Effectiveness of Digital Interventions for Preventing Alcohol Consumption in Pregnancy: Systematic Review and Meta-analysis

Oh, Sarah Soyeon; Moon, Jong Youn; Chon, Doukyoung; Mita, Carol; Lawrence, J. R.; Kawachi, Ichiro

doi:10.2196/35554

Cited by 19 publications

(20 citation statements)

References 43 publications

(81 reference statements)

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“… 33 – 42 A recent meta-analysis of six of the 10 studies included in this review supports the potential of digital interventions. 45 …”

Section: Discussionmentioning

confidence: 99%

Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?

Chang¹

2023

ARCR

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PURPOSE This narrative review summarizes and synthesizes the clinical trials and randomized clinical trials that evaluated selected and targeted approaches to reducing preconception and prenatal alcohol exposure (PAE) and alcohol-exposed pregnancy (AEP) since 2011. SEARCH METHODS A professional hospital librarian completed the primary search using strategies specified within this review, resulting in 94 records returned in PubMed, Ovid MEDLINE, Clinical Key, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov . The author completed two supplementary literature searches. SEARCH RESULTS From the total of 238 records returned from the three searches, 217 records were eliminated. Elimination reasons included other medical problem (119); duplicate entry (34); no content/results (23); secondary analysis (16); focus on effects of PAE (9); treatment of childhood fetal alcohol spectrum disorders (FASD) (6); maternal risk factors (3); and other (7). The remaining 21 studies were included with four overarching themes: (1) case management efforts ( n = 4); (2) preconception efforts to reduce AEP ( n = 5); (3) motivational interviewing and screening, brief intervention, and referral to treatment ( n = 2); and (4) use of technology to deliver the intervention ( n = 10). DISCUSSION AND CONCLUSIONS Case management and home visits did not appear to have strong current empirical support. Study limitations included small sample sizes and no comparison groups, whereas larger efforts did not demonstrate definitive advantages to justify this intensive approach. The studies of preconception efforts, all based on the Project CHOICES approach, had similar outcomes, with the reduction in AEP risk largely due to improved contraception in women of childbearing age who were sexually active and drank alcohol but were not pregnant. It is unknown whether these women refrained from alcohol use when they became pregnant. Two studies of motivational interviewing to reduce prenatal alcohol use did not demonstrate the efficacy of the intervention. Both were small, with less than 200 pregnant women combined; moreover, the study samples had low baseline levels of alcohol use, allowing little opportunity for improvement. Finally, studies evaluating the impact of technological approaches to reducing AEP were reviewed. These exploratory investigations had small sample sizes and provided preliminary evaluations of techniques such as text messages, telephone contact, computer-based screening, and motivational interviewing. The potentially promising findings may inform future research and clinical efforts. Future directions may include research to address the limitations of the evidence to date and should reflect the complexities of FASD that include the biological and soc...

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“… 33 – 42 A recent meta-analysis of six of the 10 studies included in this review supports the potential of digital interventions. 45 …”

Section: Discussionmentioning

confidence: 99%

Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?

Chang¹

2023

ARCR

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“…Studies examining digital technology and AI in providing preconception and perinatal care for parents and parents‐to‐be, to date, have not included the use of chatbots 22–29 . Because chatbots can help to improve preconception and perinatal health outcomes, 30,31 the insights of parents and parents‐to‐be in using these chatbots deserve further analysis.…”

Section: Introductionmentioning

confidence: 99%

“…18,21 Studies examining digital technology and AI in providing preconception and perinatal care for parents and parents-tobe, to date, have not included the use of chatbots. [22][23][24][25][26][27][28][29] Because chatbots can help to improve preconception and perinatal health outcomes, 30,31 the insights of parents and parents-to-be in using these chatbots deserve further analysis. Therefore, this mixed studies review aims to address this research gap by consolidating findings from both quantitative and qualitative studies to provide a comprehensive understanding of the insights of parents and parents-to-be into using chatbots for their preconception, pregnancy, and postpartum health.…”

Section: Introductionmentioning

confidence: 99%

Insights of Parents and Parents‐To‐Be in Using Chatbots to Improve Their Preconception, Pregnancy, and Postpartum Health: A Mixed Studies Review

Chua

Choolani

Chee

et al. 2023

J Midwife Womens Health

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IntroductionChatbots, which are also known as conversational or virtual agents, are digital programs that can interact with humans using voice, text, or animation. They have shown promise in providing preconception, pregnancy, and postpartum care. This review aims to consolidate the insights of parents and parents‐to‐be in using chatbots to improve their preconception, pregnancy, and postpartum health.MethodsSeven electronic databases were searched from their inception dates until April 2022 (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, and ProQuest Dissertations and Theses Global) for relevant studies. English language primary studies that were conducted on parents or parents‐to‐be aged ≥18 years old who had undergone interventions involving the use of any type of chatbot were included in this review. The quality of included studies was appraised using the Mixed Methods Appraisal Tool. A convergent qualitative synthesis design for mixed studies reviews was used to synthesize the findings, and results were thematically analyzed.ResultsFifteen studies met the inclusion criteria: quantitative (n = 11), qualitative (n = 1), and mixed method (n = 3). Three main themes were identified: (1) welcoming a new health resource, (2) obstacles blocking the way, and (3) moving toward a digital health era.DiscussionParents and parents‐to‐be appreciated the informational, socioemotional, and psychological support provided by chatbots. Recommendations for technological improvements in the functionality of the chatbots were made that include training sessions for health care providers to familiarize them with this new digital technology. Multidisciplinary chatbot development teams could also be established to develop more comprehensive chatbot‐delivered health programs for more diverse populations.

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“…Although the results suggested that both mothers and fathers benefited from the mobile interventions, the lack of data prevented the ability to draw conclusions regarding the relative mobile app effectiveness, and the authors suggested that future studies including fathers are needed [40]. In contrast to the growing popularity and promising findings of digital programs for mothers in the perinatal period [41][42][43][44][45], the authors of this review are not aware of any other reviews that have examined digital interventions (including any digital modalities) for fathers of young children.…”

Section: Introductionmentioning

confidence: 99%

Digital Parenting Interventions for Fathers of Infants From Conception to the Age of 12 Months: Systematic Review of Mixed Methods Studies

Xie,

Jung,

Kaur

et al. 2023

J Med Internet Res

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Background Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers. Objective This systematic review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum. Methods A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool. Results A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall. Conclusions New and expecting fathers use digital technologies, which could be used to help address father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers, father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.

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Effectiveness of Digital Interventions for Preventing Alcohol Consumption in Pregnancy: Systematic Review and Meta-analysis

Cited by 19 publications

References 43 publications

Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?

Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?

Insights of Parents and Parents‐To‐Be in Using Chatbots to Improve Their Preconception, Pregnancy, and Postpartum Health: A Mixed Studies Review

Digital Parenting Interventions for Fathers of Infants From Conception to the Age of 12 Months: Systematic Review of Mixed Methods Studies

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