Let's Talk About CDC's Innovative Message Testing and New Materials on Alcohol Use During Pregnancy and Alcohol Screening and Brief Intervention for Healthcare Providers

Theoretical Background and research questions/hypothesis: In 2021, CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) selected Oak Ridge Associated Universities (ORAU) to develop new communication materials about alcohol use during pregnancy and the importance of alcohol screening and brief intervention (SBI). ORAU will share insights from our experience conducting message testing and subsequent material development based on these research questions.

1. What HCP and patient characteristics correlate with specific information needs on these topics?
2. What factors most impede or facilitate integration of SBI for HCPs? What ideas/solutions do HCPs have that can address the identified barriers?
3. What factors most impede or facilitate patient adherence to CDC guidelines on these topics? What ideas/solutions do WRA have that can address the identified barriers?
4. What feelings, opinions, levels of understanding, motivation, and agreement do HCPs and patients express in response to presented messages and phrases?
5. Through what messaging channels, formats, and organizations do HCPs prefer to get information on these topics?
6. What are patients’ opinions about discussing alcohol use with their HCPs? What are their preferences for how conversations about alcohol use could best be provided in clinical settings?

Methods: ORAU conducted online, moderated discussion boards with 48 patients who can become pregnant and in-person focus groups with 49 of these patients. ORAU also conducted online discussion boards with 47 HCPs, and virtual in-depth interviews with a subset of 21 of those HCPs. The HCPs represented a variety of roles (i.e., MDs, NPs, PAs, RNs, CNMs, and MAs) and specialties (i.e., PCP and obstetrics/gynecology).

Results: Our research found that only 51% of HCP respondents and 33% of patients strongly disagreed with the statement that “it is okay for women to drink a small amount of alcohol at some points during pregnancy.” The research also found:

• 94% of patients expressed interest in learning more about alcohol use and pregnancy.
• Patients who believed it is acceptable to drink a small amount of alcohol during pregnancy were much more open to changing their opinion on the topic than those who believed one should not drink at all during pregnancy.
• Patients affirmed the value they place on their healthcare providers’ guidance on the topic.

Conclusions: Researchers identified a concerning level of misperceptions among both HCPs and patients about some alcohol during pregnancy being safe, with only 51% of HCPs and 33% of patients strongly disagreeing that some amount of alcohol during pregnancy may be okay. Yet, we also identified viable and exciting opportunities for NCBDDD to effect change.

Implications for research and/or practice: ORAU has developed an innovative and visually engaging set of “Let’s Talk” materials that includes fact sheets, badge cards, videos, articles, infographics, and social media message sets for providers to use or reference when caring for their patients. We have also designed a CDC Guide to Improve Patient-Provider Communication on the Risks of Alcohol Use During Pregnancy to encourage HCPs to conduct alcohol SBI and equip HCPs to effectively communicate with patients about alcohol and pregnancy.