Study examines Internet-delivered intervention to reach woman at risk for drinking during pregnancy

May 9 2018

Alcohol use during pregnancy can lead to Fetal Alcohol Spectrum Disorders (FASDs), a range of effects that include lowered intelligence and developmental delays. Over 30 percent of the pregnancies in the United States are unplanned, with most women unaware of being pregnant until after the fourth week, and many not recognizing that they are pregnant until after that. However, the early weeks of pregnancy are critical for fetal development and susceptibility to the damaging effects of alcohol. While face-to-face interventions can significantly reduce risk for an alcohol-exposed pregnancy (AEP), this study, the Contraception and Alcohol Risk Reduction Internet Intervention (CARRII), examined an Internet-delivered intervention designed to reach more women at risk.

Researchers advertised via Craigslist, Facebook, Twitter, and with other methods for women ages 18-44 who were fertile, could legally provide informed consent, spoke and read English, had Internet and telephone access, possessed risky drinking habits – defined as more than one episode of drinking four or more drinks/day during the previous three months – and were at risk for unintended pregnancy due to ineffective, inconsistent, or absent contraception. A total of 71 women were assigned to either the CARRII intervention group (n=36) or a standard patient-education (PE) group (n=35). Assessments were delivered online via questionnaires and diaries, and telephone interviews were administered at baseline, nine weeks post-treatment, and at six-month follow-up to measure participants' rates of risky drinking, unprotected sex episodes, and AEP risk.

Compared to the PE group, the CARRII group had a high study completion rate, showed a promising ability to reduce AEP risk, and found it to be an acceptable intervention. For example, CARRII participants showed significant reductions from pre-treatment to post-treatment in their rate of unprotected sex (which went from 88.9% to 70.6%) and risky drinking (which went from 75.0% to 50.0%). There were no significant changes on these variables in the PE group. The study's authors recommended that the CARRII intervention undergo further testing in a fully-powered study, as it appears to reach women who would otherwise not receive help to address these risky behaviors.