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Abstract
CHOICES is an integrated behavioral intervention for prevention of prenatal alcohol exposure in women at high risk for alcohol-exposed pregnancies. The intervention uses motivational interviewing and cognitive-behavioral strategies, and targets adoption of effective contraception and reduction of alcohol use. The CHOICES intervention includes four manual-guided counseling sessions delivered by behavioral health counselors and one contraceptive session with a family planning clinician. CHOICES's efficacy has been established through a series of randomized controlled trials in settings including primary care, university hospital–based obstetrical/gynecology practices, urban jails, substance abuse treatment settings, and a media-recruited sample in three large cities. This article describes the CHOICES line of research including the epidemiology, feasibility, and efficacy studies. It also details the CHOICES intervention and the components of each session. In addition, the authors describe current studies testing modifications of the CHOICES intervention, the dissemination efforts to date, and implications for social work practice.
Notes
Funding for this study was provided by the Centers for Disease Control and Prevention (CDC). The authors acknowledge and thank the following Project CHOICES investigators and team members: Dr. Louise Floyd, Dr. Mark Sobell, Dr. Karen Ingersoll, Dr. Linda Sobell, and Dr. Mary Nettleman. The authors give special thanks to all of the CHOICES research assistants and counselors. The authors also thank Tom Umberger, LMSW, and Dr. Nanette Stephens for their outstanding help with this manuscript.