A culturally tailored intervention to reduce risk of alcohol-exposed pregnancies in American Indian communities: Rationale, design, and methods

Jessica D. Hanson, Kyra Oziel, Michelle Sarche, Richard F. MacLehose, Robert Rosenman, Dedra Buchwald

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Introduction: Prenatal exposure to alcohol can cause lifelong physical and cognitive challenges in the form of fetal alcohol syndrome and other fetal alcohol spectrum disorders (FASDs). The prevention of prenatal alcohol exposure is thus a public health priority – and one that should account for the particular needs of subpopulations, including in American Indian/Alaska Native (AI/AN) communities. Prior to conception, alcohol-exposed pregnancy prevention is accomplished by encouraging the reduction or elimination of risky alcohol use and/or promoting effective contraceptive use among risky drinkers who could become pregnant. The current study builds on promising findings about the impact of the Centers for Disease Control and Prevention CHOICES intervention with AI/AN communities by implementing a randomized control trial of Native CHOICES, a cultural adaptation of CHOICES, with AI/AN women in a rural reservation community. Methods: AI/AN women aged 18–44 who are at-risk for an alcohol-exposed pregnancy are being recruited. Participants are randomized in 1:1 proportion to the intervention and a services-as-usual, waitlist control condition. The Native CHOICES intervention consists of 2 motivational interviewing (MI) sessions, an elective contraception counseling session, and electronic messaging to boost the effects of MI. Data are collected at baseline and at 6 weeks, 3 months, and 6 months post-baseline. Those assigned to the control group are eligible to enroll in Native CHOICES following the completion of the 6 months post-baseline data collection. In addition to testing intervention effectiveness, the study is designed to yield a comprehensive economic evaluation, which will provide important information regarding the financial feasibility and sustainability of Native CHOICES for healthcare systems serving AI/ANs.

Original languageEnglish (US)
Article number106351
JournalContemporary Clinical Trials
Early online dateMar 8 2021
StatePublished - May 2021

Bibliographical note

Publisher Copyright:
© 2021 Elsevier Inc.


  • Alcohol
  • Alcohol-exposed pregnancy
  • American Indian tribes
  • CHOICES intervention
  • Contraception
  • Prevention of fetal alcohol spectrum disorders


Dive into the research topics of 'A culturally tailored intervention to reduce risk of alcohol-exposed pregnancies in American Indian communities: Rationale, design, and methods'. Together they form a unique fingerprint.

Cite this