AN ENHANCED BRIEF INTERVENTION FOR PRENATAL ALCOHOL USE

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No universally safe level of prenatal alcohol consumption has been identified. The consequences of drinking while pregnant range from subtle developmental problems to fetal alcohol syndrome. Yet, the rate of frequent drinking by pregnant women has increased substantially in recent years. Brief interventions have been generally recommended as the first approach to treatment for mild to moderate alcohol problems, and their effectiveness documented in several well designed studies. Pregnant women at risk for antenatal consumption are an especially appropriate group to receive brief interventions, given the potential consequences of prenatal drinking and the relative infrequency of dependent alcohol use in this population. Our previous efforts to improve the identification and modification of alcohol use in pregnancy have demonstrated higher rates of abstinence among women randomized to a brief intervention. The purpose of this study is to test the effectiveness of an enhanced brief intervention involving an individual chosen by the pregnant woman. This support partner will assist in the maintenance and application of skills learned as a result of the brief intervention. Three hundred pregnant women initiating prenatal care, who are alcohol screen positive and currently drinking, or drank during a previous pregnancy, or drank at least one drink daily before pregnancy will be randomized to either the enhanced brief intervention with assessment or assessment only. The aim specific to this proposed randomized clinical trial is to test the hypothesis that 70 percent of the women will be abstinent after the enhanced brief intervention in contrast to 50 percent of the women after the assessment only. This proposed study seeks interventions to prevent drinking by pregnant women, and builds upon our previous research by incorporating advances in feminine psychology which recognize the importance of relationships in women's lives.