A public health intervention to change knowledge, attitudes and behaviour regarding alcohol consumption in pregnancy

Aim. To evaluate the effectiveness of a public health intervention aimed at changing knowledge, attitudes and behaviour.
Methods. A non-blinded parallel group randomised controlled trial of pregnant women over 18 years of age. Women were
recruited in the second trimester and assigned to one of two treatment groups. Both groups completed an initial questionnaire
assessing knowledge, attitudes, and practices relating to alcohol consumption during pregnancy. The intervention group then
received a mocktail recipe booklet and participants were asked to share the information with their partner. The control group
received standard antenatal care. A follow-up questionnaire was conducted four weeks post birth. Primary outcome measures
were a knowledge score of the health risks associated with alcohol consumption during pregnancy and an attitude score toward
drinking during pregnancy. Secondary outcome measures included whether or not the woman and her partner abstained from
drinking. Ethical approval was granted by the Women’s and Children’s Health Network and the University of South Australia.
Results. A total of 161 participants were recruited at baseline (intervention = 82, control = 79) and 96 participants completed
the trial (intervention = 49, control = 47). The findings suggest that the mocktail booklet was effective at improving knowledge
(p<0.001; effect size 0.80) and improving attitudes towards drinking during pregnancy (p=0.017; effect size 0.43) in
the intervention group compared to the control group. Although women in the intervention group were 30% more likely
to abstain from drinking than in the control group (RR=1.3, 95% CI 0.97 – 1.75), this result was not statistically
significant (p=0.077).
Conclusions. Knowledge regarding the effects of alcohol consumption as well as attitudes towards drinking significantly
improved as a result of a mocktail recipe booklet. Improving knowledge and changing attitudes has the potential to change
health behaviour. Therefore, this intervention may reduce the percentage of women who continue to drink alcohol while they are
pregnant and improve outcomes for infants and children.