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Indirect Assessment and Intervention for Perinatal Drug Use: The Parent Health Project
Working title: WIDUS II
Funder: NIH-NIDA
Project expiration: 7/31/2015
This randomized controlled trial seeks to investigate the usefulness of an indirect screener for identifying recent mothers who could be at risk in a number of areas related to substance use. A positive screen gives the participant an opportunity to work with the tablet further by answering questions about their behaviors and motivations. They are able to receive strengths-based feedback, advice, and information concerning their risk areas while the tablet tailors its content to their demographics and responses. They are given an opportunity to reflect on their parenting strengths and weaknesses and create an action plan if they feel a change is necessary. Participants are followed-up at 3 months and 6 months post-partum to assess their use of substances, changes they might have made, and a multitude of other psychological and health-related behaviors

Computer-delivered SBIRT for alcohol use in pregnancy: Planning a Stage II trial
Working title: Healthy Pregnancy Study
Funder: NIH-NIDA
Project expiration: 3/31/2014
Steve Ondersma is Principal Investigator on a 3-year pilot clinical trial funded by the National Institute on Alcohol Abuse and Alcoholism to investigate how a screening and brief intervention delivered through a hand-held computer can change drinking behavior.  Dr. Ondersma uses the SBIRT (screening, brief intervention and referral for treatment) approach via smart phones and tablets to interact with high-risk mothers and help motivate them to change.

Computer-based SBIRT for marijuana use in pregnancy: Planning a Stage II trial
Working title: Healthy Pregnancy Detroit
Funder: NIH-NIDA
Project expiration: 6/30/2017
Steve Ondersma is funded by the National Institute on Drug Abuse to develop and test a technology-based screening and intervention program to decrease marijuana use during pregnancy. This is a Phase I clinical trial with 80 participants. The goal is to create a computerized, single-session screening, brief intervention and referral to treatment (i.e., SBIRT) that can be used in any clinic, plus tailored text-message reminders during pregnancy to discourage marijuana use.

Indirect Assessment and Intervention for Perinatal Drug Use: Cross-Validation of WIDUS
Working title: Cross-Validation of WIDUS
Funder: NIH-NIDA
Project expiration:
7/31/2015
Using a sample of high risk, primarily African-American urban women, we have developed a novel indirect screener that evaluates correlates of illicit drug use (such as smoking or emotional distress) rather than drug use itself. This phase of the larger randomized controlled trial aims to continue development and validation of the indirect screener for drug use in the perinatal period, via concomitant collection of screener protocols and hair/urine samples at baseline, with particular emphasis on building that screener’s ability to indirectly predict HIV risk.
 

Additional Projects

MOST: 
The MOST study is the first study of its kind to experimentally evaluate the role of common factors in computer-delivered interventions for high-risk alcohol use. The software used to create the interventions for this study are highly interactive and individualized, and rely heavily on realistic interactions with a three-dimensional, animated narrator that can mimic the more conversational nature of person-delivered brief interventions. Following the Multiphase Optimization Strategy (MOST), a factorial design model will test 32 combinations of 5 common intervention factors. These factors include empathy/positive regard and voice/narrator while also systematically varying the presence vs. absence of motivational content. This unique design element allows us to examine the relative therapeutic contribution of specific motivational strategies, vs. simply providing information about the problem. This study is the first e-intervention study to examine the role of common factors using random assignment to conditions involving different combinations of common factors. Virtually all existing common factors research is correlational. As a result, it is unclear whether certain types of clients elicit certain types of reactions from therapists (e.g., motivated clients may elicit more positive, empathic responses than unmotivated clients). Additionally, it is unclear whether ‘common factors,’ are the cause or the result of a successful therapy outcome (i.e., does empathy cause less alcohol use or does less alcohol use elicit more empathy). By using random assignment and systematically manipulating common factors—albeit in a unique context—the MOST study will break new ground in the study of the association between common factors and outcomes.

EtG: 
The presence of the biomarkers ethyl glucuronide (EtG) and ethyl sulfate (EtS) in the urine provides evidence of recent alcohol consumption or abstinence. Given that even a moderate amount of alcohol consumption during pregnancy is highly dangerous to the fetus, reliable and consistent EtG detection cutoffs are needed for women specifically of childbearing years. Using a calibrated alcohol administration and timed urine collection method, this study aims to determine the ability of a combined EtG/EtS assay and a singular EtG assay to indicate alcohol consumption in women of childbearing years. It also aims to acquire a better understanding of the window of detection for EtG, and the need for measuring both EtG and EtS metabolites.

PCC E-Intervention:
Preconception care (PCC) interventions identify risks to a woman’s health or pregnancy outcome through prevention and management. This is achieved by emphasizing the factors which must be acted on before conception to have maximal impact on the prevention of unwanted or substance exposed pregnancies. These factors include regular and consistent use of reliable birth control methods and forgoing use of alcohol, tobacco, marijuana, and other harmful drugs. The goal of this PCC E-intervention is to prevent substance exposed pregnancies through reduced substance use, effective contraception use, or both. Following the Multiphase Optimization Strategy (MOST), a factorial design model will test 4 combinations of 2 common intervention factors: Narration and Empathy. At-risk female participants in the pre-conception period will be randomly assigned interventions containing none, one or both of the two common factors and will then rate their intention to reduce substance use or begin regular effective contraception use. 100% of this study will be implemented online, and is the first study to utilize the mobile CIAS programming software.

LPICS:
The LoTTS Parent-infant Interaction Coding Scale (LPICS) is a brief coding system for measuring parent-child interactions. It is made up of 3 global scales rating the entire interactions (warmth, responsiveness and empathy) and behavior counts for the presence of 4 positive parenting behaviors (Looking, Touching, Talking to and Smiling at the child: LoTTS). The LPICS was designed to be relatively easy to use (with a day or less of training) and work in any setting or interaction between a caregiver and their infant or toddler. Current focus is on obtaining further reliability estimates to determine which aspects of the scale are best given the short duration of training and exploring its usefulness as a live coding system. Future studies will examine the validity of the measure in ongoing research study.

Positive Parenting Promotion in Pediatrics (4Ps):

Brief surveys were collected from pediatricians and parents in order to assess the need for and openness to technology-based behavioral health services for young children in pediatrics. Sixty pediatricians completed a brief survey designed to assess the need for behavioral health services, if time permits adequately addressing behavioral health concerns, and openness to using technology. Fifty parents, recruited at child cares centers, completed several brief surveys, including a help seeking survey (see survey here) designed to assess if they are using pediatrics, if they are using pediatrics for behavioral health questions, if they are using technology to get information about parenting and/or child behavior, and if they are open to using technology, pediatrics, and technology within pediatrics for behavioral health? Results will information future effort to design technology-based approaches to the promotion of positive parenting.