BACKGROUND:Alcohol-exposed pregnancy (AEP) is a leading cause of birth defects. Effective face-to-face preconception interventions based on motivational interviewing (MI) exist and should be translated into remote formats for maximum public health impact. This study investigated the feasibility and promise of a one-session, remote-delivered, preconception, MI-based AEP intervention (EARLY Remote) for non-treatment-seeking community women. SUBJECTS AND METHODS: This was a single-arm, prospective pilot intervention study. All participants received the intervention via telephone and mail. Feasibility of remote-delivery methods, treatment engagement, treatment credibility, MI treatment integrity, and therapeutic alliance were examined. Outcomes were 3- and 6-month drinks per drinking day (DDD), rate of unreliable contraception, and proportion of women at risk for AEP due to continued risk drinking and no or unreliable contraception use. RESULTS: Feasibility of remote delivery was established; participants were engaged by the intervention and rated it as credible. Integrity to MI and therapeutic alliance were good. Both DDD and rate of unreliable contraception decreased significantly over time. Proportions of women who drank at risk levels, used unreliable or no contraception, and/or were at risk for AEP in the past 90 days decreased significantly from baseline to 6 months. CONCLUSIONS: Remote delivery was feasible, and the translated remote intervention may reduce AEP risk. Refinement of EARLY Remote may facilitate its placement within a spectrum of effective MI-based preconception AEP interventions as part of a stepped-care approach. EARLY Remote may have an important role within a stepped-care model for dissemination to geographically disperse women at risk for AEP. This could result in substantial public health impact through reduction of AEP on a larger scale.
RCT Entities:
BACKGROUND:Alcohol-exposed pregnancy (AEP) is a leading cause of birth defects. Effective face-to-face preconception interventions based on motivational interviewing (MI) exist and should be translated into remote formats for maximum public health impact. This study investigated the feasibility and promise of a one-session, remote-delivered, preconception, MI-based AEP intervention (EARLY Remote) for non-treatment-seeking community women. SUBJECTS AND METHODS: This was a single-arm, prospective pilot intervention study. All participants received the intervention via telephone and mail. Feasibility of remote-delivery methods, treatment engagement, treatment credibility, MI treatment integrity, and therapeutic alliance were examined. Outcomes were 3- and 6-month drinks per drinking day (DDD), rate of unreliable contraception, and proportion of women at risk for AEP due to continued risk drinking and no or unreliable contraception use. RESULTS: Feasibility of remote delivery was established; participants were engaged by the intervention and rated it as credible. Integrity to MI and therapeutic alliance were good. Both DDD and rate of unreliable contraception decreased significantly over time. Proportions of women who drank at risk levels, used unreliable or no contraception, and/or were at risk for AEP in the past 90 days decreased significantly from baseline to 6 months. CONCLUSIONS: Remote delivery was feasible, and the translated remote intervention may reduce AEP risk. Refinement of EARLY Remote may facilitate its placement within a spectrum of effective MI-based preconception AEP interventions as part of a stepped-care approach. EARLY Remote may have an important role within a stepped-care model for dissemination to geographically disperse women at risk for AEP. This could result in substantial public health impact through reduction of AEP on a larger scale.
Authors: R Louise Floyd; Mark Sobell; Mary M Velasquez; Karen Ingersoll; Mary Nettleman; Linda Sobell; Patricia Dolan Mullen; Sherry Ceperich; Kirk von Sternberg; Burt Bolton; Kenneth Johnson; Bradley Skarpness; Jyothi Nagaraja Journal: Am J Prev Med Date: 2007-01 Impact factor: 5.043
Authors: D V Sheehan; Y Lecrubier; K H Sheehan; P Amorim; J Janavs; E Weiller; T Hergueta; R Baker; G C Dunbar Journal: J Clin Psychiatry Date: 1998 Impact factor: 4.384
Authors: Hilde M van Keulen; Ilse Mesters; Marlein Ausems; Gerard van Breukelen; Marci Campbell; Ken Resnicow; Johannes Brug; Hein de Vries Journal: Ann Behav Med Date: 2011-02
Authors: Karen S Ingersoll; Thomas Banton; Eugenia Gorlin; Karen Vajda; Harsimran Singh; Ninoska Peterson; Linda Gonder-Frederick; Daniel J Cox Journal: Internet Interv Date: 2015-05-01
Authors: Jennifer Hettema; Stephanie Cockrell; Jennifer Russo; Joan Corder-Mabe; Alycia Yowell-Many; Christian Chisholm; Karen Ingersoll Journal: J Womens Health (Larchmt) Date: 2015-07-31 Impact factor: 2.681
Authors: Krista S Viau; Jessica L Jones; Maureen A Murtaugh; Lisa H Gren; Joseph B Stanford; Deborah A Bilder Journal: Mol Genet Metab Rep Date: 2016-01-18