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Dimension and heart rate I

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Identifying pregnant women who drink alcoholic beverages Patricia Dolan Mullen, DrPH,a Joseph P. Carbonari, EdD: and Marianna C. Glenday, MPH' Houston, Texas This randomized 2 x 2 study compared disclosure rates of alcohol use with two response formats (multiple choice and dichotomous) and two communication channels (oral and written) in an adult prenatal population (N = 1078). The multiple choice question improved disclosure, regardless of channel, by 40% across white, African-American, and Hispanic subgroups. (AM J GBSTET GVNECOL 1991 ;165:1429-30.)

Key words: Prenatal risk assessment, prenatal history taking, self-reported alcohol consumption

Obstetricians need accurate information about their patients' alcohol consumption. Many pregnant women do not report use of alcohol,! and some physicians are reluctant to broach this sensitive area. Available screening tools for general patient populations are not very helpful with pregnant women 2 and provide information only about abusive drinking or alcoholism. Therefore we tested a question to identify all pregnant drinkers of alcohol, regardless of amount of consumption.

Material and methods Two response formats ("yes or no" and multiple choice, Table I) and two channels of questioning (oral and written) were compared, by means of a random-

Fmm the Center fm' Health Pm1notion Research and Dellelo-pment, School of Public Health, University of Texas Health Srience Cent!!'r at Houston," and the Department of Psychology, University of Houston.' Suppo-rted fry the American Heart Association. Texas Affiliate (grant No. 88G-258, Michael Wolf. Project Officer). The Kelsey-Seybold Clinic contributed personnel time for 18 months of subject intake. Receivedforpublication October 31.1990; rwised March 28, 1991; accepted April 22, 1991. Reprint requests: Patricia D. Mullen, D,.PH, Associate Pmfesso,. of Behavioral Sciences and Associate Director of Centerfa,. Health Promotion Resem'ch and Development, School of Public Health, University of Texas Health Science Center. Box 20186, Houston. TX

77225 611130442

Table I. Multiple choice question Which of the following statements best describes your use of any alcoholic beverages, including beer, wine, and hard liquor? Would you say: I. I drink regularly now-about the same amount as before finding out I was pregnant. 2. I drink regularly now, but I've cut down since 1 found out I was pregnant. 3. I drink every once in a while. 4. I have quit drinking since finding out 1 was pregnant. 5. I wasn't drinking around the time 1 found out I was pregnant, and I don't currently drink.

ized, 2 x 2 factorial design. In all study groups we combined the alcohol history question with questions about use of automobile safety belts, smoking, and illicit drugs. All study subjects were English-speaking women ~ 18 years old who were free of mental and sensory handicaps and who entered prenatal care at one of four multispecialty group satellite clinics between September 1988 and February 1990. The experiment was conducted during the first visit after confirmation of pregnancy. The experimental questions were embedded in the oral and written history questions. Prenatal history information was stripped of identifiers before being given to universitybased researchers, a procedure approved by the uni1429

November 1991 Am J Obstet Gynecol

1430 Mullen, Carbonari, and Glenday

versity and clinic human subjects protection committees. Results

Of 1206 pregnant women seen for care during the study, 1078 (89.4%) were eligible. The sample was Hispanic (14.7%), African-American (32.6%), and white, non-Hispanic (50.1%); married (82.5%); with a mean age of 28 years; with low parity (80.7% with

Identifying pregnant women who drink alcoholic beverages.

This randomized 2 x 2 study compared disclosure rates of alcohol use with two response formats (multiple choice and dichotomous) and two communication...
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