Reducing Alcohol-Exposed Pregnancies Through the Use of Community-Level Guided Self-Change Programs

Community resources for assisting individuals who are problem drinkers but who are not alcohol-dependent are limited in most communities. Over the past decade, increasing attention has been directed toward programs focused on engaging the individual’s own capacity for self-change as a means of achieving recovery from alcohol problems. This approach is supported by findings that up to 75% of individuals who change their problem drinking habits do so without the use of formal treatment programs. Guided self-change (GSC) programs tend to be of low intensity as compared with traditional treatments, targeted toward the community at large, and focused on problem drinkers as opposed to severely alcohol-dependent drinkers. The goal of these programs is to attract and assist motivated individuals in the early stages of alcohol abuse to take part in an intervention aimed at facilitating a client-driven, self-change process of alcohol reduction or abstinence. GSC intervention components are similar to those of brief interventions and include personal feedback, advice, goal-setting, and self-monitoring of behavior reformatted into self-administered materials that can be completed at home.

In 2004, CDC funded two universities to 1) develop, implement, and evaluate community-level, self-guided change projects targeting women 18 to 44 years of age who are at risk for an alcohol-exposed pregnancy; and 2) demonstrate a 15% reduction in the proportion of women at risk for an alcohol-exposed pregnancy in community-based intervention sites as compared with non-intervention community-based sites.


Funded Projects:
Nova Southeastern University—Ft. Lauderdale, Florida
An intervention will be instituted for a sample of women 18 to 44 years of age who are at risk for an alcohol-exposed pregnancy in three counties in south Florida. Participants will be recruited through the media (e.g., newspaper advertisements, mail flyers, television, billboards, and radio public service announcements). Once respondents are screened and determined to be eligible, they will be randomly assigned either to a motivational intervention promoting self-change, or to a control intervention that will provide information only about the risk of fetal alcohol syndrome. The intervention group will receive a one-time mailing about how to either reduce alcohol consumption or increase use of effective birth control. Women who are unsuccessful at reducing their risk can access professional services for help. The specific goals of the study are to 1) determine the degree to which participants decrease their risk for an alcohol-exposed pregnancy, and 2) determine the level of use of professional resources for self-change. The efficacy of the intervention will be evaluated and the results will be disseminated to health care providers in the local community. For more information about the program at Nova Southeastern University, contact the Guided Self-Change Clinic at (954) 262-5968 or visit their web site at http://www.nova.edu/gsc.
 

St. Louis University—St. Louis, Missouri
A community-based self-change project will be conducted with the goal of reducing the risk of alcohol-exposed pregnancies by 15% among African-American women in St. Louis. St. Louis has a high number of childbearing age women in an at-risk community, with a high prevalence of binge drinking that continues during pregnancy. Kansas City is the comparison community. Baseline risk for alcohol-exposed pregnancies in both St. Louis and Kansas City will be assessed using a random digit dial survey. Behaviors relating to both alcohol use and contraceptive use will be assessed. Recruitment of participants will take place through advertisements in the media, through the random digit dial survey, and through health care provider offices and WIC clinics. Educational materials about reducing at-risk drinking or increasing proper use of birth control will be mailed to participants, but will also be available through the Internet. These materials will guide participants through a self-change process. Follow-up will occur 4 months after enrollment.

[Return to Top]