Reducing the risk of alcohol-exposed pregnancies: a study of a motivational intervention in community settings

• Published in: Pediatrics (Evanston) 2003-05, Vol.111 (5 Pt 2), p.1131
• Main Authors: Ingersoll, Karen, Floyd, Louise, Sobell, Mark, Velasquez, Mary M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alcohol; Alcohol Drinking; Alcohol-Related Disorders - prevention & control; Alcoholic Intoxication - prevention & control; Alcoholism - therapy; Behavior; Contraception Behavior; Counseling - methods; Drinking (Alcoholic beverages); Drinking of alcoholic beverages; Female; Fetal Alcohol Spectrum Disorders - prevention & control; Fetal alcohol syndrome; Health aspects; Humans; Mental health; Motivation; Pediatrics; Pilot Projects; Pregnancy; Pregnancy Complications - prevention & control; Pregnant women; Prenatal influences; Risk; Women
• ISSN: 0031-4005; 1098-4275

To test the feasibility and impact of a motivational intervention in reducing drinking and/or increasing effective contraception in women who are at risk for an alcohol-exposed pregnancy. A multisite single-arm pilot study was conducted in 6 community settings in 3 large cities. A total of 2384 women were screened for eligibility; 230 were eligible on the basis of their alcohol use and lack of contraception. Of the eligible women, 190 consented and were enrolled, and 143 (75.3%) completed the 6-month follow-up. The intervention consisted of 4 manual-guided motivational counseling sessions delivered by mental health clinicians and 1 contraceptive counseling session delivered by a family planning clinician. Outcome measures include intervention completion rates, alcohol use (frequency, quantity, and bingeing), contraceptive use and effectiveness, and risk for alcohol-exposed pregnancy. Among women who completed the 6-month follow-up, 68.5% were no longer at risk of having an alcohol-exposed pregnancy; 12.6% of women who completed the program reduced drinking only; 23.1% used effective contraception only; and 32.9% reported both. Results were consistent across the 6 diverse high-risk settings. This study provides evidence that providing 4 sessions of motivational interviewing plus a contraception counseling session is feasible and strongly suggests that this intervention can decrease the risk of alcohol-exposed pregnancy in women in high-risk settings. Additional investigation in a randomized controlled trial is warranted.