A randomized trial comparing telephone versus in-person brief intervention to reduce the risk of an alcohol-exposed pregnancy

Abstract

Brief, effective interventions are needed to reduce the risk of an alcohol-exposed pregnancy in women who drink and do not use effective contraception. The Healthy Choices study compared telephone and in-person administration of a brief intervention. In addition to indicators of alcohol use and effective contraception, compliance with the intervention was examined. Women between the ages of 18 and 44 who were drinking above recommended levels and not using effective contraception were randomly assigned to either a telephone (n=68) or in-person (n=63) brief (2 session) intervention. Overall, participants showed small but significant reductions in alcohol use and larger increases in effective use of contraception. Risk of alcohol-exposed pregnancy was thus significantly reduced, largely due to improved contraception with minor reductions in alcohol use. There was no significant difference in success of the intervention between the two conditions (telephone vs. in-person). These findings suggest telephone-based brief intervention may be equally successful and cost-effective in reducing the risk of an alcohol-exposed pregnancy and thus fetal alcohol syndrome.

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

“…A higher rate of participants in our study and other CHOICES-based studies (Ingersoll et al, 2013; Ingersoll et al, 2005; Letourneau et al, 2016; Wilton et al, 2013) increased effective birth control use, rather than reduced drinking. This consistent recent finding demonstrates that reducing risk for AEP and FASD cannot just occur through a focus on alcohol reduction, as many women improve birth control use to achieve lowered AEP risk.…”

“…A CHOICES study with Hispanic women found that two thirds (66%) of all Hispanic women had reduced their overall risk of an AEP, primarily by practicing effective birth control (Letourneau et al, 2016), as we found with American Indian women. 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).…”

Substance Use in the Perinatal Period

“…Additionally, recent work has highlighted the importance of social support in perinatal alcohol prevention, particularly for groups wherein social support has increased significance [96]. A randomized trial suggested that telephone-based brief intervention may have comparable success to in-person interventions in reducing perinatal drinking, and due to its relative cost-effectiveness, might be a viable avenue for additional work [97]. CM has not been well-studied for perinatal alcohol use.…”

Community Education and Engagement in Family Planning: Updated Systematic Review

“…The objectives of included studies from this updated review varied: Three aimed to prevent alcohol-exposed pregnancies 10–12 ; one involved school-based family planning education 13 ; one encouraged parent–teen communication about safe sex 14 ; one promoted condom use 15 ; one promoted oral contraceptives 16 ; one promoted contraception, condoms, and abstinence 17 ; and one aimed to prevent repeat teen pregnancy. 18 One study assessed a mass media campaign 14 ; three studies assessed print media/mailing campaigns.…”