Web-Based Intervention for Alcohol Use in Women of Childbearing Potential

Fetal alcohol spectrum disorders (FASDs), resulting from prenatal exposure to alcohol, are among the most common developmental disabilities in the United States occurring in as many as one in 100 children. Despite widespread educational efforts about the fetal health risks associated with prenatal alcohol use, recent estimates from the Centers for Disease Control and Prevention indicate that 10 percent of women who know they are pregnant report alcohol use. There is therefore a need for more effective education to reduce women’s use of alcohol before conception and during pregnancy.  

This project adapted an existing Web-based program aimed at reducing alcohol consumption in non-pregnant women who drink at risky levels. The project then examined the sustainability in reduced alcohol consumption between women who participated in the Web-based program and those who did not. The project was targeted to low-income women whose children and dependents received services through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in San Diego County, California.

The objectives of this project were to:

• Evaluate the effectiveness of the adapted Web-based assessment and intervention program in reducing risky alcohol consumption in non-pregnant women who have children or dependents enrolled in WIC by comparing rates of reduction in alcohol consumption between women who receive the Web-based feedback intervention and women who do not at 1 month post-baseline. 
• Evaluate the sustainability of reduction in alcohol consumption (number of risky-drinking occasions) between women who receive the Web-based feedback intervention and women who do not at 2 months post-baseline among women reporting a reduction at 1 month post-baseline.

A total of 150 non-pregnant women of reproductive age who consumed alcohol at a moderate risk level, defined as consuming greater than 3 drinks on more than 1 occasion in the prior month, were enrolled in the study. Participants ranged from 18-44 years-of-age, and 44 percent were English-speaking Latina. A Web-based assessment was completed by all of the women, who were then randomly assigned to either receive a personalized feedback intervention or general health information about alcohol consumption and FASD.  Personalized feedback included information on a woman’s alcohol consumption, health risks associated with risky alcohol use, and social norms. Followup occurred at 1 and 2 months after the initial assessment. 

Women in both groups reported similar and substantial reductions in the number of risky alcohol consumption occasions than the prior month, as well as in mean drinks per occasion than the previous two weeks. The project team theorized that the Web-based assessment itself, taken by all study participants, had an impact on drinking that was not significantly improved by the personalized feedback.   

This project was able to demonstrate that Web-based assessment of alcohol consumption among low-income women of reproductive age is feasible and acceptable. It provides a baseline for additional studies to test the effectiveness of Web-based assessments and interventions to reduce risky drinking behavior in women of reproductive age.