Computer-based brief intervention a randomized trial with postpartum women.

Full Abstract

BACKGROUND:
Drug use among parenting women is a significant risk factor for a range of negative child outcomes, including exposure to violence, child maltreatment, and child behavior problems. Implementation of brief interventions with this population may be greatly facilitated by computer-based interventions.

DESIGN:
Randomized clinical trial with 4-month follow-up.

SETTING/PARTICIPANTS:
Participants were 107 postpartum women recruited from an urban obstetric hospital primarily serving a low-income population. Women were randomized into assessment only versus assessment plus brief intervention conditions; 76 (71%) returned for follow-up evaluation.

INTERVENTION:
A 20-minute, single-session, computer-based motivational intervention (based on motivational interviewing methods), combined with two nontailored mailings and voucher-based reinforcement of attendance at an initial intake/treatment session.

MAIN OUTCOME MEASURES:
Illicit drug use as measured by qualitative urinalysis and self-report.

RESULTS:
Frequency of illicit drug use other than marijuana increased slightly for the control group, but declined among intervention group participants (p<0.05, between-group Mann-Whitney U; d=0.50); the magnitude of intervention effects on changes in marijuana use frequency was similar, but did not reach statistical significance. Point-prevalence analysis at follow-up did not show significant group differences in drug use. However, trends under a range of assumptions regarding participants lost to follow-up all favored the intervention group, with most effect sizes in the moderate range (odds ratios 1.4 to 4.7).

CONCLUSIONS:
Results tentatively support the efficacy of this high-reach, replicable brief intervention. Further research should seek to replicate these findings and to further develop the computer as a platform for validated brief interventions.

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Author information

Author/s: Ondersma, Steven J (SJ); Svikis, Dace S (DS); Schuster, Charles R (CR);

Affiliation: Department of Psychiatry and Behavioral Neurosciences, and Obstetrics and Gynecology, Wayne State University, Detroit, Michigan 48207, USA. s.ondersma(-atsign-)wayne.edu

Grants: DA00516 (Agency:NIDA NIH HHS) ; DA14621 (Agency:NIDA NIH HHS) ; K23 DA000516-04 (Agency:NIDA NIH HHS) ; K23 DA000516-05 (Agency:NIDA NIH HHS) ; R21 DA014621-01 (Agency:NIDA NIH HHS) ; R21 DA014621-02 (Agency:NIDA NIH HHS) ; R21 DA014621-03 (Agency:NIDA NIH HHS)

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural

Journal: American journal of preventive medicine (Am J Prev Med), published in Netherlands. (Language: eng)

Reference: 2007-Mar; vol 32 (issue 3) : pp 231-8

Dates: Created 2007/02/13; Completed 2007/05/04; Revised 2008/11/20;

PMID: 17236741, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

ErratumIn: Am J Prev Med. 2007 Jun;32(6):549.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
African Americans - psychology
Computers
Female
Health Promotion - methods
Humans
Marijuana Abuse - ethnology; prevention & control
Mothers - psychology
Motivation

Motivation
Postpartum Period
Prospective Studies
Risk Factors
Self Disclosure
Self Efficacy
Street Drugs
Substance-Related Disorders - ethnology; prevention & control
United States

Associated Chemicals: Street Drugs (0)

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