Prevention of alcohol-exposed pregnancies among nonpregnant American Indian women.

Purpose: The goal of this project was to evaluate an intervention on reducing alcohol-exposed 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.