Preventing alcohol-exposed pregnancies: A randomized controlled trial

[Correction Notice: An erratum for this article was reported in Vol 32(4) of American Journal of Preventive Medicine (see record 2007-05170-007). In the article, Dr. Kenneth Johnson's name was inadvertently omitted from the list of authors. The correct listing should be: R. Louise Floyd, DSN, RN, Mark Sobell, PhD, ABPP, Mary M. Velasquez, PhD, Karen Ingersoll, PhD, Mary Nettleman, MD, MS, Linda Sobell, PhD, ABPP, Patricia Dolan Mullen, DrPH, Sherry Ceperich, PhD, Kirk Von Sternberg, PhD, Burt Bolton, MS, Kenneth Johnson, DO, Bradley Skarpness, PhD, Jyothi Nargaraja, MS, on behalf of the Project CHOICES Efficacy Study Group.] Background: Prenatal alcohol exposure is a leading preventable cause of birth defects and developmental disabilities in the United States. Design: A randomized controlled trial (2002-2005; data analyzed 2005-2006) of a brief motivational intervention to reduce the risk of an alcohol-exposed pregnancy (AEP) in preconceptional women by focusing on both risk drinking and ineffective contraception use. Setting/Participants: A total of 830 nonpregnant women, aged 18-44 years, and currently at risk for an AEP were recruited in six diverse settings in Florida, Texas, and Virginia. Combined settings had higher proportions of women at risk for AEP (12.5% overall) than in the general population (2%). Interventions: Participants were randomized to receive information plus a brief motivational intervention (n = 416) or to receive information only (n = 414). The brief motivational intervention consisted of four counseling sessions and one contraception consultation and services visit. Main Outcome Measures: Women consuming more than five drinks on any day or more than eight drinks per week on average, were considered risk drinkers; women who had intercourse without effective contraception were considered at risk of pregnancy. Reversing either or both risk conditions resulted in reduced risk of an AEP. Results: Across the follow-up period, the odds ratios (ORs) of being at reduced risk for AEP were twofold greater in the intervention group: 3 months, 2.31 (95% confidence interval [CI] = 1.69-3.20); 6 months, 2.15 (CI = 1.52-3.06); 9 months, 2.11 (CI = 1.47-3.03). Between-groups differences by time phase were 18.0%, 17.0%, and 14. 8%, respectively. Conclusions: A brief motivational intervention can reduce the risk of an AEP. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)