Abstinence outcomes among women in reproductive health centers administered clinician or electronic brief interventions

Yonkers, Kimberly A.; Dailey, Jason I.; Gilstad‐Hayden, Kathryn; Ondersma, Steven J.; Forray, Ariadna; Olmstead, Todd A.; Martino, Steve

doi:10.1016/j.jsat.2020.02.012

Cited by 7 publications

(16 citation statements)

References 36 publications

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“…In all, 11 studies (44%) did not explicitly mention conducting intention to treat (ITT) analysis [ 55 , 58 , 61 , 62 , 66 , 67 , 72 , 74 , 76 , 78 , 79 ]. In total, 18 studies (88.5%) did not mention blinding the assessor (data analyst) or the follow-up researcher to the intervention condition [ 56 – 60 , 63 – 65 , 67 , 69 , 71 – 76 , 78 , 79 ]. Two (8%) studies did not report the effect-size [ 65 , 76 ].…”

Section: Resultsmentioning

confidence: 99%

“…Half of the studies ( n = 13; 50%) were conducted in obstetrics or prenatal clinics within hospitals [ 54 , 55 , 57 , 61 , 62 , 64 – 69 , 77 , 79 ], followed by 8 (30.8%) in clinics or health care centers in rural or urban areas [ 56 , 58 – 60 , 63 , 70 , 71 , 73 ], and 2 (7.8%) in midwives’ offices [ 75 , 76 ], and maternity care or women health centers [ 72 , 78 ]. One (3.8%) study was conducted in an in-patient pre-delivery and emergency unit of the hospital [ 74 ] (Additional File 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Among the 25 studies that had a control group, 18 (72%) studies were RCTs [ 55 – 58 , 60 – 69 , 72 – 74 , 77 ], and 3 (12%) were C-RCTs [ 54 , 71 , 75 ]. Among the remaining four studies, two studies selected non-equivalent controls from the same setting using different time points [ 76 , 78 ], and two studies examined controls from a different setting [ 59 , 79 ] (Additional File 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of brief alcohol interventions for pregnant women: a systematic literature review and meta-analysis

Popova

Dozet

Pandya

et al. 2023

BMC Pregnancy Childbirth

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Background Prenatal alcohol exposure (PAE) can result in a range of adverse neonatal outcomes, including Fetal Alcohol Spectrum Disorder (FASD). This systematic review and meta-analysis sought to investigate the effectiveness of brief interventions (BIs) in eliminating or reducing 1) alcohol consumption during pregnancy; and 2) PAE-related adverse neonatal outcomes; and 3) cost-effectiveness of BIs. Method We conducted a systematic literature search for original controlled studies (randomized control trials (RCTs); quasi-experimental) in any setting, published from 1987 to 2021. The comparison group was no/minimal intervention, where a measure of alcohol consumption was reported. Studies were critically appraised using the Centre for Evidence-based Medicine Oxford critical appraisal tool for RCTs (1). The certainty in the evidence for each outcome was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) (2). Meta-analysis of continuous and binary estimates of effect-size for similar outcome measures for BIs versus control groups were pooled and reported as mean difference (MD) Hedges’ g and odds ratios (ORs), respectively. Results In total, 26 studies, all from high income countries, met inclusion criteria. Alcohol abstinence outcome available in 12 studies (n = 2620) found modest effects in favor of BIs conditions by increasing the odds of abstinence by 56% (OR = 1.56, 95% confidence interval (CI) = 1.15–2.13, I2 = 46.75%; p = 0.04). BIs effects for reduction in mean drinks/week (Cohen’s d = − 0.21, 95%CI = - 0.78 to 0.36; p = 0.08) and AUDIT scores (g = 0.10, 95%CI = − 0.06 to 0.26; p = 0.17) were not statistically significant. Among seven studies (n = 740) reporting neonatal outcomes, BI receipt was associated with a modest and significant reduction in preterm birth (OR = 0.67, 95% CI = 0.46–0.98, I2 = 0.00%; p = 0.58). No statistically significant differences were observed for mean birthweight or lower likelihood of low birth weight (LBW). Certainty in the evidence was rated as ‘low’. No eligible studies were found on cost-effectiveness of BIs. Conclusion BIs are moderately effective in increasing abstinence during pregnancy and preventing preterm birth. More studies on the effectiveness of BIs are needed from low- and middle-income countries, as well as with younger mothers and with a broader range of ethnic groups.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of brief alcohol interventions for pregnant women: a systematic literature review and meta-analysis

Popova

Dozet

Pandya

et al. 2023

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

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“…Indeed, simulating realistic exchanges between humans and computers within the context of health issues has the potential to feel to human users as disingenuous, contrived, or overly stereotypical, which may be a deterrent to use [ 30 ]. There is evidence that suggests SBIRT (Screening, Brief Intervention, and Referral to Treatment) interventions can be at least as good as face-to-face, clinician-delivered interventions [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Barriers and Considerations in the Design and Implementation of Digital Behavioral Interventions: Qualitative Analysis

Marcu¹,

Ondersma²,

Spiller³

et al. 2022

J Med Internet Res

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Background Digital behavioral interventions have become increasingly popular for their ability to support patient diagnosis and treatment, chronic disease self-management, behavior change, and adherence to recommended care. However, digital intervention development is impeded by challenges such as limited technical skills, limited access to developers, and cost. The purpose of this study is to elicit in-depth qualitative feedback from intervention developers who have interest in digital behavioral interventions but lack programming skills regarding the barriers they experience and key considerations in the design and implementation of digital interventions. Objective This study aims to understand barriers in the design and implementation of digital behavioral interventions, as well as to identify key considerations for researchers who are developing these interventions. Methods We conducted semistructured qualitative interviews with 18 researchers who had experience either designing (but not coding) digital behavioral interventions or running research studies with them. Participants were a convenience sample of users of the Computerized Intervention Authoring System platform, an existing no-code development platform for building digital intervention content, and were recruited through either direct email solicitation or snowball sampling. All interviews were conducted and recorded over videoconference between February and April 2020. Recordings from interviews were transcribed and thematically analyzed by multiple coders. Results Interviews were completed with 18 participants and lasted between 24 and 65 (mean 46.9, SD 11.3) minutes. Interviewees were predominantly female (17/18, 94%) and represented different job roles, ranging from researcher to project/study staff. Three key barriers in the development of digital behavior interventions were identified during interviews: lack of cross-disciplinary understanding; variability in recipients’ technology access, infrastructure, and literacy; and the idea that evidence-based in-person interactions do not translate directly to digital interactions. Interviewees identified several key considerations that interventionists learned to prioritize, which have the potential to overcome these barriers and lead to successful interventions. Conclusions Barriers in the development of digital behavioral interventions are often created by a lack of cross-disciplinary understanding, which can lead to difficulties conceptualizing interventions, unrealistic expectations in terms of cost, and confusion about the development process. Moreover, concerns about research study participant characteristics and access to technology, as well as the translation of in-person interventions to digital, are apparent. Appropriate training in how to work with software development teams may help future digital behavior intervention creators overcome these barriers and may lead to new, exciting innovations in this space.

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“…CIAS supports intervention development features such as multiple question types, natural language reflections, branching and tailoring, and integration of video content. CIAS has been used by numerous research groups to develop a variety of digital interventions, many of which have focused on stigmatized behaviors such as substance use [ 15 , 18 - 21 ]. With support from the National Institutes of Health (EB028990), our team is redesigning CIAS from the ground up.…”

Section: Methodsmentioning

confidence: 99%

The Perceived Benefits of Digital Interventions for Behavioral Health: Qualitative Interview Study

Marcu¹,

Ondersma²,

Spiller³

et al. 2022

J Med Internet Res

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Background Digital interventions have gained momentum in terms of behavioral health. However, owing to lacking standard approaches or tools for creating digital behavioral interventions, clinical researchers follow widely varying conceptions of how best to go about digital intervention development. Researchers also face significant cost-, time-, and expertise-related challenges in digital intervention development. Improving the availability of tools and guidance for researchers will require a thorough understanding of the motivations and needs of researchers seeking to create digital interventions. Objective This study aims to understand the perceptions of behavioral researchers toward digital interventions, and inform the use of these interventions, by documenting the reasons why researchers are increasingly focusing their efforts on digital interventions and their perspectives on the perceived benefits that digital approaches can provide for researchers and intervention recipients. Methods We conducted semistructured qualitative interviews with 18 researchers who had experience designing digital behavioral interventions or running studies with them. A convenience sample of interviewees was recruited from among users of the Computerized Intervention Authoring System platform, a web-based tool that facilitates the process of creating and deploying digital interventions in behavioral research. Interviews were conducted over teleconference between February and April 2020. Recordings from the interviews were transcribed and thematically analyzed by multiple coders. Results Interviews were completed with 18 individuals and lasted between 24 and 65 (mean 46.9, SD 11.3) minutes. Interviewees were predominantly female (17/18, 94%) and represented different job roles, ranging from researcher to project or study staff. Four major themes came out of the interviews concerning the benefits of digital interventions for behavioral health: convenience and flexibility for interventionists and recipients, support for implementing evidence-based interventions with fidelity, scaling and improving access to interventions, and getting a foot in the door despite stigma and disenfranchisement. Conclusions Interviewees described a number of important potential benefits of digital interventions, particularly with respect to scientific rigor, scalability, and overcoming barriers to reaching more people. There are complex considerations with regard to translating behavior change strategies into digital forms of delivery, and interventionists make individual, sometimes unexpected, choices with minimal evidence of their relative effectiveness. Future research should investigate how behavioral researchers can be supported in making these choices toward usability, ease of access, and approachability of digital interventions. Our study underscores the need for authoring platforms that can facilitate the process of creating and deploying digital interventions to reach their full potential for interventionists and recipients alike.

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Abstinence outcomes among women in reproductive health centers administered clinician or electronic brief interventions

Cited by 7 publications

References 36 publications

Effectiveness of brief alcohol interventions for pregnant women: a systematic literature review and meta-analysis

Effectiveness of brief alcohol interventions for pregnant women: a systematic literature review and meta-analysis

Barriers and Considerations in the Design and Implementation of Digital Behavioral Interventions: Qualitative Analysis

The Perceived Benefits of Digital Interventions for Behavioral Health: Qualitative Interview Study

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