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.
aDepartment of Psychiatry and Behavioral Neurosciences, and Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
bDepartment of Psychology, Virginia Commonwealth University, Richmond, Virginia
Address correspondence and reprint requests to: Steven J. Ondersma, PhD, Departments of Psychiatry and Behavioral Neurosciences, and Obstetrics and Gynecology, Wayne State University, 2761 E. Jefferson Ave., Detroit MI 48207.
ABSTRACT