New risk assessment/intervention for pregnant women

DESCRIPTION (provided by investigator): Drug use is common among pregnant women, yet only an estimated 32% to 42% of prenatal care providers routinely ask prenatal patients about their use of drugs. Prenatal visits afford a unique opportunity for providers to educate women about prevention, and to detect, drug use during pregnancy. To facilitate efficient use of provider resources, we have developed a computerized interactive survey interview (CASI), the Pregnancy Information Program (PIP) that has been well received in multiple ethnic/racial pregnant populations, and more importantly, shown to evoke more honest responses regarding drug use and other socially stigmatized behaviors that impact birth outcomes. The program will be updated, to integrate current diagnostic standards and new information about motivational interventions, to expand domains of use to clinicians, and to exploit computer advancements including audio and video. For this Phase I project, we propose to develop a commercial quality CD ROM prototype of the entire instrument, with revised scoring and reporting, ethnic/racial sensitivity, redesigned input screens, and motivational feedback customized to the respondent's readiness to change. Phase II funds will allow extensive validation studies of the revised instrument's ability to promote behavior change from the initial to the third trimester of pregnancy.