{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:43:00Z","timestamp":1787013780269,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T00:00:00Z","timestamp":1734825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["P60AA026112"],"award-info":[{"award-number":["P60AA026112"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prevention of alcohol\u2010exposed pregnancy (AEP) involves reducing risky alcohol consumption among women at\u2010risk for pregnancy, using effective contraception among women drinking at risky levels to prevent pregnancy, or both. This study presents the outcomes of a randomized controlled trial assessing the efficacy of Native CHOICES, a culturally tailored adaptation of the CHOICES intervention, among American Indian\/Alaska Native (AI\/AN) women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>AI\/AN women aged 18\u201344 who were at\u2010risk for an AEP were randomly assigned in a 1:1 ratio to either the Native CHOICES intervention or a waitlist control group. Native CHOICES comprised two sessions of motivational interviewing and an elective contraception counseling session. Data were collected at baseline, and 6\u2009weeks, 3\u2009months, and 6\u2009months postbaseline. Due to the pandemic, the intervention was at times delivered remotely.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 404 women participated: 199 in the control group and 205 in the intervention group. Sixty\u2010seven percent of the intervention group received the intervention in\u2010person, and 33% participated by telephone or video call. Sixty\u2010four percent of women completed all follow\u2010up visits. At the six\u2010month follow\u2010up, the intervention did not demonstrate a significant impact on AEP risk compared with the control arm when analyzing all the data (RR\u2009=\u20090.94; 95% confidence interval [CI]: 0.83\u20131.07). However, an exploratory subgroup analysis showed evidence of a reduction in AEP risk among participants who completed the study in\u2010person before the COVID\u201019 pandemic (RR\u2009=\u20090.79; 95% CI: 0.63\u20130.98), which was not observed during or after the pandemic (RR\u2009=\u20091.06; 95% CI: 0.91\u20131.24).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Native CHOICES intervention did not show evidence of effectiveness overall. However, exploratory analyses offer some evidence that the intervention was effective prior to the pandemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.15521","type":"journal-article","created":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T20:59:28Z","timestamp":1734901168000},"page":"488-498","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A randomized controlled trial of Native\n                    <scp>CHOICES<\/scp>\n                    : Impact on alcohol\u2010exposed pregnancy risk reduction among American Indian and Alaska Native women"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8867-2300","authenticated-orcid":false,"given":"Jessica","family":"Hanson","sequence":"first","affiliation":[{"name":"Department of Applied Human Sciences University of Minnesota Duluth  Duluth Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Noonan","sequence":"additional","affiliation":[{"name":"Institute for Research and Education to Advance Community Health Washington State University  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyra","family":"Oziel","sequence":"additional","affiliation":[{"name":"Institute for Research and Education to Advance Community Health Washington State University  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Little","family":"Wounded","sequence":"additional","affiliation":[{"name":"Missouri Breaks Industries Research Inc.  Eagle Butte South Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serea","family":"Darnell","sequence":"additional","affiliation":[{"name":"Missouri Breaks Industries Research Inc.  Eagle Butte South Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Rosenman","sequence":"additional","affiliation":[{"name":"School of Economic Sciences Washington State University  Pullman Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia","family":"O'Leary","sequence":"additional","affiliation":[{"name":"Missouri Breaks Industries Research Inc.  Eagle Butte South Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"MacLehose","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Sarche","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Colorado School of Public Health Centers for American Indian and Alaska Native Health  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dedra","family":"Buchwald","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, UW Medicine University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/35.5.509"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.329"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03569.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191113481998"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/03630242.2019.1584144"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-014-1563-3"},{"key":"e_1_2_9_8_1","first-page":"441","article-title":"Motivational intervention to reduce alcohol\u2010exposed pregnancies\u2010\u2010Florida, Texas, and Virginia, 1997\u20132001","volume":"52","author":"Centers for Disease Control and Prevention","year":"2003","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_9_9_1","unstructured":"Centers for Disease Control and Prevention. (2022)Binge drinking. Available at:https:\/\/www.cdc.gov\/alcohol\/fact\u2010sheets\/binge\u2010drinking.htm[Accessed 14th September 2023]."},{"key":"e_1_2_9_10_1","unstructured":"Centers For Disease Control And Prevention. (2023)Birth control methods. Available at:https:\/\/www.cdc.gov\/reproductivehealth\/contraception\/index.htm[Accessed 14th September 2023]."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-010-9308-2"},{"key":"e_1_2_9_12_1","first-page":"22","article-title":"Critical periods for prenatal alcohol exposure: evidence from animal and human studies","volume":"18","author":"Coles C.","year":"1994","journal-title":"Alcohol Health and Research World"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-014-0603-2"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-008-0328-2"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1506575"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/152460999319048"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.09.018"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2006.08.028"},{"key":"e_1_2_9_19_1","unstructured":"Great Plains Tribal Chairmen's Health Board. (2017)South Dakota tribal pregnancy risk assessment monitoring system 2017. Available at:https:\/\/mch.gptchb.org\/wp\u2010content\/uploads\/2020\/04\/FINAL\u2010SD\u2010Tribal\u2010PRAMS\u2010Aggregate\u2010Final\u2010with\u2010IRB\u201011\u201022\u201019.pdf[Accessed 1st July 2020]."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6504a6"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.4278\/ajhp.120113-QUAN-25"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13348"},{"key":"e_1_2_9_23_1","first-page":"2","article-title":"Adaptations of an RCT during COVID: case study in one rural American Indian community","volume":"5","author":"Hanson J.D.","year":"2022","journal-title":"Collaborations (Coral Gables, Fla.)"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph13010001"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4256"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13635"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/15332640.2015.1093991"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.07.013"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/DBP.0b013e3182905587"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-018-1264-3"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.S1.1136"},{"key":"e_1_2_9_32_1","unstructured":"National Institute On Alcohol Abuse And Alcoholism. (n.d.)Drinking levels defined. Available at:https:\/\/www.niaaa.nih.gov\/alcohol\u2010health\/overview\u2010alcohol\u2010consumption\/moderate\u2010binge\u2010drinking[Accessed 14th September 2023]."},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/00469580231175780"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.S1.1131"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2018.11.001"},{"key":"e_1_2_9_37_1","unstructured":"Saunders J.B.(n.d.)AUDIT (Alcohol Use Disorders Identification Test). Available at:https:\/\/auditscreen.org\/[Accessed 14th September 2023]."},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2014.00393.x"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.04.027"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13385"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-021-00699-0"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/1090198110385773"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbpra.2009.02.004"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2017.78.795"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62071-1"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2013.06.006"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X211023203"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agad011"}],"container-title":["Alcohol, Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.15521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T14:51:15Z","timestamp":1743778275000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acer.15521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,22]]},"references-count":47,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/acer.15521"],"URL":"https:\/\/doi.org\/10.1111\/acer.15521","archive":["Portico"],"relation":{},"ISSN":["2993-7175","2993-7175"],"issn-type":[{"value":"2993-7175","type":"print"},{"value":"2993-7175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,22]]},"assertion":[{"value":"2024-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}