title: Computer-Delivered Screening and Brief Intervention for Alcohol Use in Pregnancy: A Pilot Randomized Trial.
abstract: BACKGROUND
  Although screening and brief intervention (SBI) for unhealthy alcohol use has demonstrated efficacy in some trials, its implementation has been limited. Technology-delivered approaches are a promising alternative, particularly during pregnancy when the importance of alcohol use is amplified. The present trial evaluated the feasibility and acceptability of an interactive, empathic, video-enhanced, and computer-delivered SBI (e-SBI) plus 3 tailored mailings, and estimated intervention effects.
  
  
  METHODS
  We recruited 48 pregnant women who screened positive for alcohol risk at an urban prenatal care clinic. Participants were randomly assigned to the e-SBI plus mailings or to a control session on infant nutrition, and were re-evaluated during their postpartum hospitalization. The primary outcome was 90-day period prevalence abstinence as measured by timeline follow-back interview.
  
  
  RESULTS
  Participants rated the intervention as easy to use and helpful (4.7 to 5.0 on a 5-point scale). Blinded follow-up evaluation at childbirth revealed medium-size intervention effects on 90-day period prevalence abstinence (OR = 3.4); similarly, intervention effects on a combined healthy pregnancy outcome variable (live birth, normal birthweight, and no neonatal intensive care unit stay) were also of moderate magnitude in favor of e-SBI participants (OR = 3.3). As expected in this intentionally underpowered pilot trial, these effects were nonsignificant (p = 0.19 and 0.09, respectively).
  
  
  CONCLUSIONS
  This pilot trial demonstrated the acceptability and preliminary efficacy of e-SBI plus tailored mailings for alcohol use in pregnancy. These findings mirror the promising results of other trials using a similar approach and should be confirmed in a fully powered trial.
authors.affiliation: Department of Psychiatry & Behavioral Neurosciences and Merrill-Palmer Skillman Institute, Wayne State University, Detroit, Michigan.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Ondersma
authors.affiliation: Department of Psychiatry & Behavioral Neurosciences and Merrill-Palmer Skillman Institute, Wayne State University, Detroit, Michigan.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Beatty
authors.affiliation: Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.|Department of Psychiatry and Obstetrics/Gynecology, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Dace S
authors.initials: DS
authors.lastname: Svikis
authors.affiliation: Henry Ford Health System, Detroit, Michigan.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Strickler
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island.
authors.forename: Golfo K
authors.initials: GK
authors.lastname: Tzilos
authors.affiliation: VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts.
authors.forename: Grace
authors.initials: G
authors.lastname: Chang
authors.affiliation: Henry Ford Health System, Detroit, Michigan.
authors.forename: George W
authors.initials: GW
authors.lastname: Divine
authors.affiliation: Henry Ford Health System, Detroit, Michigan.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Taylor
authors.affiliation: Department of Obstetrics & Gynecology, Wayne State University, Detroit, Michigan.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sokol
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008403:Mass Screening; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011247:Pregnancy / Q000523:psychology*; D013813:Therapy, Computer-Assisted / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Brief Intervention; Fetal Alcohol Spectrum Disorder; Pregnancy; Randomized Trial; Technology