Effect of a Communication Intervention on Alcohol Use During Pregnancy in Post Conflict Northern Uganda: a Quasi Experimental Study

Overview

Journal Subst Abuse Treat Prev Policy

Publisher Biomed Central

Specialty Psychiatry

Date 2022 Dec 12

PMID 36503676

Authors

Apophia Agiresaasi

Goretti Nassanga

Gakenia Wamuyu Maina

Juliet Kiguli

Elizabeth Nabiwemba

Noah Kiwanuka

Aggrey Mukose

Nazarius Mbona Tumwesigye

Affiliations

Soon will be listed here.

Abstract

Background: Alcohol use during pregnancy is a preventable risk factor for Fetal Alcohol Spectrum disorders. Psycho-social and educational interventions have been reported to enable women reduce alcohol intake levels during pregnancy and help improve some health outcomes of unhealthy alcohol use. We set out to assess the effect of a communication intervention on alcohol use during pregnancy in post conflict northern Uganda.

Methods: The study employed a quasi - experimental design to assess the effect of a community health worker led communication strategy on pregnant women's knowledge, attitudes and various patterns of alcohol use using Difference in Difference(DiD). 420 respondents were recruited at baseline as at endline.

Results: The communication messages were significantly associated with reduced odds of binge drinking (P = 0.018; OR = 0.09; CI = 0.012-0.66). Also those who received the intervention were less likely to drink frequently (P = 0.80; OR = 0.75; 95%CI = 0.074-7.5) or be harmful alcohol users(P = 0.948). The intervention also positively influenced having fair (β =0.49;P = 0.217;RRR =1.63)or adequate knowledge(β = 0.89;P = 0.25;RRR = 2.44) and having positive(β = 0.37;RRR =1.44;P = 0.46) or fair attitude(β = 0.19;RRR = 1.21; P = 0.693) although not to a significant level.

Conclusions: The communication intervention affected some patterns of alcohol use among pregnant women and not others. Our results contribute to existing evidence that communication interventions are a promising approach in reduction of alcohol exposed pregnancies. Interventions aimed at promoting alcohol abstinence during pregnancy should be implemented alongside other strategies that address factors that influence pregnant women to drink to achieve maximum results.

References

Chersich M, Urban M, Olivier L, Davies L, Chetty C, Viljoen D . Universal prevention is associated with lower prevalence of fetal alcohol spectrum disorders in Northern Cape, South Africa: a multicentre before-after study. Alcohol Alcohol. 2011; 47(1):67-74. DOI: 10.1093/alcalc/agr145. View

Harris A, McGregor J, Perencevich E, Furuno J, Zhu J, Peterson D . The use and interpretation of quasi-experimental studies in medical informatics. J Am Med Inform Assoc. 2005; 13(1):16-23. PMC: 1380192. DOI: 10.1197/jamia.M1749. View

Conigrave K, Saunders J, Reznik R . Predictive capacity of the AUDIT questionnaire for alcohol-related harm. Addiction. 1995; 90(11):1479-85. DOI: 10.1046/j.1360-0443.1995.901114796.x. View

Penfold R, Zhang F . Use of interrupted time series analysis in evaluating health care quality improvements. Acad Pediatr. 2013; 13(6 Suppl):S38-44. DOI: 10.1016/j.acap.2013.08.002. View

Jacobsen B, Lindemann C, Petzina R, Verthein U . The Universal and Primary Prevention of Foetal Alcohol Spectrum Disorders (FASD): A Systematic Review. J Prev (2022). 2022; 43(3):297-316. PMC: 9114092. DOI: 10.1007/s10935-021-00658-9. View

Symons M, Pedruzzi R, Bruce K, Milne E . A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities. BMC Public Health. 2018; 18(1):1227. PMC: 6215602. DOI: 10.1186/s12889-018-6139-5. View

Agiresaasi A, Tumwesigye N, Nabiwemba E, Kiguli J, Maina G, Nassanga G . Alcohol use during pregnancy in post-conflict northern Uganda: pregnant women's experiences and provider perceptions. Subst Abuse Treat Prev Policy. 2021; 16(1):84. PMC: 8577008. DOI: 10.1186/s13011-021-00418-2. View

Wubetu A, Habte S, Dagne K . Prevalence of risky alcohol use behavior and associated factors in pregnant antenatal care attendees in Debre Berhan, Ethiopia, 2018. BMC Psychiatry. 2019; 19(1):250. PMC: 6693166. DOI: 10.1186/s12888-019-2225-1. View

Agiresaasi A, Nassanga G, Maina G, Kiguli J, Nabiwemba E, Tumwesigye N . Various forms of alcohol use and their predictors among pregnant women in post conflict northern Uganda: a cross sectional study. Subst Abuse Treat Prev Policy. 2021; 16(1):3. PMC: 7780649. DOI: 10.1186/s13011-020-00337-8. View

10.

Sarman I . Review shows that early foetal alcohol exposure may cause adverse effects even when the mother consumes low levels. Acta Paediatr. 2018; 107(6):938-941. DOI: 10.1111/apa.14221. View

11.

Saunders J, Aasland O, Babor T, De la Fuente J, Grant M . Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993; 88(6):791-804. DOI: 10.1111/j.1360-0443.1993.tb02093.x. View

12.

Oei J . Alcohol use in pregnancy and its impact on the mother and child. Addiction. 2020; 115(11):2148-2163. DOI: 10.1111/add.15036. View

13.

Bazzo S, Battistella G, Riscica P, Moino G, Marini F, Geromel M . Evaluation of the impact of the image used in a communication campaign to raise awareness about the effects of alcohol use during pregnancy. Alcohol Alcohol. 2012; 47(6):657-62. DOI: 10.1093/alcalc/ags051. View

14.

Robertson S, Valadez J . Global review of health care surveys using lot quality assurance sampling (LQAS), 1984-2004. Soc Sci Med. 2006; 63(6):1648-60. DOI: 10.1016/j.socscimed.2006.04.011. View

15.

Popova S, Lange S, Probst C, Gmel G, Rehm J . Global prevalence of alcohol use and binge drinking during pregnancy, and fetal alcohol spectrum disorder. Biochem Cell Biol. 2017; 96(2):237-240. DOI: 10.1139/bcb-2017-0077. View

16.

OConnor M, Whaley S . Brief intervention for alcohol use by pregnant women. Am J Public Health. 2006; 97(2):252-8. PMC: 1781394. DOI: 10.2105/AJPH.2005.077222. View

17.

Briesacher B, Soumerai S, Zhang F, Toh S, Andrade S, Wagner J . A critical review of methods to evaluate the impact of FDA regulatory actions. Pharmacoepidemiol Drug Saf. 2013; 22(9):986-94. PMC: 3825208. DOI: 10.1002/pds.3480. View

18.

Floyd R, Weber M, Denny C, OConnor M . Prevention of fetal alcohol spectrum disorders. Dev Disabil Res Rev. 2009; 15(3):193-9. DOI: 10.1002/ddrr.75. View

19.

Stade B, Bailey C, Dzendoletas D, Sgro M, Dowswell T, Bennett D . Psychological and/or educational interventions for reducing alcohol consumption in pregnant women and women planning pregnancy. Cochrane Database Syst Rev. 2009; (2):CD004228. PMC: 4164939. DOI: 10.1002/14651858.CD004228.pub2. View

20.

DeJong K, Olyaei A, Lo J . Alcohol Use in Pregnancy. Clin Obstet Gynecol. 2018; 62(1):142-155. PMC: 7061927. DOI: 10.1097/GRF.0000000000000414. View