BRIEF INTERVENTION FOR DRUG USE IN PREGNANT WOMEN

描述：(申请人摘要) 产前药物使用与多种医学和发育相关 后果。尽管许多女性自发地戒除了物质使用 得知自己怀孕后，其他人在怀孕期间继续使用。 与烟酒相比，人们对产前戒烟知之甚少 非法药物使用率。此外，人们对这一现象的影响知之甚少 酒精和烟草使用对产前非法药物使用的影响，以及关于 造成能力差异的心理和其他因素 要求孕妇戒除非法药物使用。最后，更好的干预措施 以提高产前使用药物的戒断率。目前， 最常见的干预措施是简短的专业建议(BPA)，它只有 临床疗效有限。为了解决这些问题，a 将进行随机分配临床试验，以评估 两种有希望提高临床疗效的干预措施 减少产前鸦片和/或可卡因使用的强度。主题将是 社会经济地位较低、高中以下的孕妇 教育程度(入院时估计胎龄为20周)。研究对象： 怀孕前/产前鸦片和/或可卡因的使用将是随机的 分配到三个干预组之一(N=237个/组)：(1)仅双酚A (标准医疗实践)；(2)双酚A联合行为 激励(BI)；以及(3)BPA与BI和激励相结合 增强疗法(MET)。研究对象将被前瞻性地跟踪。 在整个妊娠期和产后期确定变化 在物质使用中发生的。自我报告和客观衡量 将使用物质使用。这项研究还将确定心理 以及其他因素(例如，抑郁、母婴互动、吸毒 通过显著他人)影响戒烟和复发到产前 物质使用。一组非鸦片/可卡因使用者(N=237)将 评估产前阿片剂和/或可卡因的使用对 母婴结局。这项研究还将确定 孕前药物使用对孕期内非法戒毒率的影响 药物使用以及戒烟对母婴健康的影响。

DESCRIPTION: (Applicant's Abstract) Prenatal drug use is associated with a variety of medical and developmental consequences. Although many women spontaneously quit substance use on learning they are pregnant, others continue to use throughout pregnancy. Compared to alcohol and tobacco, little is known about prenatal quitting rates for illicit drug use. Also, little is known about the influence of alcohol and tobacco use on prenatal illicit drug use, and about psychological and other factors that account for the differences in ability of pregnant women to quit illicit drug use. Finally, better interventions are needed to enhance prenatal substance use quitting rates. Currently, the most common intervention is brief professional advice (BPA), which has only limited clinical effectiveness. To address these issues, a random-assignment clinical trial will be conducted to assess the effectiveness of two promising interventions of increasing clinical intensity on reducing prenatal opiate and/or cocaine use. Subjects will be pregnant women of lower socioeconomic status with less than a high school education (estimated gestational age at admission 20 weeks). Subjects with pre-pregnancy/prior prenatal opiate and/or cocaine use will be randomly assigned to one of three intervention groups (N=237/group): (1) BPA only (standard medical practice); (2) BPA in combination with behavioral incentives (BI); and (3) BPA in combination with BI and Motivational Enhancement Therapy (MET). Subjects will be followed prospectively throughout pregnancy and into the post partum period to determine changes that occur in substance use. Both self-report and objective measures of substance use will be employed. The study will also identify psychological and other factors (e.g., depression, maternal-infant interactions, drug use by significant other) that influence quitting and relapse to prenatal substance use. A comparison group of non-opiate/cocaine users (N=237) will be included to assess effects of prenatal opiate and/or cocaine use on maternal and infant outcomes. The study will also determine the influence of pre-pregnancy substance use on within-pregnancy quitting rates of illicit drug use, and the impact of quitting on maternal and infant health.