A randomized controlled trial of motivational interviewing to prevent risk for an alcohol-exposed pregnancy in the Western Cape, South Africa
Version of Record online: 11 FEB 2013
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction
Volume 108, Issue 4, pages 725–732, April 2013
How to Cite
Rendall-Mkosi, K., Morojele, N., London, L., Moodley, S., Singh, C. and Girdler-Brown, B. (2013), A randomized controlled trial of motivational interviewing to prevent risk for an alcohol-exposed pregnancy in the Western Cape, South Africa. Addiction, 108: 725–732. doi: 10.1111/add.12081
- Issue online: 18 MAR 2013
- Version of Record online: 11 FEB 2013
- Accepted manuscript online: 7 DEC 2012 10:12AM EST
- Manuscript Accepted: 28 NOV 2012
- Manuscript Revised: 26 JUN 2012
- Manuscript Received: 17 MAY 2012
- Centers for Disease Control and Prevention (CDC)
- family planning;
- motivational interviewing;
- South Africa
To test the effectiveness of motivational interviewing (MI) to reduce the risk of an alcohol exposed pregnancy (AEP) in a high-risk population.
Randomized controlled trial.
Rural population in the Western Cape, South Africa.
A total of 165 women aged 18–44 years at risk of AEP.
Five-session MI intervention.
Structured questionnaires were administered pre-intervention and at 3 and 12 months follow-up. The primary outcome measure was AEP at 12 months. Secondary outcomes were AEP at 3 months, and alcohol use and effective contraception at 3 and 12 months.
There was a significant difference in the decline in the proportion of women at risk for an AEP in the MI group at 3 months (50 versus 24.59%; P = 0.004), maintained at 12 months (50.82 versus 28.12%; P = 0.009). In an intention-to-treat analysis these differences were also significant (32.93 versus 18.07%; P = 0.029; and 37.80 versus 21.69%; P = 0.024, respectively). The odds ratio for no longer being at risk of an AEP (MI versus control) at 12 months was 2.64 [95% confidence interval (CI): 1.18–5.94]. In the intention-to-treat analysis this ratio was 2.19 (95% CI: 1.05–4.65).
A five-session motivational interviewing intervention was found to be effective with women at risk of an alcohol-exposed pregnancy, and could be implemented as part of routine primary care clinic services in similar populations. The message of ‘no alcohol in pregnancy’ should be adapted to include better family planning and early recognition of pregnancy.