Prevention of alcohol-exposed pregnancies among nonpregnant American Indian women

Purpose: The goal of this project was to evaluate an intervention on reducing alcoholexposed pregnancies with nonpregnant American Indian women, with a focus on risky drinking and ineffective contraception use. Design. This study had a descriptive longitudinal study design, with follow-up every 3 months for 1 year. Setting: Three American Indian tribes in the Northern Plains. Subjects. Participants were 231 nonpregnant American Indian women. Intervention. Participants responded to drinking and contraception questions through the telephone and then received intervention materials via mail. Follow-up telephone surveys occurred at 3, 6, 9, and 12 months after the baseline call, and participants were again mailed intervention materials. Measures. Alcohol consumption and birth control measurements were modified from the Project CHOICES program. The intervention was based on motivational interviewing constructs. Analysis. Analysis techniques included covariate-adjusted generalized estimating equation methods and Bonferroni correction. Results: All of the alcohol consumption amount responses had significant decreases with each follow-up intervention session; the average change for the range of questions was 26% to 17%. The proportion of those stating they did not use birth control decreased from 29% to 10% during the first 3 months. Conclusions. The intervention was successful in modifying self-reported drinking and contraception behaviors. This project is the only one to date that has focused on preventing alcohol-exposed pregnancies in nonpregnant American Indian women.