BRIEF INTERVENTIONS FOR ALCOHOL, TOBACCO AND OTHER DRUGS

产前物质的使用与许多新生儿相关 后果，包括低出生体重和增加死亡率。一些人 女性在得知自己怀孕后会自发地停止使用药物。 其他人在整个怀孕期间继续服用药物，因此增加了风险 他们的婴儿存在医疗和发育问题。更好 需要采取干预措施来加强医疗和发展问题。 在他们的婴儿身上。需要更好的干预措施来加强产前检查 物质使用戒除率。目前使用最广泛的策略是 简短的专业建议(BPA)，其临床应用有限 有效性。建议的研究将进行随机分配 评估三种干预措施有效性的临床试验 加大临床力度，减少产前药物使用。 研究对象将是在产科医院登记的孕妇 诊所(估计胎龄小于28周)。他们 将从报告酒精、烟草或非法药物的患者中挑选 在过去30天内使用药物或此类使用检测呈阳性 在第一次产前检查时进行毒理筛查。一 受试组(N=270)将只接受BPA，这是标准的 医疗实践。第二组(N=270)将在#年接受BPA 结合行为激励(BI)。第三组(N=270)将 在接受激励增强疗法的同时接受BPA和BI (MET)。干预措施的效果将在两个临床上进行评估 和经济措施。这项研究还将收集流行病学数据 确定因素(包括抑郁、家族史、 依赖)与产前戒酒、戒烟和戒烟有关 非法吸毒。来自产前使用药物的受试者的结果 将与没有产前物质的社区控制措施进行比较 使用(N=270)。产前物质使用之间可能的相互作用将 也被调查。受试者将从第一次产前开始接受跟踪 产后三个月的访视，采用自我报告、毒理学和 抵押品-报告物质使用的衡量标准。主题将会更低 社会经济地位高中及以下学历的城市女性 有很高的产前药物使用率。

Prenatal substance use is associated with a number of neonatal consequences, including low birthweight and increased mortality. Some women spontaneously quit substance use on learning they are pregnant. Others continue substance use throughout pregnancy, thus increasing risk of medical and developmental problems in their infants. Better interventions are needed to enhance medical and developmental problems in their infants. Better interventions are needed to enhance prenatal substance use quit rates. Currently the most widely used strategy is brief professional advice (BPA), which has only limited clinical effectiveness. The proposed research will conduct a random-assignment clinical trial to assess effectiveness of three interventions of increasing clinical intensity on reducing prenatal substance use. Subjects will be pregnant women enrolled in a hospital obstetrical clinic (estimated gestational age less than twenty-eight weeks). They will be selected from patients reporting alcohol, tobacco, or illicit drug use during the past thirty days or testing positive for such use on toxicological screens at the time of the first prenatal visit. One group of subjects (N=270) will receive BPA only, which is standard medical practice. A second group (N=270) will receive BPA in combination with behavioral incentives (BI). A third group (N=270) will receive BPA and BI in combination with Motivational Enhancement Therapy (MET). Effects of the interventions will be evaluated on both clinical and economic measures. The study will also collect epidemiological data to identify factors (including depression, family history, level of dependence) associated with quitting of prenatal alcohol, tobacco, and illicit drug use. Results from subjects with prenatal substance use will be compared to community-based controls without prenatal substance use (N=270). Possible interactions between prenatal substance use will also be investigated. Subjects will be followed from the first prenatal visit to three mo post partum, employing self-report, toxicological, and collateral-report measures of substance use. The subjects will be lower socioeconomic status urban women with a high school or less education with high rates of prenatal substance use.