Page 28 - Zero for nine: Reducing alcohol use during pregnancy via health counselling and Internet-based computer-tailored feedback
P. 28
Chapter 1
mailings, supported by the KNOV, promotion in the Dutch Journal for Midwifery, expert meetings and conferences informed midwives about the interventions. Midwifery practices interested in the interventions could sign up for participation and refer their clients to the intervention website. On this website, pregnant women could register and were subsequently assigned to one of the interventions. The midwives of pregnant women assigned to the HC intervention were notified of their clients’ participation, implying that they could start the HC intervention with these clients; the pregnant women assigned to the CT intervention automatically received programmed emails with CT feedback.
The effectiveness of the HC and CT intervention was tested with a three- arm cluster randomized trial comparing a HC and a CT group to a control group, receiving usual care (UC) from their midwives. Measurements took place at baseline (T0) and at three (T1) and six months (T2) after baseline. During all measurements, participants had to complete an online questionnaire via the study website. The primary outcome of the study was alcohol use during pregnancy (yes/no) at three and six month follow-up. The secondary outcome was the average weekly alcohol consumption since the previous questionnaire, assessed with the Quantity Frequency-Variability (QFV) questionnaire (Lemmens, Tan, & Knibbe, 1992), also at three and six month follow-up.
With this effect evaluation, the present dissertation aimed to answer the following research questions:
In this project, also a process evaluation was conducted to assess the extent of the implementation of the HC intervention by midwives. For this purpose, semi-structured telephone interviews were conducted with all midwives who participated in the effectiveness trial. This evaluation took place after the 6 month follow-up measurement of the
10. Is HC provided by midwives effective for Dutch women to stop or reduce their alcohol use in pregnancy?
11. Is CT effective for Dutch women to stop or reduce their alcohol use in pregnancy?
26
