Computer-based brief intervention a randomized trial with postpartum women.
BACKGROUND
Drug use among parenting women is a significant risk factor for a range of negative child outcomes, including exposure to violence, child maltreatment, and child behavior problems. Implementation of brief interventions with this population may be greatly facilitated by computer-based interventions.


METHODS
Randomized clinical trial with 4-month follow-up.


METHODS
Participants were 107 postpartum women recruited from an urban obstetric hospital primarily serving a low-income population. Women were randomized into assessment only versus assessment plus brief intervention conditions; 76 (71%) returned for follow-up evaluation.


METHODS
A 20-minute, single-session, computer-based motivational intervention (based on motivational interviewing methods), combined with two nontailored mailings and voucher-based reinforcement of attendance at an initial intake/treatment session.


METHODS
Illicit drug use as measured by qualitative urinalysis and self-report.


RESULTS
Frequency of illicit drug use other than marijuana increased slightly for the control group, but declined among intervention group participants (p<0.05, between-group Mann-Whitney U; d=0.50); the magnitude of intervention effects on changes in marijuana use frequency was similar, but did not reach statistical significance. Point-prevalence analysis at follow-up did not show significant group differences in drug use. However, trends under a range of assumptions regarding participants lost to follow-up all favored the intervention group, with most effect sizes in the moderate range (odds ratios 1.4 to 4.7).


CONCLUSIONS
Results tentatively support the efficacy of this high-reach, replicable brief intervention. Further research should seek to replicate these findings and to further develop the computer as a platform for validated brief interventions.
Ondersma
Steven J
SJ
Department of Psychiatry and Behavioral Neurosciences, and Obstetrics and Gynecology, Wayne State University, Detroit, Michigan 48207, USA. s.ondersma@wayne.edu
Svikis
Dace S
DS
Schuster
Charles R
CR
D000328:Adult; D001741:Black or African American / Q000523:psychology; D003201:Computers; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D013287:Illicit Drugs; D002189:Marijuana Abuse / Q000208:ethnology / Q000517:prevention & control; D009035:Mothers / Q000523:psychology; D009042:Motivation; D049590:Postpartum Period; D011446:Prospective Studies; D012307:Risk Factors; D012650:Self Disclosure; D020377:Self Efficacy; D019966:Substance-Related Disorders / Q000208:ethnology / Q000517:prevention & control*; D014481:United States
D013287:Illicit Drugs