Trial reportAmerican journal of preventive medicine2017
Preventing Alcohol and Tobacco Exposed Pregnancies: CHOICES Plus in Primary Care.
Trial report in American journal of preventive medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01032772 (ChoicesPlus), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
ChoicesPlus: Preconception Approach to Reducing Alcohol- and Tobacco-Exposed Pregnancy
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Effectiveness of preconception interventions in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Pooled it
- Decreased Alcohol Consumption in an Implementation Study of Computerized Brief Intervention among HIV Patients in Clinical Care.AIDS and behavior · 2021Trial
- The Role of Acculturation and Alcohol Problems on Frequency of Cannabis Use Among Latinas at Risk of an Alcohol-Exposed Pregnancy.Substance use & misuse · 2019Trial
- Intervention Models and Behaviour Change Techniques to Reduce the Risk of Alcohol Exposed Pregnancies: A Systematic Review of Interventions for Non-pregnant Women.Journal of prevention (2022) · 2026Review
- Linking Reductions in Alcohol and Birth Control Use Risk Behavior to Prevention of Alcohol-Exposed Pregnancy: A Population-Level Simulation of Preconceptual Prevention Programs.Alcohol, clinical & experimental research · 2026Article
- Commentary on "A randomized controlled trial of native CHOICES: Impact on alcohol-exposed pregnancy (AEP) risk reduction among American Indian and Alaska Native women" by Hanson and colleagues.Alcohol, clinical & experimental research · 2025Article
- Integrating routine screening for pregnancy intention and contraceptive use into care of women who use alcohol or other drugs.Drug and alcohol review · 2025Article
- Independent and Combined Effects of Prenatal Alcohol Exposure and Prenatal Stress on Fetal HPA Axis Development.International journal of molecular sciences · 2024Article
- Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention.Tobacco induced diseases · 2024Article
- Reducing Prenatal Alcohol Exposure and the Incidence of FASD: Is the Past Prologue?Alcohol research : current reviews · 2023Review
- Association of Prepregnancy Substance Use and Substance Use Disorders with Pregnancy Timing and Intention.Journal of women's health (2002) · 2022Article
- Effectiveness of preconception care interventions in primary care: a systematic review protocol.BJGP open · 2022Article
- Commentary on Allen et al. (2020): Cannabis use during pregnancy-the importance of a life-course health disparities framework.Addiction (Abingdon, England) · 2020Article
- Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women.Alcohol research : current reviews · 2020Review
- Is Periconceptional Substance Use Associated with Unintended Pregnancy?Women's health reports (New Rochelle, N.Y.) · 2020Article
- The Preconception Period analysis of Risks and Exposures Influencing health and Development (PrePARED) consortium.Paediatric and perinatal epidemiology · 2019Article
- CHOICES-TEEN: Reducing Substance-Exposed Pregnancy and HIV among Juvenile Justice Adolescent Females.Research on social work practice · 2019Article
- Changing multiple health risk behaviors in CHOICES.Preventive medicine reports · 2018Article
- Prevalence of alcohol use in pregnant women with substance use disorder.Drug and alcohol dependence · 2018Article
- Alcohol use and problems among Latinas at risk of an alcohol-exposed pregnancy: The role of acculturation and interpersonal factors.Journal of ethnicity in substance abuseArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
introductionAlcohol and tobacco use are common among U.S. women, yet if used during pregnancy these substances present significant preventable risks to prenatal and perinatal health. Because use of alcohol and tobacco often continue into the first trimester and beyond, especially among women with unintended pregnancies, effective evidence-based approaches are needed to decrease these risk behaviors. This study was designed to test the efficacy of CHOICES Plus, a preconception intervention for reducing the risk of alcohol- and tobacco-exposed pregnancies (AEPs and TEPs). STUDY
designRCT with two intervention groups: CHOICES Plus (n=131) versus Brief Advice (n=130). Data collected April 2011 to October 2013. Data analysis finalized February 2016. SETTING/
participantsSettings were 12 primary care clinics in a large Texas public healthcare system. Participants were women who were non-sterile, non-pregnant, aged 18-44 years, drinking more than three drinks per day or more than seven drinks per week, sexually active, and not using effective contraception (N=261). Forty-five percent were smokers.
interventionInterventions were two CHOICES Plus sessions and a contraceptive visit or Brief Advice and referral to community resources.
main outcome measuresPrimary outcomes were reduced risk of AEP and TEP through 9-month follow-up.
resultsIn intention-to-treat analyses across 9 months, the CHOICES Plus group was more likely than the Brief Advice group to reduce risk of AEP with an incidence rate ratio of 0.620 (95% CI=0.511, 0.757) and absolute risk reduction of -0.233 (95% CI=-0.239, -0.226). CHOICES Plus group members at risk for both exposures were more likely to reduce TEP risk (incidence rate ratio, 0.597; 95% CI=0.424, 0.840 and absolute risk reduction, -0.233; 95% CI=-0.019, -0.521).
conclusionsCHOICES Plus significantly reduced AEP and TEP risk. Addressing these commonly co-occurring risk factors in a single preconception program proved both feasible and efficacious in a low-income primary care population. Intervening with women before they become pregnant could shift the focus in clinical practice from treatment of substance-exposed pregnancies to prevention of a costly public health concern.
trial registrationThis study is registered at clinicaltrials.gov NCT01032772.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.