Lyn Blackshaw, John Anderson,

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Oregon BALANCE

• Lyn Blackshaw, John Anderson,
• Lesa Dixon-Gray, Emily Havel

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BALANCE

• Birth control
• ALcohol
• Awareness
• Negotiating
• Choices
• Effectively

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Binge Drinking

• A pattern of drinking alcohol that brings blood
  alcohol concentration (BAC) to 0.08 percent or
  above.
• For a typical adult, this pattern corresponds to
  consuming 5 or more drinks (male) or 4 or more
  drinks, (female) in about two hours.
• National Institute on Alcohol Abuse and
  Alcoholism (NIAAA)

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The Dangers of Binge DrinkingFor Women

• Death or injury due to falls, fires, drowning, or
  a drunk driving crash.
• Pregnancy or sexually transmitted diseases due to
  unintended sexual activity. (Frequent binge
  drinkers are five times more likely to have
  unplanned and unprotected sex.)
• Being the victim of rape, date rape or other
  assault.
• Death from alcohol poisoning.

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The Dangers of Risky Drinking and Sex

• When a woman engages in risky or binge drinking,
  is sexually active and doesnt use birth control,
  she is at greater risk for
• Becoming pregnant
• Having a baby with birth defects or brain damage
  caused by heavy drinking, such as Fetal Alcohol
  Syndrome

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• Over half of all pregnancies in the United States
  are unplanned.

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• Most women who drink
• alcohol will continue to drink
• until their pregnancy is
• confirmed, four to eight weeks
• after conception.
• (CD Summary Sept 2007)

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Background

• Alcohol is a leading preventable cause of birth
  defects in the United States.
• Many women continue to drink alcohol during the
  early critical weeks of gestation before they
  know they are pregnant.
• Some women continue to drink alcohol throughout
  their pregnancy, unaware that it can harm their
  baby.

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Project Summary

• Increase knowledge and awareness of the risks and
  consequences of an alcohol exposed pregnancy
  among sexually active and binge drinking college
  women.
• Using a Motivational Interviewing approach,
  encourage participants to set and maintain
  declared goals to decrease their drinking and
  increase their effective use of birth control
  methods.

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The Desired Outcomes

• Reduced risk of alcohol exposed pregnancies among
  at-risk women as measured by
• Improved birth control
• Reduced binge drinking

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Motivational Interviewing

• Refers to a counseling approach developed by
  clinical psychologists Professor William R
  Miller, Ph.D. and Professor Stephen Rollnick,
  Ph.D.
• A client-centered, directive method for enhancing
  intrinsic motivation to change by exploring and
  resolving ambivalence.

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Motivational Interviewing

• Motivational interviewing is non-judgmental,
  non-confrontational and non-adversarial.
• The approach attempts to increase the client's
  awareness of the potential problems caused,
  consequences experienced, and risks faced as a
  result of the behavior in question.

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Why College Women?

• The higher a womans educational level, the more
  likely she is to drink.
• Of all Oregon women ages 18-44 who reported
  drinking
• 65 are college graduates
• 25 had not completed high school
• (Oregon Behavioral Risk Factor Surveillance
  System)

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College Students and Alcohol

• In a 2005 nationwide survey, 44.8 of college
  students were classified as binge drinkers
• Binge drinking peaks from ages 18 to 23
• 2005 SAMHSA National Survey on Drug Use and
  Health

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The Locations

• Participants from the University of Oregon
  (16,674 undergraduate students, 52 women )
• Western Oregon University (4,459 undergraduate
  students, 58 women )

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The Interviewers

• Three interventionists with masters level
  training in counseling
• Provided counseling to participants in the form
  of two motivational interviewing sessions
• Received monthly clinical supervision and ongoing
  Motivational Interviewing training

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The Materials

• Blood Alcohol Level Chart
• Birth Control Flip Chart
• Participant Guide
• Information about alcohol and birth control
• Drink size information
• Drink costs and calories

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Blood Alcohol Table(Women)

• After 1 hour of drinking and Body Weight

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Useless Observation

• Statistics show that teen pregnancy drops off
  significantly after age 25.
• (Mary Acer, Republican state senator from
  Colorado Springs)

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The Screening Questions

• 1. During the past 3 months, was there ever a
  time when you consumed 4 or more alcoholic drinks
  on any one drinking occasion?
  
• 2. During the past 3 months, was there ever a
  time when you consumed 8 or more alcoholic drinks
  in one week?
  
• 3. As far as you know, are you physically able to
  get pregnant?

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Screening Questions Cont.

• 4. Have you had sexual intercourse during the
  past 3 months?
• 5. When you had sexual intercourse in the past
  three months how often did you use contraceptives?

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The Participants
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(No Transcript)
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The Recruitment
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The Ages
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The Intervention

• Session 1 ----Face-to-Face (60 minutes)
• Reminder phone call 1 month later
• Session 2 ----Face-to-Face (20 minutes)
• 3 months after Session 1
• Incentives
• U of O Gift cards given after Session 1 and at
  the end of the intervention
• WOU One gift card after Session 2

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Session 1Comments

• Drinking is part of the culture.
• I consider myself a light drinker.
• Im not interested in changing my drinking
  behavior.

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Session 1

• Participant acknowledged that she blacked out
  last Friday but she felt that since other
  students drink much more than she does that she
  doesnt have a problem.
• Interviewer note She seems to be a high risk
  drinker, frequently binging but not identifying
  this as an area of her life that she would like
  to change.

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Alcohol Use Most Drinks in One Day,30-day
retrospective
P 0.005, N 214
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Alcohol UseInstances of 4 or More Drinks,30-day
retrospective
P 0.016, N 214
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Readiness to Drink Less

• Readiness to drink 3 or less (scale 1-10)

P 0.017, N 205
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Readiness to Use Birth ControlScale of 1-10
P 0.70, N 208
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Effective Birth Control Use
P 0.10 P 0.27
n 215
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Not At-Risk for Alcohol Exposed Pregnancy30-day
and 3-month retrospective
P 0.88
P 0.77
N 215
As defined by the CDC at the grantees meeting
no instances of risky drinking or effective use
of birth control. In our data risky drinking is 4
or more drinks in a row, effective use of birth
control is at least one method used effectively.
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Session 2Comments

• 
  
  
• I didnt know about early term pregnancies being
  affected. I told a friend who thought she might
  be pregnant. I also noticed that Im monitoring.
  Is it time to stop or not? Weve had a few big
  parties and I kept thinking about this. So, when
  I am enjoying being buzzed at 3 then I realize
  that I probably dont need a 4th. --Participant
• After our conversation I really am conscious of
  how much I drink each time Im out with friends.
  I havent gone past three drinks in a long time
  and I try to drink them slowly. Ive been
  listening to my body and Ive started to talk to
  some of my friends about alcoholism.
  --Participant

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Session 2

• I didnt think this study would have affected me
  as much as it did. Participant
• I did talk to a few friends about the
  interviewI do remember being really excited
  after the interview. I have decided that
  drinking is too much of a high risk game to take
  lightly.Ive figured out that getting
  completely drunk (to the point of not remembering
  what happened) is never again going to be an
  option for me EVER. ---Participant

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The Results

• Women who said the BALANCE interview and Blood
  Alcohol Table got them thinking and being more
  careful 95 (93)
• Women who discussed what they had learned in
  Balance with their friends 39 (38)
• Those who claimed to have reduced their drinking
  at the Second Interview 52 (51)

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The Results

• BALANCE documented a decrease in drinking in the
  intervention population
• Birth control use was high, however effective use
  was lower
• Women who completed both
• interviews showed approximately the
• same risk of AEP

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The Conclusion

• Participants claimed to use birth control
  effectively.
• Alcohol use among women in this program was high.
  
• Increasing effective use of birth control and
  further reductions in drinking would decrease
  risk of AEP.

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For More InformationContact

• Lesa Dixon-Gray, Project Coordinator
• 971-673-0360 office
• Lesa.Dixon-Gray_at_state.or.us
• John Anderson, Data Manager
• 971-673-1277
• John.A.Anderson_at_state.or.us
• Emily Havel, Office of Family Health
• 971-673-0374
• m.emily.havel_at_state.or.us