Steven J Ondersma1, Dace S Svikis2, Casey Thacker3, Ken Resnicow4, Jessica R Beatty3, James Janisse5, Karoline Puder6. 1. Merrill Palmer Skillman Institute and Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 71 E. Ferry Ave., Detroit, MI 48202, United States. Electronic address: s.ondersma@wayne.edu. 2. VCU Institute for Women's Health and Departments of Psychology, Psychiatry, and Obstetrics/Gynecology, Virginia Commonwealth University, 806 W Franklin St., Room 301, Richmond, VA 23284, United States. 3. Merrill Palmer Skillman Institute and Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 71 E. Ferry Ave., Detroit, MI 48202, United States. 4. School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States. 5. Department of Family Medicine and Public Health Sciences, Wayne State University,3939 Woodward Ave., Detroit, MI 48201, United States. 6. Department of Obstetrics and Gynecology, Wayne State University School of Medicine, 3990 John R, Detroit, MI 48201, United States.
Abstract
BACKGROUND: Under-reporting of drug use in the perinatal period is well-documented, and significantly limits the reach of proactive intervention approaches. The Wayne Indirect Drug Use Screener (WIDUS) focuses on correlates of drug use rather than use itself. This trial tested a computer-delivered, brief intervention designed for use with indirect screen-positive cases, seeking to motivate reductions in drug use without presuming its presence. METHODS: Randomized clinical trial with 500 WIDUS-positive postpartum women recruited between August 14, 2012 and November 19, 2014. Participants were randomly assigned to either a time control condition or a single-session, tailored, indirect brief intervention. The primary outcome was days of drug use over the 6-month follow-up period; secondary outcomes included urine and hair analyses results at 3- and 6-month follow-up. All outcomes were measured by blinded evaluators. RESULTS: Of the 500 participants (252 intervention and 248 control), 36.1% of participants acknowledged drug use in the 3 months prior to pregnancy, but 89% tested positive at the 6-month follow-up. Participants rated the intervention as easy to use (4.9/5) and helpful (4.4/5). Analyses revealed no between-group differences in drug use (52% in the intervention group, vs. 53% among controls; OR 1.03). Exploratory analyses also showed that intervention effects were not moderated by baseline severity, WIDUS score, or readiness to change. CONCLUSIONS: The present trial showed no evidence of efficacy for an indirect, single-session, computer-delivered, brief intervention designed as a complement to indirect screening. More direct approaches that still do not presume active drug use may be possible and appropriate.
RCT Entities:
BACKGROUND: Under-reporting of drug use in the perinatal period is well-documented, and significantly limits the reach of proactive intervention approaches. The Wayne Indirect Drug Use Screener (WIDUS) focuses on correlates of drug use rather than use itself. This trial tested a computer-delivered, brief intervention designed for use with indirect screen-positive cases, seeking to motivate reductions in drug use without presuming its presence. METHODS: Randomized clinical trial with 500 WIDUS-positive postpartum women recruited between August 14, 2012 and November 19, 2014. Participants were randomly assigned to either a time control condition or a single-session, tailored, indirect brief intervention. The primary outcome was days of drug use over the 6-month follow-up period; secondary outcomes included urine and hair analyses results at 3- and 6-month follow-up. All outcomes were measured by blinded evaluators. RESULTS: Of the 500 participants (252 intervention and 248 control), 36.1% of participants acknowledged drug use in the 3 months prior to pregnancy, but 89% tested positive at the 6-month follow-up. Participants rated the intervention as easy to use (4.9/5) and helpful (4.4/5). Analyses revealed no between-group differences in drug use (52% in the intervention group, vs. 53% among controls; OR 1.03). Exploratory analyses also showed that intervention effects were not moderated by baseline severity, WIDUS score, or readiness to change. CONCLUSIONS: The present trial showed no evidence of efficacy for an indirect, single-session, computer-delivered, brief intervention designed as a complement to indirect screening. More direct approaches that still do not presume active drug use may be possible and appropriate.
Authors: Richard Saitz; Tibor P A Palfai; Debbie M Cheng; Daniel P Alford; Judith A Bernstein; Christine A Lloyd-Travaglini; Seville M Meli; Christine E Chaisson; Jeffrey H Samet Journal: JAMA Date: 2014-08-06 Impact factor: 56.272
Authors: Peter Roy-Byrne; Kristin Bumgardner; Antoinette Krupski; Chris Dunn; Richard Ries; Dennis Donovan; Imara I West; Charles Maynard; David C Atkins; Meredith C Graves; Jutta M Joesch; Gary A Zarkin Journal: JAMA Date: 2014-08-06 Impact factor: 56.272