The health-related, social, and financial costs of drug abuse are well known; these costs are only multiplied when perinatal drug use also places an infant at risk, both prenatally and postnatally. A wide range of relevant programs exist, but are not able to either (a) reach all women who are in need of treatment, or (b) engage and retain many of those they do identify and intend to treat. However, combining techniques from brief motivational interventions and interactive computer-based models may prove effective--particularly when applied in a primary care setting, allowing an extremely high proportion of at-risk women to be intervened upon. The goal of this exploratory/developmental proposal is to develop a low-cost, highly adaptable brief motivational intervention for perinatal drug abuse via embedding motivational principles in a self-contained interactive computer system. The Motivation Enhancement System (MES) will utilize a touch-screen, audio enhancement, and an interactive narrator to guide women in the immediate postpartum period through evaluation (thus facilitating self-report) and a one-time motivational intervention. A taxi voucher will be provided to further facilitate entry into treatment, and multiple tailored self-help mailings will be issued following discharge. If validated, this intervention could offer a highly cost-effective, replicable, and prescriptive method for increasing self-change and treatment involvement in drug abusers. Following development of the MES, a preliminary pilot phase will study the use of the MES with postpartum drug-using women and make necessary modifications, using data from participant debriefings and a single-case research design. After optimization of the MES, a clinical trial will randomly assign 120 postpartum drug-using women into treatment or assessment only conditions, with a 3-month blinded follow up to evaluate intervention effects on drug use, readiness to change, and consequences of drug use. Toxicological and self-report measures, as well as objective analysis of infant development, will be utilized. Participants will be lower socioeconomic status urban women recruited from WSU's Hutzel Hospital, where universal meconium screening has revealed a 44 percent rate of prenatal drug exposure.
| Ondersma, Steven J; Grekin, Emily R; Svikis, Dace (2011) The potential for technology in brief interventions for substance use, and during-session prediction of computer-delivered brief intervention response. Subst Use Misuse 46:77-86 |
| Tzilos, Golfo K; Grekin, Emily R; Beatty, Jessica R et al. (2010) Commission versus receipt of violence during pregnancy: associations with substance abuse variables. J Interpers Violence 25:1928-40 |
| Grekin, Emily R; Ondersma, Steven J (2009) The relationship between prenatal care, personal alcohol abuse and alcohol abuse in the home environment. Drugs (Abingdon Engl) 16: |
| Ondersma, Steven J; Svikis, Dace S; Schuster, Charles R (2007) Computer-based brief intervention a randomized trial with postpartum women. Am J Prev Med 32:231-8 |
| Ondersma, Steven J; Chase, Sara K; Svikis, Dace S et al. (2005) Computer-based brief motivational intervention for perinatal drug use. J Subst Abuse Treat 28:305-12 |
