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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D019973:Alcohol-Related Disorders / Q000517:prevention & control; D000435:Alcoholic Intoxication / Q000517:prevention & control*; D000437:Alcoholism / Q000628:therapy*; D003268:Contraception Behavior; D003376:Counseling / Q000379:methods*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000517:prevention & control*; D006801:Humans; D009042:Motivation; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D012306:Risk