A randomized controlled trial of Native CHOICES: Impact on alcohol‐exposed pregnancy risk reduction among American Indian and Alaska Native women

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Hauptverfasser: Jessica Hanson, Carolyn Noonan, Kyra Oziel, Karen Little Wounded, Serea Darnell, Robert Rosenman, Marcia O'Leary, Richard MacLehose, Michelle Sarche, Dedra Buchwald
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Veröffentlicht: Wiley 2024
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author Jessica Hanson
Carolyn Noonan
Kyra Oziel
Karen Little Wounded
Serea Darnell
Robert Rosenman
Marcia O'Leary
Richard MacLehose
Michelle Sarche
Dedra Buchwald
author_facet Jessica Hanson
Carolyn Noonan
Kyra Oziel
Karen Little Wounded
Serea Darnell
Robert Rosenman
Marcia O'Leary
Richard MacLehose
Michelle Sarche
Dedra Buchwald
Jessica Hanson
Carolyn Noonan
Kyra Oziel
Karen Little Wounded
Serea Darnell
Robert Rosenman
Marcia O'Leary
Richard MacLehose
Michelle Sarche
Dedra Buchwald
collection Wiley Open Access
contents A randomized controlled trial of Native CHOICES: Impact on alcohol‐exposed pregnancy risk reduction among American Indian and Alaska Native women Jessica Hanson Carolyn Noonan Kyra Oziel Karen Little Wounded Serea Darnell Robert Rosenman Marcia O'Leary Richard MacLehose Michelle Sarche Dedra Buchwald Alcohol, Clinical and Experimental Research AbstractBackgroundPrevention of alcohol‐exposed pregnancy (AEP) involves reducing risky alcohol consumption among women at‐risk for pregnancy, using effective contraception among women drinking at risky levels to prevent pregnancy, or both. This study presents the outcomes of a randomized controlled trial assessing the efficacy of Native CHOICES, a culturally tailored adaptation of the CHOICES intervention, among American Indian/Alaska Native (AI/AN) women.MethodsAI/AN women aged 18–44 who were at‐risk for an AEP were randomly assigned in a 1:1 ratio to either the Native CHOICES intervention or a waitlist control group. Native CHOICES comprised two sessions of motivational interviewing and an elective contraception counseling session. Data were collected at baseline, and 6 weeks, 3 months, and 6 months postbaseline. Due to the pandemic, the intervention was at times delivered remotely.ResultsA total of 404 women participated: 199 in the control group and 205 in the intervention group. Sixty‐seven percent of the intervention group received the intervention in‐person, and 33% participated by telephone or video call. Sixty‐four percent of women completed all follow‐up visits. At the six‐month follow‐up, the intervention did not demonstrate a significant impact on AEP risk compared with the control arm when analyzing all the data (RR = 0.94; 95% confidence interval [CI]: 0.83–1.07). However, an exploratory subgroup analysis showed evidence of a reduction in AEP risk among participants who completed the study in‐person before the COVID‐19 pandemic (RR = 0.79; 95% CI: 0.63–0.98), which was not observed during or after the pandemic (RR = 1.06; 95% CI: 0.91–1.24).ConclusionsThe Native CHOICES intervention did not show evidence of effectiveness overall. However, exploratory analyses offer some evidence that the intervention was effective prior to the pandemic. 10.1111/acer.15521 http://creativecommons.org/licenses/by-nc-nd/4.0/
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spellingShingle A randomized controlled trial of Native CHOICES: Impact on alcohol‐exposed pregnancy risk reduction among American Indian and Alaska Native women
Jessica Hanson
Carolyn Noonan
Kyra Oziel
Karen Little Wounded
Serea Darnell
Robert Rosenman
Marcia O'Leary
Richard MacLehose
Michelle Sarche
Dedra Buchwald
Alcohol, Clinical and Experimental Research
A randomized controlled trial of Native CHOICES: Impact on alcohol‐exposed pregnancy risk reduction among American Indian and Alaska Native women Jessica Hanson Carolyn Noonan Kyra Oziel Karen Little Wounded Serea Darnell Robert Rosenman Marcia O'Leary Richard MacLehose Michelle Sarche Dedra Buchwald Alcohol, Clinical and Experimental Research AbstractBackgroundPrevention of alcohol‐exposed pregnancy (AEP) involves reducing risky alcohol consumption among women at‐risk for pregnancy, using effective contraception among women drinking at risky levels to prevent pregnancy, or both. This study presents the outcomes of a randomized controlled trial assessing the efficacy of Native CHOICES, a culturally tailored adaptation of the CHOICES intervention, among American Indian/Alaska Native (AI/AN) women.MethodsAI/AN women aged 18–44 who were at‐risk for an AEP were randomly assigned in a 1:1 ratio to either the Native CHOICES intervention or a waitlist control group. Native CHOICES comprised two sessions of motivational interviewing and an elective contraception counseling session. Data were collected at baseline, and 6 weeks, 3 months, and 6 months postbaseline. Due to the pandemic, the intervention was at times delivered remotely.ResultsA total of 404 women participated: 199 in the control group and 205 in the intervention group. Sixty‐seven percent of the intervention group received the intervention in‐person, and 33% participated by telephone or video call. Sixty‐four percent of women completed all follow‐up visits. At the six‐month follow‐up, the intervention did not demonstrate a significant impact on AEP risk compared with the control arm when analyzing all the data (RR = 0.94; 95% confidence interval [CI]: 0.83–1.07). However, an exploratory subgroup analysis showed evidence of a reduction in AEP risk among participants who completed the study in‐person before the COVID‐19 pandemic (RR = 0.79; 95% CI: 0.63–0.98), which was not observed during or after the pandemic (RR = 1.06; 95% CI: 0.91–1.24).ConclusionsThe Native CHOICES intervention did not show evidence of effectiveness overall. However, exploratory analyses offer some evidence that the intervention was effective prior to the pandemic. 10.1111/acer.15521 http://creativecommons.org/licenses/by-nc-nd/4.0/
title A randomized controlled trial of Native CHOICES: Impact on alcohol‐exposed pregnancy risk reduction among American Indian and Alaska Native women
topic Alcohol, Clinical and Experimental Research
url https://onlinelibrary.wiley.com/doi/10.1111/acer.15521