Computer-Delivered Screening and Brief Intervention for Alcohol Use in Pregnancy: A Pilot Randomized Trial

Background Although screening and brief intervention (SBI) for unhealthy alcohol use has demonstrated efficacy in some trials, its implementation has been limited. Technology‐delivered approaches are a promising alternative, particularly during pregnancy when the importance of alcohol use is amplified. The present trial evaluated the feasibility and acceptability of an interactive, empathic, video‐enhanced, and computer‐delivered SBI (e‐SBI) plus 3 tailored mailings, and estimated intervention effects. Methods We recruited 48 pregnant women who screened positive for alcohol risk at an urban prenatal care clinic. Participants were randomly assigned to the e‐SBI plus mailings or to a control session on infant nutrition, and were re‐evaluated during their postpartum hospitalization. The primary outcome was 90‐day period prevalence abstinence as measured by timeline follow‐back interview. Results Participants rated the intervention as easy to use and helpful (4.7 to 5.0 on a 5‐point scale). Blinded follow‐up evaluation at childbirth revealed medium‐size intervention effects on 90‐day period prevalence abstinence (OR = 3.4); similarly, intervention effects on a combined healthy pregnancy outcome variable (live birth, normal birthweight, and no neonatal intensive care unit stay) were also of moderate magnitude in favor of e‐SBI participants (OR = 3.3). As expected in this intentionally underpowered pilot trial, these effects were nonsignificant (p = 0.19 and 0.09, respectively). Conclusions This pilot trial demonstrated the acceptability and preliminary efficacy of e‐SBI plus tailored mailings for alcohol use in pregnancy. These findings mirror the promising results of other trials using a similar approach and should be confirmed in a fully powered trial.