Español (Spanish)
Preventing Alcohol-Exposed Pregnancies
Project CHOICES
(Changing High-Risk
AlcOhol Use and Increasing
Contraception Effectiveness
Study) Preventing Alcohol-Exposed Pregnancies Among High-Risk Women in Special Community-Based Settings
In September 1997, CDC awarded cooperative
agreements to three university grantees to develop brief interventions
aimed at preventing alcohol-exposed pregnancies among women of
childbearing age in special settings. The selected settings had access
to relatively large numbers of women of childbearing age who drink at
high-risk levels and do not use contraception effectively. The grantees,
along with the special settings they worked in, were:
Nova Southeastern University in Ft. Lauderdale, Florida
-
Adult and Pediatric Primary Care Centers in the North Brossard Hospital District of Ft. Lauderdale
-
Recruitment of a cohort of women concerned about problem drinking through media advertisement in the Ft. Lauderdale area
University of Texas Health Sciences Center at Houston, School of Public Health in Houston, Texas
-
Harris County Jail
-
Houston Recovery Campus
Virginia Commonwealth University, Medical College of Virginia in Richmond, Virginia
Funded grantees worked collaboratively
with one another and CDC to develop a uniform study protocol for
implementation in the six special settings. The objectives of the study
were to:
-
Characterize the women in the special
high-risk settings.
-
Reduce the rate of alcohol consumption
among women who are not using contraception effectively and increase
contraception effectiveness among women who do not reduce their alcohol
consumption.
-
Examine the relationship between
selected process variables and study outcomes.
An epidemiologic survey, administered to
approximately 500 women in each of the six settings, was conducted
during the first phase of the study. The purpose of the survey is to
characterize the overall population in the special settings in terms of
prevalence and patterns of alcohol use, prevalence of characteristics
associated with heavy alcohol use, reproductive health status (for
example, parity, contraceptive practices, current sexual activity, and
fertility), alcohol treatment histories, and history of psychiatric
illnesses.
A common protocol for a behavioral
intervention was developed, implemented, and evaluated in each of the
six settings. A feasibility study designed to test the behavioral
intervention was conducted from March 2000 until May 2001. Study
participants (50 women from each of the six special settings) were
provided a brief intervention of four sessions delivered over the course
of eight weeks. The intervention consisted of the following:
-
In-depth assessment of alcohol use and contraceptive use patterns.
-
Counseling about the consequences of alcohol use during pregnancy.
-
Brief advice and counseling for moderate-to-heavy drinkers to reduce intake levels, or referral to community treatment services for alcohol-dependent drinkers.
-
Reproductive health education about contraceptive methods, provision of contraceptive services, and client follow-up.
The final phase of Project CHOICES
assessed the efficacy of this behavioral intervention further in a
scientifically rigorous manner (through a randomized control group
design). This phase began in 2002 and was completed in 2005.
Related Publications:
Floyd RL, Sobell M, Velasquez M, Ingersoll K, et al. Preventing
alcohol-exposed pregnancies: a randomized controlled trial. American
Journal of Preventive Medicine 2007;32(1):1-10. [Abstract]
Centers for Disease Control and Prevention. Motivational intervention
to reduce alcohol-exposed pregnancies - Florida, Texas, and Virginia,
1997-2001. Morbidity and Mortality Weekly Report 2003;52(19):441-444.
[Full
text]
Project CHOICES Intervention Research Group. Reducing the risk of
alcohol-exposed pregnancies: A study of a motivational intervention in
community settings. Pediatrics 2003;111(5):1131-1135. [Abstract]
Project CHOICES Research Group. Alcohol-exposed pregnancy:
Characteristics associated with risk. American Journal of Preventive
Medicine 2002;23(3):166-173. [Abstract]
[Return
to Top]