Our Research on Preventing Alcohol-Exposed Pregnancy

My team and I have completed several studies to generate an understanding of what puts women at risk for Alcohol- Exposed Pregnancy (AEP), and to test interventions to prevent AEP.

CHOICES Epidemiological Study (1997-1999):  This study established that some settings had more women at risk of AEP, from 10-26%, than other settings (estimated to be 2% risk nationally).  Our paper referencing these:

Project CHOICES Research Group. (2002). Alcohol-exposed pregnancy: characteristics associated with risk.  American Journal of Preventive Medicine.  23, 166-174.

CHOICES Feasibility Study (1997-1999):  We developed CHOICES as a Motivational Interviewing plus Feedback intervention with 4 sessions plus a free medical visit for contraception counseling.  A description of the intervention can be found in this paper:

Velasquez, M.M., Ingersoll, K.S., Sobell, M.B., Floyd, R.L., Sobell, L.C., & von Sternberg, K (2010). A Dual-Focus Motivational Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy, Cognitive and Behavioral Practice, 17, 203-212.

This study was the first test of CHOICES as an intervention.  It reduced AEP risk for 66% of women.  The citation is:

Project CHOICES Intervention Research Group. (2003). Reducing the risk of alcohol-exposed pregnancies: A study of motivational interviewing in community settings. Pediatrics, 111 (5), 1131-1135.

CHOICES Efficacy Study (2000-2003):  This study was the definitive randomized trial of CHOICES.  It showed that CHOICES doubles the odds of preventing AEP risk compared to a control condition.  This is the citation:

Floyd RL, Sobell M, Velasquez MM, Ingersoll K, Nettleman M, Sobell L, Mullen PD, Ceperich S, von Sternberg K, Bolton B, Johnson K, Skarpness B, Nagaraja J and the Project CHOICES Efficacy Study Group (2007), Preventing alcohol-exposed pregnancies: a randomized controlled trial. American Journal of Preventive Medicine, 32, 1-10.

BALANCE Epidemiological Study (2001-2004): In this study, we assessed what proportion of university women might be at risk for an AEP.  The answer, in the paper cited below, is 17%.  Yikes!

Ingersoll, K. S., Ceperich, S. D., Nettleman, M.D., Johnson, B. A. (2008).  Risk drinking and contraception effectiveness among college women.  Psychology and Health, 23(8), 965-981.

BALANCE Efficacy Study (2001-2004).  In this study, we modified CHOICES for college women and tested it as a single session intervention, housed in the student health clinic.  The great news is that for university women with good access to contraception, a single session intervention is as powerful as the 4 session CHOICES intervention. The citation is:

Ceperich, S.D. & Ingersoll, K.S. (2011). Motivational Interviewing + Feedback Intervention to Reduce Alcohol-Exposed Pregnancy Risk among College Binge Drinkers: Determinants and Patterns of Response.  Journal of Behavioral Medicine, 34, 381-395.

EARLY Efficacy Study (2006-2011): In this study, we modified the CHOICES/BALANCE interventions to be appropriate for community-based women without easy access to contraception.  The bottom line is that EARLY worked, but had a smaller effect size than CHOICES or BALANCE, especially on drinking.  The EARLY intervention, a Motivational Interviewing plus Feedback intervention, was better than the control conditions on reducing ineffective contraception and AEP risk.   The main paper is in press at the Journal of Substance Abuse Treatment, but isn’t available publicly yet.

EARLY Remote Feasibility Study (2009-2012):  In this study, we modified the EARLY intervention for delivery over the telephone and using mailed materials.  This paper is under review so I can’t give you the results (except to say that they are promising) and I’ll update you when the report is available!

CARRI (2012-2015):  In this newly funded NIAAA R34 grant, we will be collaborating with Dr. Lee Ritterband’s group of experts on evidence-based Internet interventions to adapt CHOICES into an Internet intervention.  It will be compared to a static patient education website.  No results yet!


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