PREVENTING ALCOHOL USE IN PREGNANT WOMEN UTILIZING WIC

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The proposed study is a controlled brief intervention designed to decrease alcohol use by low-income, ethnically diverse pregnant women enrolled in the Los Angeles County WIC (Women, Infants and Children) program. A number of aims will be addressed: To increase the detection of alcohol use during pregnancy in the WIC population; to evaluate the impact of brief intervention on reduction of maternal drinking during pregnancy; to identify maternal characteristics that influence the effectiveness of brief intervention; to identify characteristics of the brief intervention that contribute to a reduction in maternal alcohol consumption; and to evaluate the impact of brief intervention on infant birth outcomes. Twelve WIC clinics will be matched and randomized to one of two conditions: (1) the Assessment Only (AO) Condition (n=252), in which mothers will receive a comprehensive assessment of alcohol use, followed by the current WIC standard of care; or (2) the Brief Intervention (BI) Condition (n=252), in which mothers receive the same comprehensive assessment plus a standardized brief intervention designed to reduce maternal alcohol consumption. Women who endorse any alcohol use during their monthly appointment with a WIC nutritionist will be recruited for study. Assessment and intervention will be carried out by nutritionists during the mother's prenatal visits. Multiple self-report measures of alcohol consumption will be used to obtain an accurate assessment of alcohol use. For those women in the BI Condition, a manualized brief intervention procedure will be employed. Maternal variables of interest will include: ethnicity and acculturation, age, age of onset of drinking, duration of drinking history, depression, and social drinking milieu. Characteristics of intervention will include: the timing and quantity of interventions, and nutritionist attitudes and beliefs. Infant outcome measures will include: birth weight and length, gestation, and neonatal complications. Provided the hypotheses are upheld, and improved assessment and brief intervention techniques are successful in reducing maternal alcohol consumption among WIC mothers, the intervention represents a low-cost model for FAS prevention that can be disseminated nation-wide in the WIC system.