The Trajectory of Fetal Alcohol Spectrum Disorders (FASD) Across the Life Span: Continuing Prevention and Longitudinal Epidemiology

Not Applicable

Completed

Interventions: Behavioral: Informational Pamphlet
Behavioral: Brief Motivational Enhancement Therapy (MET) Session

Brief Summary: Screen women of childbearing age (15 - 44 years) for high risk drinking in antenatal clinics of the established research sites in the Western Cape Province of South Africa (SA). While there are multiple reasons for this screening, the purpose is for selective (secondary) prevention of FASD. A.) Initiate a case control trial/efficacy study (n=400) of the use of one-session brief motivation enhancement therapy (MET) in busy public health settings (versus information only) in these rich research sites where very high rates of FASD have been documented over the entirety of the past two decades. B.) These targeted prevention activities follow both findings and staff experience in prevention over the past decade which indicate that the most likely venue for prevention activities is in antenatal clinics of the local, primary care clinics and hospitals. These activities will also provide tangible community-level pay back for participation in ongoing research activities and lay the groundwork for sustainable services going forward.

Detailed Description: The purpose of the research is to find out if Motivational Enhancement Therapy is more effective than printed information alone (Informational pamphlets only) in helping women reduce their risk of giving birth to children with Fetal Alcohol Spectrum Disorders (FASD) at Primary Health Care Facilities, in addition to evaluation individuals for risky health behaviors by having them complete brief screening questionnaires that give them information of how much risk they might be facing from their alcohol or other drug use. When a pregnant mother drinks alcohol, she puts her baby at risk. FASD is a group of growth, mental, and physical problems that may occur in a baby when a mother drinks alcohol during pregnancy.

Recruitment & Eligibility

Inclusion Criteria

Drinking pregnant women who are defined as women who:
- Drank in the 3 months prior to pregnancy and/or
- Drank alcohol at least once at any time during the prenatal period.
Gestational age less than or equal to 16 weeks, but not more than 20 weeks at intake

Exclusion Criteria

Non-drinking pregnant women who are defined as women who have not had any alcohol during the past 30 days.
Gestational age >20 weeks

Arm && Interventions

Group	Intervention	Description
MET Group	Informational Pamphlet	MET women will be provided with a one (1) hour and 30 minute session of Motivational Enhancement Therapy (MET) and informational pamphlet(s) (both in Afrikaans).
Pamphlet-only	Informational Pamphlet	Pamphlet-only women will be provided with two (2) informational pamphlet(s) (both in Afrikaans).
MET Group	Brief Motivational Enhancement Therapy (MET) Session	MET women will be provided with a one (1) hour and 30 minute session of Motivational Enhancement Therapy (MET) and informational pamphlet(s) (both in Afrikaans).

Primary Outcome Measures

Name	Time	Method
Change in the Alcohol Use Disorders Identification Test (AUDIT) Score Over Time	Baseline through 9 months post-partum, an average of approximately 67 weeks.	The AUDIT is a 10-item, self-report, screening tool to assess alcohol consumption, drinking behaviors, and alcohol-related problems. The AUDIT was developed and adopted by the World Health Organization. AUDIT scoring for questions 1 to 8 are scored on a five-point scale from 0,1,2,3, or 4; questions 9 and 10 are scored on a three-point scale from 0,2, or 4. The minimum total score for the AUDIT is 0. The maximum total score for the AUDIT is 40. Interpretation of the AUDIT Total Score is as follows: 0-7 indicates a low-risk level; a score of 8-15 is risky or hazardous level; a score of 16-19 is a high-risk or harmful level; and 20 or more is considered high-risk/almost certainly dependent on alcohol.

Secondary Outcome Measures

Name	Time	Method