Results from a randomized clinical trial to reduce alcohol-exposed pregnancies

Many young women who drink alcohol and have unprotected sex are at risk for an alcohol-exposed pregnancy. Recent work by researchers in the United States shows that a brief intervention with women in colleges can be successful in reducing this risk and have a number of other positive benefits.

There are two ways to think about reducing the risk of an alcohol-exposed pregnancy: (1) support women in reducing their alcohol use or (2) support women in finding and using a method of contraception that makes sense for their life and situation. One survey of 18-24 year old women in a public urban university found that one-quarter of the college women (23%) drank eight or more drinks per week on average, and 63% binged in the past 90 days. Nearly all sexually active women used some form of contraception (94%), but 18% used their method ineffectively and were potentially at risk for pregnancy.

Project BALANCE (Birth Control and ALcohol Awareness: Negotiating Choices Effectively) is a modified form of Project CHOICES (see previous posts here and here) which is based on motivational interviewing and focuses both on drinking and unprotected sex and supports women in addressing either or both areas of their lives.

The research team conducted a randomized clinical trial of 207 women at Virginia Commonwealth University between the ages of 18 and 24 years who were at risk for an alcohol-exposed pregnancy. Women were split into two groups: one group received an assessment and a face-to-face session and the other group received an assessment only. The two groups were followed up at 1 month and 4 months. At four months, the rate of alcohol-exposed pregnancy risk was significantly lower in the intervention group (20.2%) than in the control group (34.9%).

Project CHOICES has been adopted and supported by researchers and policy makers due to its simplicity and effectiveness. Project BALANCE is one possible intervention that could be easily implemented in existing student health or university alcohol programs.

References:

Ceperich, S.D. and 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, 2011 Feb 12. [Epub ahead of print]. DOI: 10.1007/s10865-010-9308-2

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.

Ingersoll, K.S., Ceperich, S.D., Nettleman, M.D., Karanda, K., Brocksen, S., and Johnson, B.A. (2005). Reducing alcohol-exposed pregnancy risk in college women: initial outcomes of a clinical trial of a motivational intervention. Journal of Substance Abuse Treatment, 29(3): 173-80. Download free full-text from PubMed Central.