A Brief Mobile Intervention to Address Prenatal Cannabis Use

About This Grant

PROJECT SUMMARY Prenatal cannabis use (PCU) is a growing public health concern, linked to fetal harms and risks to the pregnant woman, including depression and cannabis use disorder. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists advise against PCU, yet its prevalence continues to rise. Despite some understanding of the risks associated with PCU, pregnant women often choose to use cannabis to offset physical and mental health symptoms. The desire to manage adverse symptoms is often accompanied by inconsistent and/or limited unsolicited information offered by healthcare providers on PCU harms or alternatives, and pregnant women are hesitant to disclose PCU to providers even if asked. In this proposed pilot randomized controlled trial (RCT), we will incorporate feedback from experts and pregnant women who use cannabis to tailor our team’s existing, evidence- based, brief, mobile phone-based intervention to target PCU. The intervention will: (1) present accurate information in a motivational enhancement format to reduce resistance around health messaging, correct misperceptions, and provide instruction around discerning credible and accurate information from other sources in the future; and (2) offer harm reduction and cognitive behavioral skills proven to be efficacious in reducing cannabis use in other groups (e.g., use of protective behavioral strategies and distress tolerance skills) to teach alternate strategies to manage physical and mental health symptoms during pregnancy. In an initial phase of the project, we will beta-test our screening, recruitment, and intervention procedures with 15 pregnant women in the first trimester who use cannabis. We will conduct interviews to evaluate feasibility and acceptability of the intervention and refine content based on feedback. We will then pilot test the intervention in a second phase by randomly assigning first trimester pregnant women who use cannabis to the intervention condition (N = 50) or a brief information-only control condition (i.e., treatment as usual; N = 50) to be delivered in the first trimester, with a booster in the third trimester. Follow-up will occur during subsequent trimesters and 3-months post-pregnancy. This first-ever stand-alone, self-directed mobile intervention for PCU has potential for large-scale reduction of cannabis use among an at-risk population. This mobile phone-based intervention can reach pregnant women who may have otherwise received no intervention, or who would have sought information from less credible sources. This and future projects can help identify and address individual-, policy- and system-level barriers to harm reduction services among pregnant women as we develop and test new digital health technologies to deliver novel prevention, treatment, and recovery interventions to a vulnerable population (two NIDA priority areas).