/or preventing unintended pregnancy. Methods The OST CHOICES Program was made culturally appropriate for American Indian women and implemented with three communities, two on the reservation and one off. Data on drinking, sexual activity, and contraception use were collected at baseline and 3- and 6-months post-intervention. Data were analyzed using descriptive statistics, one-way ANOVA, and a random intercept generalized estimating equation (GEE) model. Results A total of 193 non-pregnant American Indian women enrolled in the OST CHOICES Program, and all were at-risk for AEP because of binge drinking and being at-risk for an unintended pregnancy. Fifty-one percent of participants completed both 3- and 6-month follow-up. Models showed a significant decrease in AEP risk from baseline at both 3- and 6-month follow-ups, indicating the significant impact of the OST CHOICES intervention. Women in the OST CHOICES Program were more likely to reduce their risk for AEP by utilizing contraception, rather than decreasing binge drinking. Conclusions Even with minor changes to make the CHOICES intervention culturally and linguistically appropriate and the potential threats to program validity those changes entail, we found a significant impact in reducing AEP risk. This highlights the capacity for the CHOICES intervention to be implemented in a wide variety of settings and populations.

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Section: Discussionsupporting

confidence: 76%

Impact of the CHOICES Intervention in Preventing Alcohol‐Exposed Pregnancies in American Indian Women

Hanson

Nelson

Jensen

et al. 2017

Alcoholism Clin & Exp Res

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“…For one example, an evaluation of counseling to prevent alcohol-exposed pregnancies in two clinics had effects on sexual behavior, although it did not measure STD. 38 …”

Section: Discussionmentioning

confidence: 99%

The Role of Behavioral Counseling in Sexually Transmitted Disease Prevention Program Settings

Brookmeyer

Hogben

Kinsey

2016

Sexually Transmitted Diseases

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Background Behavioral counseling for STD prevention is recommended for persons at risk, and the body of evidence yields numerous interventions that have STD preventive efficacy. What is needed is a review of the subset of these interventions that could be feasible in clinical settings, especially settings in STD prevention programs. Methods We reviewed existing systematic reviews of the literature and abstracted from them studies that fit the following criteria in that the interventions: (1) used no more than 60 minutes contact time in 1 to 2 sessions, (2) were individual-level and face to face, (3) took place in a clinical setting, (4) had STD outcomes available, (5) were based in the United States, (6) were peer-reviewed, and (7) had a control group. Results From 6 reviews (published 2006 – 2014) covering 91 studies, we found 13 analyses representing 11 intervention studies that fit the selection criteria. Of these 13, 5 returned lower STD rates in the intervention group at follow-up; one study reported a higher rate of STD in one subset of the intervention group (men who have sex with men: MSM). Studies with effects on STD at follow-up were quite similar to studies across populations, settings and follow-up periods, although successful interventions were more likely to demonstrate behavioral effects as well (5 of 5 versus 2 of 5 among 10 interventions measuring behavior change). Conclusions Counseling is likely to benefit some STD clinic attendees, although unlikely to benefit MSM. The balance of costs and benefits of implementing behavioral counseling in STD programs is unclear, but feasibility would be improved if behavioral counseling were implemented in the context of other prevention efforts. Because populations outside typical STD clinic settings could also benefit, programs may exercise a valuable role through partnerships.

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“…At that time, OST was conducting individual CHOICES sessions using a 2-session intervention format previously tested in Baltimore and Denver STI clinics (Hutton et al, 2014), so the CHOICES Group intervention also used a two-session model. Ingersoll conducted training with four current OST CHOICES staff (2 Native and 2 non-Native) to fine-tune their MI and CHOICES intervention skills, to demonstrate how to conduct CHOICES sessions in a group format, and to provide opportunities to practice CHOICES Group skills.…”

Section: Methodsmentioning

confidence: 99%

Development and Implementation of CHOICES Group to Reduce Drinking, Improve Contraception, and Prevent Alcohol-Exposed Pregnancies in American Indian Women

Hanson

Ingersoll

Pourier

2015

Journal of Substance Abuse Treatment

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Public health officials assert that prevention of alcohol-exposed pregnancies (AEP) should begin before conception, by reducing alcohol consumption in women at-risk for or planning pregnancy, and/or preventing pregnancy in women who are drinking at risky levels. One such effort is the Oglala Sioux Tribe (OST) CHOICES Program. While the OST CHOICES Program has been successfully implemented, a community-based needs assessment determined that the OST CHOICES intervention should expand and be delivered in a group setting using group motivational interviewing (MI) techniques. After extensive group MI and CHOICES group trainings, recruitment for CHOICES Group began and within a ten month period, a total of twelve groups with non-pregnant American Indian women were held for this pilot intervention. Evaluations completed by participants indicated that CHOICES Group sessions positively engaged members, had low levels of anger or tension, and had average levels of avoidance of personal responsibility. An evaluation of the CHOICES Group leaders indicated strengths in certain MI skills, although improvement is needed in some core MI and group leadership skills. This is an important expansion of a successful AEP prevention program (CHOICES), as well as a novel application of MI, and recommendations and future plans for this intervention are outlined.

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A Novel Integration Effort to Reduce the Risk for Alcohol-Exposed Pregnancy among Women Attending Urban STD Clinics

Cited by 15 publications

References 21 publications

Impact of the CHOICES Intervention in Preventing Alcohol‐Exposed Pregnancies in American Indian Women

Impact of the CHOICES Intervention in Preventing Alcohol‐Exposed Pregnancies in American Indian Women

The Role of Behavioral Counseling in Sexually Transmitted Disease Prevention Program Settings

Development and Implementation of CHOICES Group to Reduce Drinking, Improve Contraception, and Prevent Alcohol-Exposed Pregnancies in American Indian Women

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