{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:43:53Z","timestamp":1785836633496,"version":"3.56.0"},"reference-count":49,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01 DA050696"],"award-info":[{"award-number":["R01 DA050696"]}],"id":[{"id":"10.13039\/100000026","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":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The most popular alcohol\u2010exposed pregnancy (AEP) prevention program (AEP\u2010P) is a brief intervention that dually promotes reducing alcohol use and increasing birth control use. The primary outcome variable used to evaluate AEP\u2010P involves aggregating behavioral change into a binary variable, despite differences in how AEP\u2010P impacts each behavior. This study examined if all three possible AEP\u2010P behavior\u2010change outcomes (alcohol only (AO), birth control only (BCO), or both behaviors [BB]) are equally effective in preventing subsequent AEP itself.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We simulated implementing an AEP\u2010P in a United States small metropolitan area under 252 different scenarios (policy tests), varying the (1) percent of the eligible population who changed AEP risk behavior; (2) proportion of AEP\u2010P participants in AO, BCO, and BB groups; and (3) ratio of participants changing alcohol use to non\u2010risky drinking or abstinence. We calculated the percent difference in next\u2010year new cases of total AEP, high\u2010risk AEP, and low\u2010risk AEP for each policy test compared to a \u201cno implementation\u201d baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Policies with higher BB proportions had larger reductions for total and high\u2010risk AEP, with the 100% BB policy providing the highest reductions (5.58%\u201317.13% and 16.27%\u2013 42.43% total and high\u2010risk AEP, respectively). All policies increased low\u2010risk AEP, except for the 100% BCO policy. Policies with higher BCO proportions resulted in lower increases in low\u2010risk AEP, but lower reductions to high\u2010risk AEP. Policy increases in low\u2010risk AEP were driven by the fraction of people transitioning to abstention compared to non\u2010risky drinking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Study results suggested that different constructs of behavioral changes made during AEP\u2010P confer different levels of preventing AEP itself. Using a binary AEP risk aggregate variable may bias our understanding of AEP\u2010P preventative efficacy and inhibit further understanding of how to improve AEP\u2010P.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70379","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:53:38Z","timestamp":1784782418000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Linking Reductions in Alcohol and Birth Control Use Risk Behavior to Prevention of Alcohol\u2010Exposed Pregnancy: A Population\u2010Level Simulation of Preconceptual Prevention Programs"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-5297","authenticated-orcid":false,"given":"Arielle R.","family":"Deutsch","sequence":"first","affiliation":[{"name":"Avera Research Institute, Avera Health  Sioux Falls South Dakota USA"},{"name":"Sanford School of Medicine, University of South Dakota  Vermillion South Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-3442","authenticated-orcid":false,"given":"Ali","family":"Akhavan","sequence":"additional","affiliation":[{"name":"Center for Health Technology Assessment Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Sloan School of Management, Massachusetts Institute of Technology  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6769-2732","authenticated-orcid":false,"given":"Mohammad S.","family":"Jalali","sequence":"additional","affiliation":[{"name":"Center for Health Technology Assessment Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Sloan School of Management, Massachusetts Institute of Technology  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2016.77.272"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-010-9308-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2023.1605669"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000414"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","unstructured":"Deutsch A. 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