Doris McGartland Rubio1, Nancy L Day2, Joseph Conigliaro3, Barbara H Hanusa4, Cynthia Larkby2, Melissa McNeil5, Elan Cohen6, Bobby Jones2, Margaret Watt-Morse7, Carol Gilmour8, Michelle Lancet5, Kevin L Kraemer5. 1. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Data Center, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: rubiodm@upmc.edu. 2. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 3. Department of Medicine, New York University, New York, NY, USA. 4. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. 5. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 6. Data Center, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 7. Department of Obstetrics and Gynecology, Magee Women's Hospital, Pittsburgh, PA, USA. 8. Neonatology, UPMC Hamot Women's Hospital, Erie, PA, USA.
Abstract
AIMS: The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use. DESIGN: This study is a single-blinded, randomized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10-30 minutes each and occurring at study enrollment, 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks postpartum. SETTING: The setting is in a large, urban, obstetrics clinic. PARTICIPANTS: Participants were women who were ≥ 18 years old, <20 weeks of gestation, and consumed alcohol during pregnancy. Of 3438 women screened, 330 eligible women were assigned to usual care (n = 165) or intervention (n=165). Due to missing data, we analyzed 125 in the intervention group and 126 in the usual care group. MEASUREMENTS: The measurements were the proportion of women with any alcohol use and the number of drinks per day, reported via follow-up telephone interviews at 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks, 6 months, and 12 months postpartum. FINDINGS: In random effects models adjusted for confounders, the intervention group was less likely to use any alcohol (odds ratio 0.50; 95% confidence interval [CI], 0.23-1.09; P=0.08) and consumed fewer drinks per day (coefficient -0.11; 95% CI -0.23-0.01; P=0.07) than, the usual care group in the postpartum period but these differences were non-significant. Missing data during the prenatal period prevented us from modeling prenatal alcohol use. CONCLUSIONS:Brief motivational enhancement intervention delivered in an obstetrical outpatient setting did not conclusively decrease alcohol use during the postpartum period.
RCT Entities:
AIMS: The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use. DESIGN: This study is a single-blinded, randomized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10-30 minutes each and occurring at study enrollment, 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks postpartum. SETTING: The setting is in a large, urban, obstetrics clinic. PARTICIPANTS: Participants were women who were ≥ 18 years old, <20 weeks of gestation, and consumed alcohol during pregnancy. Of 3438 women screened, 330 eligible women were assigned to usual care (n = 165) or intervention (n=165). Due to missing data, we analyzed 125 in the intervention group and 126 in the usual care group. MEASUREMENTS: The measurements were the proportion of women with any alcohol use and the number of drinks per day, reported via follow-up telephone interviews at 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks, 6 months, and 12 months postpartum. FINDINGS: In random effects models adjusted for confounders, the intervention group was less likely to use any alcohol (odds ratio 0.50; 95% confidence interval [CI], 0.23-1.09; P=0.08) and consumed fewer drinks per day (coefficient -0.11; 95% CI -0.23-0.01; P=0.07) than, the usual care group in the postpartum period but these differences were non-significant. Missing data during the prenatal period prevented us from modeling prenatal alcohol use. CONCLUSIONS: Brief motivational enhancement intervention delivered in an obstetrical outpatient setting did not conclusively decrease alcohol use during the postpartum period.
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