Merrill Palmer Skillman Institute, Wayne State University, Detroit, Michigan.
Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, Michigan.
J Womens Health (Larchmt). 2019 Sep;28(9):1295-1301. doi: 10.1089/jwh.2018.7169. Epub 2019 Jan 18.
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. In this exploratory feasibility trial, pregnant women seeking prenatal care services and scoring positive for marijuana use risk ( = 45) were randomly assigned to e-SBI, text messaging, or e-SBI plus text messaging. We examined completion rates and acceptability ratings as a function of intervention condition and participant characteristics. All participants assigned to receive the e-SBI ( = 30) were able to complete it during the in-clinic baseline session. Participants assigned to text messaging ( = 30) received a median of 24 text messages before giving birth; 6 of 30 (20%) chose to end text messages before giving birth. Acceptability ratings for the e-SBI were high, with most being above 4.4 on a 5-point scale (., for ease of use, respectfulness, and helpfulness). Acceptability ratings for some aspects of the texting intervention were also high (., for ease of understanding and respectfulness). Participants in the combined e-SBI plus texting condition chose to stop messages at a rate of 13.3% (2 of 15), versus 26.7% (4 of 15) in the texting-only condition ( = 0.37). These two high-reach intervention elements showed strong feasibility and modest to high acceptability. Future efforts evaluating efficacy are warranted, and should specifically examine the possibility that combining text messaging with a brief intervention may promote retention.
目前，针对怀孕期间使用大麻的情况，尚无循证干预措施，尽管这是迄今为止孕妇最常使用的非法药物。由于缺乏寻求治疗的意识，再加上实施方面的挑战，高危孕妇能够获得任何干预措施的程度非常有限。本研究旨在评估两种高覆盖率的基于技术的干预措施的可行性和可接受性：电子筛查和简短干预（e-SBI）和定制短信服务，单独或联合使用。在这项探索性可行性试验中，接受产前保健服务且大麻使用风险呈阳性（ = 45）的孕妇被随机分配到 e-SBI、短信服务或 e-SBI 加短信服务组。我们根据干预条件和参与者特征，检查了完成率和可接受性评分。所有被分配接受 e-SBI 的参与者（ = 30）都能够在门诊基线阶段完成干预。被分配接受短信服务的参与者（ = 30）在分娩前收到了中位数为 24 条短信；30 人中的 6 人（20%）选择在分娩前停止短信服务。e-SBI 的可接受性评分较高，大多数在 5 分制上超过 4.4 分（., 用于易用性、尊重性和有用性）。短信干预的某些方面的可接受性评分也较高（., 用于易于理解和尊重性）。在联合 e-SBI 和短信服务组中，有 13.3%（2 人）的参与者选择停止信息，而在仅短信服务组中，有 26.7%（4 人）选择停止信息（ = 0.37）。这两种高覆盖率的干预元素表现出很强的可行性和适度到高度的可接受性。未来需要进行评估疗效的努力，应特别研究短信服务与简短干预相结合是否有可能提高保留率。
