Page 27 - Zero for nine: Reducing alcohol use during pregnancy via health counselling and Internet-based computer-tailored feedback

feedback. For example, participants who considered alcohol abstinence 1 advantageous for the development of the baby were confirmed in their
answer and were informed that prenatal alcohol use may impede the
baby’s development by causing physical or mental impairment.
Feedback 3 took place six weeks after Feedback 2. In this session, the participant’s alcohol use and her determinants to abstain from prenatal alcohol use were reassessed. The participant received feedback which was tailored to changes with the determinants assessed in the baseline questionnaire. Information was presented on why it is important to remain abstinent from alcohol during the remainder of her pregnancy and tips were provided for maintaining this behaviour change. Participants were again given the opportunity to make action and coping plans to carry out the behaviour change and cope with difficult situations.
Pre-tests of the interventions
The midwives’ protocol of the HC intervention was pretested among five midwives and the CT intervention was pretested among five pregnant women using alcohol. The pre-tests yielded useful findings, for example about unclear questions and formulations both in the protocol and in the CT intervention. In addition, the pre-test of the CT intervention revealed that pregnant women using alcohol are highly sensitive when they believe that their alcohol use is being overestimated or when they sense that they are thought to be alcohol dependent. These findings led to an improvement of the texts in the final versions of the HC protocol and CT intervention.
Effect evaluation
After the development of the two interventions to reduce prenatal alcohol use, a plan for program use was developed, including adoption and implementation. In this plan, the collaboration with midwives and their professional association (KNOV) was central. Several large-scale
General Introduction
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