The Efficacy of Technology‐Based Interventions for Alcohol and Illicit Drug Use Among Women of Childbearing Age: A Systematic Review and Meta‐Analysis

Abstract

Background: Alcohol and illicit drug use is prevalent among women of childbearing age and may lead to higher risk for substance-exposed pregnancy and related health consequences for both women and their offspring. Technology-based interventions (TBIs) are increasingly used to prevent or reduce substance use among women of childbearing age. The efficacy of these approaches, however, is unclear. This review critically reviewed existing research evidence from randomized controlled trials (RCTs) on the efficacy of TBIs in preventing and reducing alcohol and illicit drug use among childbearing-aged women.Methods: Seven electronic databases were searched to identify eligible studies. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Robust variance estimation in meta-regression was used to estimate effect sizes and conduct moderator analyses.Results: Fifteen RCTs including 3,488 participants were included in the systematic review. Metaanalysis results based on 13 RCTs suggest that TBIs were efficacious relative to control conditions in preventing and reducing substance use among women of childbearing age (d = 0.19, 95% CI = 0.02, 0.35). Preliminary moderator analysis results suggest that the efficacy of TBIs might not vary by participant age, race/ethnicity, the type of technology used, or whether a virtual health assistant was used. TBIs' efficacy in terms of specific substance use types (alcohol use and illicit drug use) or control types (inactive control and active controls) was inconclusive, due to the limited number of studies in each category.Conclusions: This systematic review and meta-analysis found evidence of TBIs' efficacy in reducing alcohol and illicit drug use among women of childbearing age. Implications for future research and practice are discussed.

Benefits of Digital Health Resources for Substance Use Concerns in Women: Scoping Review

“…This review supported the feasibility of digital health resources for substance use concerns, but found less consistent support for their efficacy or effectiveness. In a review centered on women of childbearing age, Hai et al [23] evaluated the efficacy of technology-based interventions for substance use, with a focus on randomized controlled trials. This review located 15 trials, and a meta-analysis of 13 trials supported the efficacy of the digital health interventions for alcohol use concerns specifically compared with control conditions.…”

“…This review extends the foundational work in several ways. First, Hai et al [23] specifically focused on studies conducted in women of childbearing age, precluding an evaluation of differential effects across sex or gender. Second, both Hai et al [23] and Nesvåg and McKay [22] specifically focused on randomized controlled trials; however, initial investigations as well as investigations with a focus on effectiveness and/or implementation outcomes in real-world settings may utilize different research designs.…”

“…First, Hai et al [23] specifically focused on studies conducted in women of childbearing age, precluding an evaluation of differential effects across sex or gender. Second, both Hai et al [23] and Nesvåg and McKay [22] specifically focused on randomized controlled trials; however, initial investigations as well as investigations with a focus on effectiveness and/or implementation outcomes in real-world settings may utilize different research designs. Third, previous reviews have not systematically extracted data regarding the trauma endorsed by samples, limiting the capacity to determine the degree to which this crucial clinical feature is integrated into research designs, analyses, and interpretations.…”

“…Sample: We considered adults aged 18 years or older, who endorsed or exhibited risky or harmful substance use. Similar to previous reviews [22,23], we did not include nicotine or caffeine. A minimum of 20% of participants was required to identify as female and/or women, or to report a trauma history, regardless of sex or gender.…”

Evidence for the Effectiveness and Acceptability of e-SBI or e-SBIRT in the Management of Alcohol and Illicit Substance Use in Pregnant and Post-partum Women

“…With the advancement of mobile technologies and the nearuniversal access to these technologies, has come the opportunity to provide alcohol and drug services to a typically hard to reach and underserved group of women. Technology in the form of apps and social media is increasingly used to facilitate SBIRT with encouraging preliminary evidence particularly among studies of adolescent girls and women (107,125,126). The emerging evidence for the potential effectiveness and usability of SBIRT delivered through mHealth technology (sometimes referred to as e-SBI) to reduce alcohol and illicit substance use in women during pregnancy or the early post-partum period has largely come from reports by one research group (32)(33)(34)(35)(36)(37)(38)(39)(40)(127)(128)(129)(130).…”