Risk Identification in Perinatal Health Care Settings via Technology-Based Recruitment Methods: Comparative Study.

Background: Digital screening and intervention tools have shown promise in the identification and reduction of substance use in health care settings. However, research in this area is impeded by challenges in integrating recruitment efforts into ongoing clinical workflows or staffing multiple study clinics with full-time research assistants, as well as by the underreporting of substance use.

Objective: The aim of the study is to evaluate pragmatic methods for facilitating study recruitment in health care settings by examining recruitment rates and participant characteristics using in-person-based versus flyer approaches.

Risk, Emotional Support, Child Abuse Potential, and Parenting During the First Year of the COVID-19 Pandemic.

The COVID-19 pandemic and associated mitigation efforts created stress that threatened parent and child well-being. Conditions that increase stress within families heighten the likelihood of child abuse, but social support can mitigate the impact. This short-term investigation considered whether cumulative risk, COVID-19 specific risk, and emotional support (one aspect of social support), were associated with child abuse potential during the pandemic.

Participant Satisfaction with Computer-Delivered Intervention Components and Its Relation to Alcohol Outcomes.

Few computer-delivered brief intervention (CDBI) studies have evaluated participant satisfaction with individual elements of the intervention, or whether participant satisfaction impacts intervention outcomes. This factorial trial examined whether subjective reactions to a CDBI for heavy drinking (1) varied depending on the presence versus absence of an animated narrator, a spoken voice, empathic reflections, and motivational interviewing (MI) strategies and (2) were associated with drinking outcomes at 3-month follow-up. Participants were 352 heavy drinking university students.

Testing the efficacy of motivational strategies, empathic reflections, and lifelike features in a computerized intervention for alcohol use: A factorial trial.

Although computer delivered brief interventions (CDBIs) have been effective in reducing alcohol use, few studies have examined which components of CDBIs are most associated with drinking reductions. The current factorial trial deconstructed a brief alcohol intervention into component parts to identify main and interaction effects on drinking outcomes. Participants (N = 352) were randomly assigned to 1 of 16 possible combinations of four dichotomous (present vs.

Accuracy of five self-report screening instruments for substance use in pregnancy.

Background And Aims: The accuracy of current screening instruments for identification of substance use in pregnancy is unclear, particularly given methodological shortcomings in existing research. This diagnostic accuracy study compared five existing instruments for ability to identify illicit drug, opioid and alcohol use, under privacy expectations consistent with applied practice and using a gold standard incorporating toxicological analysis.

Design: Prospective cross-sectional screening accuracy study.

Mobile Health Interventions: Exploring the Use of Common Relationship Factors.

The use of mobile health (mHealth) interventions has risen dramatically over the past two decades. It is important to consider mHealth intervention research within the broader therapy outcome literature. Among other key findings, this broader literature suggests that common relationship factors such as empathy, positive regard, and genuineness may play a critical role in therapy effectiveness.

Feasibility and Acceptability of e-Screening and Brief Intervention and Tailored Text Messaging for Marijuana Use in Pregnancy.

There are at present no evidence-based interventions for marijuana use during pregnancy, despite it being by far the most commonly used illicit drug during pregnancy. Lack of treatment-seeking, combined with implementation challenges, has limited the extent to which at-risk women receive interventions of any kind. This study sought to evaluate the feasibility and acceptability of two high-reach technology-based interventions: electronic screening and brief intervention (e-SBI) and tailored text messaging, delivered either alone or in combination.

Computer-delivered indirect screening and brief intervention for drug use in the perinatal period: A randomized trial.

Background: Under-reporting of drug use in the perinatal period is well-documented, and significantly limits the reach of proactive intervention approaches. The Wayne Indirect Drug Use Screener (WIDUS) focuses on correlates of drug use rather than use itself. This trial tested a computer-delivered, brief intervention designed for use with indirect screen-positive cases, seeking to motivate reductions in drug use without presuming its presence.

Electronic Brief Intervention and Text Messaging for Marijuana Use During Pregnancy: Initial Acceptability of Patients and Providers.

Background: Marijuana is the most widely used illicit substance during pregnancy. Technology-delivered brief interventions and text messaging have shown promise in general and pregnant samples but have not yet been applied to marijuana use in pregnancy.

Objective: The objective of the study was to evaluate, among pregnant women and prenatal care providers, the acceptability of an electronic brief intervention and text messaging plan for marijuana use in pregnancy.

Utility of Commercial Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS) Testing for Detection of Lighter Drinking Among Women of Childbearing Years.

Objective: Even moderate alcohol consumption during pregnancy can pose risks to the fetus, making reliable and consistent detection of drinking in pregnancy critical. Ethyl glucuronide (EtG) and ethyl sulfate (EtS) have shown some ability to detect lower levels of drinking, but the sensitivity of commercial EtG/EtS testing to lower levels of drinking among women of childbearing age is unknown. This study sought to determine the ability of an EtG/EtS algorithm, as well as EtG alone, to detect alcohol consumption in women of childbearing age using commercial testing and cutoffs.

Effects of narrator empathy in a computer delivered brief intervention for alcohol use.

Computer-delivered, brief interventions (CDBIs) have been an increasingly popular way to treat alcohol use disorders; however, very few studies have examined which characteristics of CDBIs maximize intervention effectiveness. The literature has consistently demonstrated that therapist empathy is associated with reduced substance use in in-person therapy; however, it is unclear whether this principle applies to CDBIs. Therefore, the study aimed to examine whether the presence of an empathic narrator increased intentions to reduce heavy drinking in a CDBI.

An Ecodevelopmental Exploration of Mediators Between Maltreatment in Childhood and Drug use During Pregnancy.

Child maltreatment is associated with increased risk of substance abuse in adulthood. However, prior investigations have not examined substance use specifically in pregnancy, and have relied on self-report of substance use. The present study addresses these gaps via secondary analysis of 295 primarily low-income, Black postpartum women who agreed to complete a brief questionnaire and subsequently provided urine and hair samples.

A randomised trial of a computer-delivered screening and brief intervention for postpartum alcohol use.

Introduction And Aims: Most women cut down or quit alcohol use during pregnancy, but return to pre-pregnancy levels of use after giving birth. Universal screening and brief intervention for alcohol use has shown promise, but has proven challenging to implement and has rarely been evaluated with postpartum women. This trial evaluated a single 20-min, electronic screening and brief intervention (e-SBI) for alcohol use among postpartum women.

Commercial Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS) Testing is Not Vulnerable to Incidental Alcohol Exposure in Pregnant Women.

Background: Ethyl Glucoronide (EtG) and Ethyl Sulfate (EtS) have shown promise as biomarkers for alcohol and may be sensitive enough for use with pregnant women in whom even low-level alcohol use is important. However, there have been reports of over-sensitivity of EtG and EtS to incidental exposure to sources such as alcohol-based hand sanitizer. Further, few studies have evaluated these biomarkers among pregnant women, in whom the dynamics of these metabolites may differ.

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.

Acceptability of a computerized brief intervention for alcohol among abstinent but at-risk pregnant women.

Background: Limitations in time and training have hindered widespread implementation of alcohol-based interventions in prenatal clinics. Also, despite the possibility of underreporting or relapse, many at-risk women report that they quit drinking after pregnancy confirmation so that interventions focusing on current drinking may seem unnecessary. The Computerized Brief Intervention for Alcohol Use in Pregnancy (C-BIAP) was designed to (a) be implemented via a handheld device in prenatal clinics, and (b) use a modified brief intervention strategy with women who screen at-risk but report no current drinking.

A randomized study of the effect of anonymity, quasi-anonymity, and Certificates of Confidentiality on postpartum women's disclosure of sensitive information.

Background: Under-reporting of substance use and other sensitive information is a substantial threat to internal study validity, particularly during the perinatal period. Anonymous approaches are associated with greater disclosure but are incompatible with longitudinal follow-up. Alternative approaches include use of a U.

Computer-delivered screening and brief intervention (e-SBI) for postpartum drug use: a randomized trial.

Electronic screening and brief intervention (e-SBI) approaches for substance use have shown early promise. This trial was designed to replicate previous findings from a single 20-minute e-SBI for drug use among postpartum women. A total of 143 postpartum, primarily low-income African-American women meeting criteria for drug use, were randomly assigned to either a tailored e-SBI or a time-matched control condition.

Prevalence and Perceived Financial Costs of Marijuana versus Tobacco use among Urban Low-Income Pregnant Women.

Objective: To examine the relative prevalence of marijuana and tobacco use among low-income post-partum women, using self-report, urine, and hair testing data; and to further explore perceptions of the substances among postpartum women by evaluating perceived risk and monetary cost of prenatal marijuana versus tobacco use.

Methods: Data from two studies were available for a total of 100 (Study 1) and 50 (Study 2) low-income, primarily African-American post-partum women. Study 1 participants completed brief self-report measures of substance use as well as urine and hair samples; study 2 participants completed a brief opinion survey regarding the risks and monetary costs of prenatal marijuana use.

A randomized trial of the effects of anonymity and quasi anonymity on disclosure of child maltreatment-related outcomes among postpartum women.

Anonymity may facilitate disclosure of maltreatment-related variables among parents, particularly in the perinatal period. This study was conducted in order to (a) confirm the effect of anonymity on commonly used measures in the field of child maltreatment; (b) examine the extent to which quasi anonymity (in which identifying information is collected but not linked to research data) can also facilitate disclosure on maltreatment-related measures; and (c) examine potential explanatory mechanisms of any association between level of anonymity and disclosure. This study further sought to evaluate these associations in the perinatal period, a crucial point for intervention that is also a time when rates of disclosure may be particularly low.

Commission versus receipt of violence during pregnancy: associations with substance abuse variables.

The tendency for women to report both commission and receipt of violence is an understudied phenomenon. In particular, little is known about individual differences as a function of commission vs. receipt of partner violence among pregnant women.