A Randomized Controlled Trial of Native CHOICES: Impact on alcohol-exposed pregnancy risk reduction among American Indian and Alaska Native women
Dublin Core
Title
A Randomized Controlled Trial of Native CHOICES: Impact on alcohol-exposed pregnancy risk reduction among American Indian and Alaska Native women
Subject
Pregnant women--Alcohol use--Prevention
Electronic Resource Item Type Metadata
Journal Name
Alcohol, Clinical and Experimental Research
Volume
Vol. 49
Issue
No. 2
Publication Date
2025
Publisher
Wiley-Blackwell
Document Type
Journal article
Language
English
ISBN
29937175
Access
Open Access
View Source
Abstract
Background
Prevention of alcohol-exposed pregnancy (AEP) involves reducing risky alcohol consumption among women at-risk for pregnancy, using effective contraception among women drinking at risky levels to prevent pregnancy, or both. This study presents the outcomes of a randomized controlled trial assessing the efficacy of Native CHOICES, a culturally tailored adaptation of the CHOICES intervention, among American Indian/Alaska Native (AI/AN) women.
Methods
AI/AN women aged 18–44 who were at-risk for an AEP were randomly assigned in a 1:1 ratio to either the Native CHOICES intervention or a waitlist control group. Native CHOICES comprised two sessions of motivational interviewing and an elective contraception counseling session. Data were collected at baseline, and 6 weeks, 3 months, and 6 months postbaseline. Due to the pandemic, the intervention was at times delivered remotely.
Results
A total of 404 women participated: 199 in the control group and 205 in the intervention group. Sixty-seven percent of the intervention group received the intervention in-person, and 33% participated by telephone or video call. Sixty-four percent of women completed all follow-up visits. At the six-month follow-up, the intervention did not demonstrate a significant impact on AEP risk compared with the control arm when analyzing all the data (RR = 0.94; 95% confidence interval [CI]: 0.83–1.07). However, an exploratory subgroup analysis showed evidence of a reduction in AEP risk among participants who completed the study in-person before the COVID-19 pandemic (RR = 0.79; 95% CI: 0.63–0.98), which was not observed during or after the pandemic (RR = 1.06; 95% CI: 0.91–1.24).
Conclusions
The Native CHOICES intervention did not show evidence of effectiveness overall. However, exploratory analyses offer some evidence that the intervention was effective prior to the pandemic.
Prevention of alcohol-exposed pregnancy (AEP) involves reducing risky alcohol consumption among women at-risk for pregnancy, using effective contraception among women drinking at risky levels to prevent pregnancy, or both. This study presents the outcomes of a randomized controlled trial assessing the efficacy of Native CHOICES, a culturally tailored adaptation of the CHOICES intervention, among American Indian/Alaska Native (AI/AN) women.
Methods
AI/AN women aged 18–44 who were at-risk for an AEP were randomly assigned in a 1:1 ratio to either the Native CHOICES intervention or a waitlist control group. Native CHOICES comprised two sessions of motivational interviewing and an elective contraception counseling session. Data were collected at baseline, and 6 weeks, 3 months, and 6 months postbaseline. Due to the pandemic, the intervention was at times delivered remotely.
Results
A total of 404 women participated: 199 in the control group and 205 in the intervention group. Sixty-seven percent of the intervention group received the intervention in-person, and 33% participated by telephone or video call. Sixty-four percent of women completed all follow-up visits. At the six-month follow-up, the intervention did not demonstrate a significant impact on AEP risk compared with the control arm when analyzing all the data (RR = 0.94; 95% confidence interval [CI]: 0.83–1.07). However, an exploratory subgroup analysis showed evidence of a reduction in AEP risk among participants who completed the study in-person before the COVID-19 pandemic (RR = 0.79; 95% CI: 0.63–0.98), which was not observed during or after the pandemic (RR = 1.06; 95% CI: 0.91–1.24).
Conclusions
The Native CHOICES intervention did not show evidence of effectiveness overall. However, exploratory analyses offer some evidence that the intervention was effective prior to the pandemic.
Cataloger
Julia Arizono
Citation
“A Randomized Controlled Trial of Native CHOICES: Impact on alcohol-exposed pregnancy risk reduction among American Indian and Alaska Native women,” ICMGLT Digital Library, accessed November 3, 2026, https://library.icmglt.org/items/show/745.