The Oglala Sioux Tribe CHOICES Program: Preventing Alcohol-Exposed Pregnancies with American Indian Women

INTRODUCTION: Alcohol-exposed pregnancies are concerning for many American Indian communities. The goal of the Oglala Sioux Tribe (OST) CHOICES (Changing High-risk alcohOl use and Increasing Contraception Effectiveness Study) Program is to prevent alcohol-exposed pregnancies (AEP) and fetal alcohol syndrome through alcohol reduction and pregnancy prevention.

METHODS: The OST CHOICES Program began in September, 2010, with two pilot sites, one on the reservation and a second 60 miles north of the reservation. The CHOICES curriculum utilized motivational interviewing and 2 to 4 brief intervention sessions (plus a separate contraceptive physician visit) to reduce risk for AEP by decreasing binge drinking and/or increasing birth control use. Recruitment occurred via flyers and newspaper ads, radio broadcasts, and referrals. Participants were contacted at 3- and 6- months after their last CHOICES session for follow-up data collection.

RESULTS: A total of 66 non-pregnant American Indian women were enrolled at one of the two pilot sites. The majority of participants met with a health care provider to discuss birth control and were actively planning to obtain birth control or were using an effective form by the end of the intervention. In addition, the average number of drinks on a usual day decreased from baseline to the end of the intervention, although did increase again in the months after the intervention. With their final goal statement about alcohol use, participants made goals to not binge drink, to socialize with friends and family that do not drink, attend AA or other support meetings, and to look at their children as motivators in avoiding drinking.

CONCLUSIONS: The intervention was successful in reducing risk for AEP in non-pregnant American Indian women in this pilot study. The next step is to expand the intervention to include more areas of the tribe and to enroll a greater number of women.