A Pilot RCT of an Internet Intervention to Reduce the Risk of Alcohol‐Exposed Pregnancy. (9th May 2018)

• Record Type: Journal Article
• Authors: Ingersoll, Karen; Frederick, Christina; MacDonnell, Kirsten; Ritterband, Lee; Lord, Holly; Jones, Brogan; Truwit, Lauren
• Is Part Of: Alcoholism. Volume 42:Number 6(2018)
• Page Start: 1132
• Page End: 1144
• Publication Date: 2018-05-09
• Subjects: Alcohol‐Exposed Pregnancy -- eHealth -- Internet -- Prevention -- Contraception -- Risk Drinking; Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.13635
• Languages: English
• ISSNs: 0145-6008

Abstract

Abstract : Background: Preventing alcohol‐exposed pregnancies (AEPs) could reduce the incidence of fetal alcohol spectrum disorders. Previous face‐to‐face interventions significantly reduced risk for AEP, but a scalable intervention is needed to reach more women at risk. Methods: This study compared a 6 Core automated, interactive, and tailored Internet intervention, the Contraception and Alcohol Risk Reduction Internet Intervention (CARRII), to a static patient education (PE) website for its effect on AEP risk. Participants were recruited online to a pilot randomized clinical trial (RCT) with baseline, 9 weeks posttreatment, and 6‐month (6‐M) follow‐up assessments. Seventy‐one women completed online questionnaires and telephone interviews and were randomized to CARRII ( n = 36) or PE ( n = 35). Primary outcomes were rates of risky drinking, unprotected sex episodes, and AEP risk, collected from online prospective diaries. Results: CARRII participants showed significant reductions in rate of unprotected sex from pretreatment (88.9%) to posttreatment (70.6%) ( p < 0.04) and to 6‐M follow‐up (51.5%) ( p = 0.001); rate of risky drinking from pretreatment (75.0%) to posttreatment (50.0%) ( p < 0.02), but insignificant change from pretreatment to 6‐M follow‐up (57.6%) ( p < 0.09); and rate of AEP risk from pretreatment (66.7%) to posttreatment (32.4%) ( p = 0.001) and to 6‐M follow‐up (30.3%) ( p = 0.005). PE participants demonstrated no significant changes on all 3 variables across all time points. Intent‐to‐treat group‐by‐time tests were not significant, but power was limited by missing diaries. Over 72% of CARRII participants completed all 6 Cores. Exploratory analyses suggest that higher program utilization is related to change. Conclusions: These data show that CARRII was acceptable, feasible, promising to reduce AEP risk, and merits further testing in a fully powered RCT.