computer-delivered screening and brief intervention for alcohol use in pregnancy

Conditions: Alcohol Abuse

Summary: the purpose of this study is to lay the ground work for a fully powered clinical trial of a computer-delivered screener and intervention for alcohol use during pregnancy. the pilot study will include: 1. evaluation of the usefulness of handheld devices and anonymous screening for self report of at-risk alcohol use among pregnant women. 2. assessing the validity of an alcohol biomarker, ethyl glucoronide (etg), for the detection of at-risk drinking in pregnant women. 3. evaluation of the efficacy of a computer-delivered brief intervention and use of tailored handouts to supplement the computer-based brief intervention focusing on alcohol use during pregnancy.

infants born to african-american and/or low ses women appear to be at increased risk of adverse effects due to prenatal exposure to alcohol. computer-delivered sbirt approaches may provide consistent screening and evidence-based brief interventions, at low cost, without requiring substantial investments of time or energy from medical staff. however, several stage i steps are necessary before moving to a stage ii clinical trial. this r34 application will therefore lay the groundwork for a fully powered clinical trial of a computer-delivered sbirt for alcohol use during pregnancy. it will do so through the conduct of five key preliminary studies, including: (1) evaluation of the utility of handheld mobile devices and an anonymous self-interview format in screening for at-risk drinking among patients attending a prenatal clinic; (2) modification of an existing computer-delivered motivational intervention for alcohol use during pregnancy, to previously set standards of acceptability (to experts as well as representative pregnant women); (3) development of an evidence-based tailored messaging supplement to the single-session brief intervention; (4) examining the validity of, and cut scores for, the biomarker ethyl glucoronide (etg) in pregnant women; and (5) collecting data on the acceptability, feasibility, and estimated effect size of the modified computer-delivered intervention through an n = 50 phase i randomized clinical trial. participants in this trial will be a diverse sample of women at-risk for alcohol use during pregnancy, the majority of whom will be african-american and/or low ses. these key preparatory steps will greatly facilitate the subsequent development of an r01 application to conduct a stage ii clinical trial for alcohol use during pregnancy. these steps will also provide important preliminary data on (a) a novel method for risk factor screening in primary care; (b) the potential utility of etg as a biomarker for alcohol use during pregnancy and in the perinatal period; and (c) the effect size estimate for a fully computer-delivered, combined brief interactive/tailored messaging intervention requiring only a single contact. if successful, this line of research could lead to a highly cost-effective, high-reach intervention for alcohol use during pregnancy; these reductions in alcohol use could in turn have a meaningful population impact on fetal alcohol spectrum disorders.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * intention to carry pregnancy to term * self-reported alcohol use * willingness to be sent tailored messages * gives consent to access medical records for collection of birth outcome data exclusion criteria: * unable to communicate in english * less than 4 months before delivery due date

Keywords: pregnancy screening motivation