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Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services
BACKGROUND: The aim of this study was to examine the effect of a practice change intervention to support the implementation of guideline-recommended care for addressing alcohol use in pregnancy on self-reported alcohol use during pregnancy. METHODS: A randomized, stepped-wedge controlled trial in th...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9429389/ https://www.ncbi.nlm.nih.gov/pubmed/36045392 http://dx.doi.org/10.1186/s13011-022-00490-2 |
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author | Tsang, Tracey W. Kingsland, Melanie Doherty, Emma Wiggers, John Attia, John Wolfenden, Luke Dunlop, Adrian Tully, Belinda Symonds, Ian Rissel, Chris Lecathelinais, Christophe Elliott, Elizabeth J. |
author_facet | Tsang, Tracey W. Kingsland, Melanie Doherty, Emma Wiggers, John Attia, John Wolfenden, Luke Dunlop, Adrian Tully, Belinda Symonds, Ian Rissel, Chris Lecathelinais, Christophe Elliott, Elizabeth J. |
author_sort | Tsang, Tracey W. |
collection | PubMed |
description | BACKGROUND: The aim of this study was to examine the effect of a practice change intervention to support the implementation of guideline-recommended care for addressing alcohol use in pregnancy on self-reported alcohol use during pregnancy. METHODS: A randomized, stepped-wedge controlled trial in three clusters (sectors) within the Hunter New England Local Health District (NSW, Australia). We evaluated a practice change intervention that supported the introduction of a new model of care for reducing alcohol use in pregnancy, consistent with local and international guidelines, and implemented in random order across the sectors. Each week throughout the study period, pregnant women who attended any public antenatal services within the previous week, for a 27–28 or 35–36 week gestation visit, were randomly sampled and invited to participate in the survey. The intended intervention for all women was Brief advice (to abstain from alcohol and information about potential risks). Women identified as medium-risk alcohol consumers using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) were to be offered referral to a phone coaching service, and women identified as high-risk were to be offered referral to a Drug and Alcohol Service. Rates of self-reported alcohol use (AUDIT-C risk level and special occasion drinking) were summarized and compared in groups of women pre-intervention and post-intervention using multivariable logistic regression. RESULTS: Surveys were completed by 1309 women at pre-intervention and 2540 at post-intervention. The majority of women did not drink during pregnancy (pre-intervention: 89.68%; post-intervention: 90.74%). There was no change in the proportion of women classified as No risk from drinking (AUDIT-C score = 0) or Some risk from drinking (AUDIT-C score ≥ 1) pre- or post-intervention (p = 0.08). However, a significant reduction in special occasion drinking was observed (pre-intervention: 11.59%; post-intervention: 8.43%; p < 0.001). CONCLUSIONS: Special occasion drinking was reduced following implementation of guideline-recommended care. Failure to change other patterns of alcohol use in pregnancy may reflect barriers to implementing the model of care in antenatal care settings and the need to address other social determinants of alcohol use. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (registration number: ACTRN12617000882325; date: 16 June 2017). |
format | Online Article Text |
id | pubmed-9429389 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-94293892022-09-01 Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services Tsang, Tracey W. Kingsland, Melanie Doherty, Emma Wiggers, John Attia, John Wolfenden, Luke Dunlop, Adrian Tully, Belinda Symonds, Ian Rissel, Chris Lecathelinais, Christophe Elliott, Elizabeth J. Subst Abuse Treat Prev Policy Research BACKGROUND: The aim of this study was to examine the effect of a practice change intervention to support the implementation of guideline-recommended care for addressing alcohol use in pregnancy on self-reported alcohol use during pregnancy. METHODS: A randomized, stepped-wedge controlled trial in three clusters (sectors) within the Hunter New England Local Health District (NSW, Australia). We evaluated a practice change intervention that supported the introduction of a new model of care for reducing alcohol use in pregnancy, consistent with local and international guidelines, and implemented in random order across the sectors. Each week throughout the study period, pregnant women who attended any public antenatal services within the previous week, for a 27–28 or 35–36 week gestation visit, were randomly sampled and invited to participate in the survey. The intended intervention for all women was Brief advice (to abstain from alcohol and information about potential risks). Women identified as medium-risk alcohol consumers using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) were to be offered referral to a phone coaching service, and women identified as high-risk were to be offered referral to a Drug and Alcohol Service. Rates of self-reported alcohol use (AUDIT-C risk level and special occasion drinking) were summarized and compared in groups of women pre-intervention and post-intervention using multivariable logistic regression. RESULTS: Surveys were completed by 1309 women at pre-intervention and 2540 at post-intervention. The majority of women did not drink during pregnancy (pre-intervention: 89.68%; post-intervention: 90.74%). There was no change in the proportion of women classified as No risk from drinking (AUDIT-C score = 0) or Some risk from drinking (AUDIT-C score ≥ 1) pre- or post-intervention (p = 0.08). However, a significant reduction in special occasion drinking was observed (pre-intervention: 11.59%; post-intervention: 8.43%; p < 0.001). CONCLUSIONS: Special occasion drinking was reduced following implementation of guideline-recommended care. Failure to change other patterns of alcohol use in pregnancy may reflect barriers to implementing the model of care in antenatal care settings and the need to address other social determinants of alcohol use. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (registration number: ACTRN12617000882325; date: 16 June 2017). BioMed Central 2022-08-31 /pmc/articles/PMC9429389/ /pubmed/36045392 http://dx.doi.org/10.1186/s13011-022-00490-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Tsang, Tracey W. Kingsland, Melanie Doherty, Emma Wiggers, John Attia, John Wolfenden, Luke Dunlop, Adrian Tully, Belinda Symonds, Ian Rissel, Chris Lecathelinais, Christophe Elliott, Elizabeth J. Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services |
title | Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services |
title_full | Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services |
title_fullStr | Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services |
title_full_unstemmed | Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services |
title_short | Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services |
title_sort | effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9429389/ https://www.ncbi.nlm.nih.gov/pubmed/36045392 http://dx.doi.org/10.1186/s13011-022-00490-2 |
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