A Pilot Randomized Controlled Trial of a Computer-Delivered Brief Intervention for Substance Use and Risky Sex During Pregnancy

Wernette, Golfo Tzilos; Plegue, Melissa; Kahler, Christopher W.; Sen, Ananda; Zlotnick, Caron

doi:10.1089/jwh.2017.6408

Cited by 35 publications

(85 citation statements)

References 38 publications

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“…Other goals of the study were to examine the efficacy of SHE in reducing women's overall number of psychosocial health risks, as well as symptoms of PTSD, hazardous drinking, and recent experiences of IPV compared to the control group. Although other single-session interventions have shown positive effects on drinking, IPV, and PTSD [29][30][31][32] , there were no differences in any of these measures between the SHE and control groups, potentially because the study was powered to detect only a medium effect size when most behavioral interventions yield small-to medium-range effect sizes 54 . Moreover, the study was underpowered to test mediation models, and any impact on clinical outcomes would likely be through treatment utilization.…”

Section: Discussionmentioning

confidence: 94%

Computerized Intervention in Primary Care for Women Veterans with Sexual Assault Histories and Psychosocial Health Risks: a Randomized Clinical Trial

et al. 2021

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Importance Sexual assault is a public health concern for women and is associated with subsequent psychosocial health risks of posttraumatic stress disorder (PTSD), hazardous drinking, and intimate partner violence (IPV). Sexual assault is associated with social stigma and other barriers shown to inhibit one from seeking mental health care. Digital health technologies may overcome these barriers. Objective To test the impact of a brief computerized intervention delivered in primary care to reduce health risks and increase mental health treatment utilization among women with histories of sexual assault and current health risks. Design, Setting, and Participants The Safe and Healthy Experiences (SHE) program was tested in a randomized controlled trial with N = 153 women veterans at a Veterans Health Administration (VHA) medical center, and they completed assessments at baseline, 2 months, and 4 months. Intervention SHE is a brief motivational interviewing and psychoeducation-based computerized intervention. SHE was compared to a screen and referral-only control condition. Main Measures Health risks were measured via validated self-report instruments. Treatment initiation and utilization were measured via self-report and chart review. Results SHE did not impact women’s number of health risks (all p’s > .05). However, women randomized to SHE showed significantly greater increases in treatment use compared to women in the control group, as measured by chart review (χ2 (1, n = 153) = 4.38, p = .036, rs = .16), and self-report (χ2 (1, n = 130) = 5.89, p = .015, rs = .21). SHE was found to be an acceptable intervention. Conclusions SHE was effective in improving mental health treatment initiation and utilization compared to a control group. Computer-based interventions to address sexual trauma and its consequences are acceptable, are highly scalable, and can add value to primary care with little cost or increase in provider time. Trial Registration Clinicaltrials.gov identifier NCT02957747.

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Section: Discussionmentioning

confidence: 94%

Computerized Intervention in Primary Care for Women Veterans with Sexual Assault Histories and Psychosocial Health Risks: a Randomized Clinical Trial

et al. 2021

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“…With respect to the type of eHealth interventions, most of the interventions were created in a way that communication of services took place through the use of technology (i.e., telephone/text), rather than the use of a specific app to reduce substance use behaviours. Four of the eHealth interventions were delivered via computer or the internet [ 42 , 43 , 44 , 45 ], one was delivered through text message (SMS) [ 41 ] and one was delivered via telephone [ 36 ]. The types of interventions that were delivered included: motivational interviewing in one study [ 43 ], the use of general health advice (presented educational information regarding substance use without a psychological component) in three studies [ 42 , 45 , 46 ], and psychoeducation in two studies [ 36 , 41 ].…”

Section: Resultsmentioning

confidence: 99%

“…The types of interventions that were delivered included: motivational interviewing in one study [ 43 ], the use of general health advice (presented educational information regarding substance use without a psychological component) in three studies [ 42 , 45 , 46 ], and psychoeducation in two studies [ 36 , 41 ]. Three studies assigned control participants to receive treatment as usual from their healthcare providers [ 41 , 43 , 46 ], one study provided control group participants access to a website with standard advice, [ 42 ] and two studies used a time-matched placebo condition [ 43 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…Interventions varied with respect to whether the eHealth intervention was guided or unguided, which was defined by whether a therapist/healthcare professional facilitated treatment. Most of the included studies were guided ( n = 4) [ 36 , 42 , 43 , 44 ]. Two studies were unguided [ 41 , 45 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two studies were unguided [ 41 , 45 ]. Length of follow-up varied across studies with follow-up occurring at 4 weeks after baseline [ 41 ], 8 weeks after baseline [ 42 ], 12 weeks after baseline [ 43 ], 16 weeks after baseline [ 44 ], up to 22 weeks after baseline [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

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eHealth Interventions to Treat Substance Use in Pregnancy: A Systematic Review and Meta-Analysis

Silang

Sanguino

Sohal

et al. 2021

IJERPH

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Substance use during pregnancy is associated with adverse pregnancy and neonatal outcomes; eHealth interventions offer a potential accessible treatment option. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of eHealth interventions for the treatment of substance use during pregnancy. A comprehensive search of PsycINFO, Medline, CINAHL, Cochrane and Embase databases was conducted from May 2020 to April 2021. The protocol for this study was registered with Prospero (CRD42020205186) through the University of York Centre for Reviews and Dissemination. Two independent reviewers completed screening, data extraction, and quality assessment. RCTs were included if they reported: (a) administration of an eHealth intervention for (b) substance use outcomes, among (c) pregnant individuals. Comprehensive Meta-Analysis Software (CMA) was used to calculate pooled effect sizes (Odds Ratio) to determine the effect of eHealth interventions on substance use outcomes. Six studies were identified with substance use outcomes that included: smoking (n = 3), alcohol (n = 2), and other (n = 1). eHealth interventions were delivered through the internet (n = 1), computer (n = 3), telephone (n = 1), and text (n = 1). Results suggested that eHealth interventions significantly reduced substance use in pregnant individuals compared to controls (OR = 1.33, 95% CI = 1.06 to 1.65, p = 0.013). eHealth interventions offer a promising and accessible treatment option to reduce substance use during pregnancy. This work was supported by the generous donors of the Alberta Children's Hospital Foundation, the Canadian Child Health Clinician Scientist Program (CCHCSP), the Canadian Institute of Health Research and the Fonds de Recherche du Québec—Santé.

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Screening for Unhealthy Drug Use

Patnode

Perdue

Rushkin

et al. 2020

JAMA

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A Pilot Randomized Controlled Trial of a Computer-Delivered Brief Intervention for Substance Use and Risky Sex During Pregnancy

Abstract: The results of this pilot study are encouraging with respect to the acceptability and preliminary efficacy of an intervention in reducing alcohol/marijuana use and condomless sex during pregnancy, supporting the next step of testing the intervention in a larger sample.

Cited by 35 publications

References 38 publications

Computerized Intervention in Primary Care for Women Veterans with Sexual Assault Histories and Psychosocial Health Risks: a Randomized Clinical Trial

Computerized Intervention in Primary Care for Women Veterans with Sexual Assault Histories and Psychosocial Health Risks: a Randomized Clinical Trial

eHealth Interventions to Treat Substance Use in Pregnancy: A Systematic Review and Meta-Analysis

Screening for Unhealthy Drug Use

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