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Oregon BALANCE

Oregon BALANCE. Lyn Blackshaw, John Anderson, Lesa Dixon-Gray, Emily Havel. BALANCE. B irth control AL cohol A wareness N egotiating C hoices E ffectively. Binge Drinking.

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Oregon BALANCE

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  1. Oregon BALANCE Lyn Blackshaw, John Anderson, Lesa Dixon-Gray, Emily Havel

  2. BALANCE • Birth control • ALcohol • Awareness • Negotiating • Choices • Effectively

  3. 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)

  4. 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.

  5. The Dangers of Risky Drinking and Sex • When a woman engages in risky or binge drinking, is sexually active and doesn’t 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

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

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

  8. 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.

  9. 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.

  10. The Desired Outcomes Reduced risk of alcohol exposed pregnancies among at-risk women as measured by: • Improved birth control • Reduced binge drinking

  11. 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.

  12. 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.

  13. Why College Women? • The higher a woman’s 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)

  14. 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

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

  16. The Interviewers • Three interventionists with master’s 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

  17. 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

  18. Blood Alcohol Table(Women) • After 1 hour of drinking and Body Weight

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

  20. 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?

  21. 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?

  22. The Participants

  23. The Recruitment

  24. The Ages

  25. 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

  26. Session 1Comments • “Drinking is part of the culture.” • “I consider myself a light drinker.” • “I’m not interested in changing my drinking behavior.”

  27. 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 doesn’t 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.

  28. Alcohol Use Most Drinks in One Day,30-day retrospective P = 0.005, N = 214

  29. Alcohol UseInstances of 4 or More Drinks,30-day retrospective P = 0.016, N = 214

  30. Readiness to Drink Less Readiness to drink 3 or less (scale 1-10) P = 0.017, N = 205

  31. Readiness to Use Birth ControlScale of 1-10 P = 0.70, N = 208

  32. Effective Birth Control Use P = 0.10 P = 0.27 n = 215

  33. 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.

  34. Session 2Comments • “I didn’t know about early term pregnancies being affected. I told a friend who thought she might be pregnant. I also noticed that I’m monitoring. Is it time to stop or not? We’ve 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 don’t need a 4th.” --Participant • “After our conversation I really am conscious of how much I drink each time I’m out with friends. I haven’t gone past three drinks in a long time and I try to drink them slowly. I’ve been listening to my body and I’ve started to talk to some of my friends about alcoholism.” --Participant

  35. Session 2 • “I didn’t think this study would have affected me as much as it did.” –Participant • “I did talk to a few friends about the interview…I do remember being really excited after the interview. I have decided that drinking is too much of a high risk game to take lightly…….I’ve 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

  36. 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%)

  37. 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

  38. 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.

  39. For More InformationContact: • Lesa Dixon-Gray, Project Coordinator • 971-673-0360 office • Lesa.Dixon-Gray@state.or.us • John Anderson, Data Manager • 971-673-1277 • John.A.Anderson@state.or.us • Emily Havel, Office of Family Health • 971-673-0374 • m.emily.havel@state.or.us

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