Abstract
BackgroundRecommended screening and brief intervention (SBI) for alcohol use during pregnancy is impeded by high patient loads and limited resources in public health settings. We evaluated the feasibility, acceptability and validity of a new self-administered, single-session, bilingual, computerized Screening and Brief Intervention (SBI) program for alcohol and sugar sweetened beverage (SSB) use in pregnancy.MethodsWe developed and tested the computerized SBI program at a public health clinic with 290 pregnant women. Feasibility, acceptability, and validity measures were included in the program which had several modules, including those on demographics, health and beverage use. Time to complete the program and user experience items were used to determine program feasibility and acceptability. Validity analyses compared proportions of prenatal alcohol use identified by the program versus in-person screening by clinic staff.ResultsMost program users (87%, n = 251) completed the entire program; 91% (n = 263) completed the key screening and brief intervention modules. Most users also completed the program in ten to fifteen minutes. Program users reported that the program was easy to use (97%), they learned something new (88%), and that they would share what they learned with others (83%) and with their doctors or clinic staff (76%). Program acceptability did not differ by age, education, or type of beverage intervention received. The program identified alcohol use in pregnancy among 21% of users, a higher rate than the 13% (p < .01) found via screening by clinic staff.ConclusionsComputerized Screening and Brief Intervention for alcohol and SSB use in public health clinics is feasible and acceptable to English and Spanish speaking pregnant women and can efficiently identify prenatal alcohol use.
Highlights
Recommended screening and brief intervention (SBI) for alcohol use during pregnancy is impeded by high patient loads and limited resources in public health settings
Existing computerized Screening and Brief Intervention (SBI) programs have limited appeal as they require clinical staff [6,7], multiple sessions [12], or internet access [13] and are only available in English. We addressed these limitations by converting the single session Early Start Plus (ESP) program into a standalone, self-administered, computerized SBI that does not require internet access
Program acceptability was examined for the 251 pregnant women (87%) who completed all the program modules
Summary
Recommended screening and brief intervention (SBI) for alcohol use during pregnancy is impeded by high patient loads and limited resources in public health settings. Acceptability and validity of a new self-administered, single-session, bilingual, computerized Screening and Brief Intervention (SBI) program for alcohol and sugar sweetened beverage (SSB) use in pregnancy. Competing priorities of high patient loads, multiple patient health issues, and resource limitations in public health clinics impede implementation of evidence-based screening and brief interventions (SBI) for alcohol use during pregnancy [1]. In 2000, Kaskutas and colleagues developed Early Start Plus (ESP), a novel computerized intervention for pregnant women. The ESP intervention incorporated detailed drink size assessment and feedback into Early Start (ES), a prevention program for pregnant women enrolled in a health maintenance organization [6,7]. For women who are unable to stop drinking, drink size information can be used to encourage reduced drinking and, thereby, facilitate harm reduction
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