A RANDOMIZED TRIAL OF A TELECOMMUNICATIONS NETWORK FOR PREGNANT-WOMENWHO USE COCAINE

Objectives. The authors describe computes services designed to make pa tients better informed and more motivated to participate in treatment. Patients use these services through their touch-tone telephone; acces s to a home computer of a modem is not needed. METHODS, The authors te sted the impact of these computer services an the management of 179 pr egnant women who had used cocaine during pregnancy Err ? month before pregnancy (as reported by :he woman). Patients were randomly assigned to control and experimental groups; only the experimental group had ac cess to the computer services; Patients were enrolled during the prena tal period and followed for 6 months after the birth of a live child. Self-reported data on the subjects' participation in drug treatment pr ograms, health status (using the SF-Sti), and addiction severity (usin g the addiction severity index) were collected. The computer collected data an the frequency of the use of the service. The dependent variab les were participation in formal treatment during the course of the pr oject, and drug and alcohol use at exit interview Multiple and logisti c regressions were used to identify the effects of the intervention af ter controlling far demographic and baseline variables. Results, Data showed that poem; pregnant, undereducated clients who used drugs and l ived in multiple residences could use the services; about one-third of clients used the services more than three times a week. Access to the service did not lead to significant change in patients' health status , drug use, or utilization of services. Use of the service did lead to significant changes ha participation in drug treatment: subjects who used the service more than three times a week were 1.5 times more like ly to participate in formal drug treatment than subjects who used the service less often. Participation in formal drug treatment, however, w as not effective in reducing the drug or the alcohol use, Conclusions. Almost all patients used the computer services to some extent, but th ere seems to be a threshold after which the use of the services had a more positive impact.