Project CHOICES as a primary prevention strategy
Last week I included a posting on the launch of Project CHOICES in Manitoba. I thought I would include some more information about Project CHOICES for those of you who may be unfamiliar with the program.
Project CHOICES was a program developed in the United States in late 1990s as a primary prevention strategy for reducing alcohol-exposed pregnancies. While the developers of the program recognized that many women significantly reduce their alcohol use once they are pregnant, they also knew that many women do not know they are pregnant until well into their first trimester. Hence, they wanted to develop a program that would address the period prior to conception. The program considered three different routes to reducing the risk of an alcohol-exposed pregnancy: (1) reducing alcohol use (2) using effective contraception (3) reducing alcohol use and using effective contraception.
Project CHOICES is based on motivational interviewing which is a counseling approach that is respectful, non-judgemental and client-centred. Motivational interviewing allows health care providers and clients to explore possible areas of change, discuss strategies that make sense for the client and their life circumstances, and provides encouragement and support.
The Project CHOICES intervention was tested in a randomised control trial and the results published in an article by Floyed et al (2007). Overall, the study found that 69% of women who received the CHOICES intervention were at lower risk of having an alcohol-exposed pregnancy at 9 months follow-up. Most women chose to use effective contraception and approximately 44% of the women reduced their alcohol use and were using effective contraception at 9 months post-intervention. Qualitative data from the evaluation asked women what the most important part of the intervention was. The most frequent responses were that providers “have a caring attitude,” were “compassionate,” and were “encouraging.”
To learn more about Project CHOICES, you might want to start with the references below.
Velasquez, MM, Ingersoll, KS, Sobell, MB, Floyd, RL, Sobell, LC, and von Sternberg, K, (2010). A Dual-Focus Motivational Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy. Cognitive and Behavioral Practice, 17(2): 203-212.
Floyd, RL, Sobell, M, Velasquez, MM, Ingersol,l K, Nettleman, M, Sobell, L, Mullen, PD, Ceperich, S, von Sternberg, K, Bolton, B, Johnson, K, Skarpness, B, and Nagaraja, J. (2007). Preventing Alcohol-Exposed Pregnancies: A Randomized Controlled Trial. American Journal of Preventive Medicine, 32(1): 1-10.
Centers for Disease Control and Prevention. (2003). Motivational Intervention to Reduce Alcohol-Exposed Pregnancies – Florida, Texas, and Virginia, 1997-2001. Morbidity and Mortality Weekly Report, 52(19): 441-444.
Project CHOICES Intervention Research Group. (2003). Reducing the Risk of Alcohol-Exposed Pregnancies: A Study of a Motivational Intervention in Community Settings
Pediatrics, 111(5): 1131-1135.
Project CHOICES Research Group. (2002). Alcohol-Exposed Pregnancy: Characteristics Associated with Risk. American Journal of Preventive Medicine, 23(3): 166-173.