Page 24 - Zero for nine: Reducing alcohol use during pregnancy via health counselling and Internet-based computer-tailored feedback

Chapter 1
in pregnancy was developed (Tzilos, Sokol, & Ondersma, 2011). Tzilos and colleagues found that users liked the program and appreciated the ease of use. Nevertheless, they did not find any significant difference on the reduction of alcohol use compared to an assessment-only condition.
Summarizing, HC has already shown to be effective in preventing prenatal alcohol use, but there is no effective HC protocol for Dutch midwives. As HC is demanding for health professionals, CT is an interesting alternative. However, the effectiveness of CT has thus far only been shown in other kinds of health behaviour. Based on these considerations, it was decided to develop an HC and a CT intervention to reduce alcohol consumption during pregnancy.
The content of the interventions to reduce prenatal alcohol use
A brief description of the interventions to reduce prenatal alcohol use which have been developed in this dissertation is provided in the following paragraphs.
HC intervention
The HC protocol was based on a health counselling protocol which has previously shown to be effective in smoking cessation during pregnancy (De Vries, et al., 2006a).
The HC protocol consisted of seven steps to be addressed by midwives in three feedback sessions. Feedback session 1 took place in the initial consultation of the midwife with the pregnant woman using alcohol and consisted of the first five steps. In step 1, the midwife assessed the amount and frequency of alcohol use of the pregnant woman before and during pregnancy and of her partner during pregnancy. She discussed with the pregnant woman whether she was motivated to stop drinking alcohol during her pregnancy. In step 2, the midwife asked women
22