BRIEF INTERVENTIONS FOR ALCOHOL, TOBACCO AND OTHER DRUGS

产前药物使用与许多新生儿 这些后果包括出生体重低和死亡率增加。一些 妇女在得知自己怀孕后会自发地戒掉毒品。 其他人在整个怀孕期间继续使用药物，从而增加风险 他们婴儿的医疗和发育问题。 更好 需要采取干预措施， 在他们的婴儿。 需要更好的干预措施来加强产前检查 物质使用戒烟率。 目前使用最广泛的策略是 简短的专业建议（BPA），只有有限的临床 有效性 拟议的研究将进行随机分配 临床试验，以评估三种干预措施的有效性， 增加减少产前药物使用的临床强度。 受试者将是入组医院产科的孕妇。 临床（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选择 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学筛查。 一 一组受试者（N=270）将仅接受标准BPA 医疗实践。 第二组（N=270）将接受BPA， 与行为激励（BI）相结合。 第三组（N=270）将 接受BPA和BI与动机增强疗法相结合 （MET）。 干预措施的效果将在两个临床 和经济措施。 这项研究还将收集流行病学数据 确定因素（包括抑郁症，家族史， 依赖）与产前戒烟有关， 非法药物使用。 产前使用药物的受试者的结果 将与没有产前物质的社区对照组进行比较 使用（N=270）。产前药物使用之间可能的相互作用将 也被调查。 受试者将从首次产前检查开始接受随访。 产后3个月访视，采用自我报告、毒理学和 物质使用的间接报告措施。科目会比较低 受过高中或以下教育的城市妇女的社会经济地位 产前药物使用率很高

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.