Page 16 - Delaware Medical Journal - February 2017
P. 16
TABLE 1: Incentive schedule
Month 1
Month 2
Month 3
Month 4
Month 5
Month 6
Month 7
Month 8
Week 1 $10 Week 2 $15 Week 3 $15 Week 4 $20 Month 1 total $60 Week 1 $20 Week 2 $25
the devastation of prenatal exposure
to alcohol and promoting the healthy practice of refraining from prenatal drinking. In 2012, HBC also collected media attention from international news by introducing a pregnancy test dispenser in a women’s restroom in a Minnesota bar to raise awareness on FASD as a result of prenatal alcohol exposure among women of drinking age. This initiative has been implemented in Alaska and provinces in Canada. Scotland and England also stated an interest in implementing the initiative.
The head of HBC, Jody Allen Crowe, realized the importance of ensuring
risk for prenatal alcohol stay abstinent during the rest of pregnancy. HBC used ongoing donations to the Peter Johnson Memorial Fund to develop a pilot project to biochemically monitor prenatal alcohol use as part of the case management process by CWCSS. HBC was also interested in incentivizing alcohol abstinence to retain referred pregnant women in case management and sustain alcohol abstinence. HBC funded a
pilot project, My Baby’s Breath, to biochemically monitor alcohol use
with mobile technology and reinforce alcohol abstinence with vouchers, in collaboration with CWCSS. Since HBC consisted of community members who were devoted to preventing FASD,
staff time has been donated to run this ongoing project.
Contingency management (CM) is
a strategy used in alcohol and other substance abuse treatment to encourage patients’ positive behavior change (e.g., abstinence), by providing incentives (or positive reinforcement) when treatment goals are met and by withholding incentives or negative consequences
when undesired behavior occurs.9 The
demonstrated, and compared favorably to other psychosocial interventions
in populations with substance use disorder (SUD)10 and even in special populations such as pregnant smokers.11 CM was incorporated to systematically reinforce alcohol abstinence with vouchers on a weekly basis, as described consulted on site and by phone before and during implementation on designing CM and problem solving on the process of monitoring and incentive schedule.
COMMUNITY-INITIATED PILOT PROGRAM “MY BABY’S BREATH”
Referral Process
Pregnant mothers at risk for continued
members and referred to Crow Wing
including screening at obstetric
treatment history of alcohol abuse at pre- risk for continued drinking were referred to HBC staff by CWCSS social workers as an option to help them abstain from drinking during pregnancy.
Monitoring Implementation
Pregnant mothers who agreed to receive the program received one-on-one instruction from HBC staff on how to use the mobile breathalyzer technology, as well as on the monitoring protocol. The breathalyzer is provided on a cellular network combined with a camera for that the breath sample is provided by the
Week 3
Week 4
Month 2 total $95 Week 1 $30 Week 2 $30 Week 3 $30 Week 4 $35 Month 3 total $125
$25 $25
Week 1
Week 2
Week 3 $40 Week 4 $40 Month 4 total $150 Week 1 $40 Week 2 $40 Week 3 $40
$35 $35
Week 4
Month 5 total
$50
$170
Week 1 $50 Week 2 $50 Week 3 $50 Week 4 $50 Month 6 total $200 Week 1 $50
Week 2
Week 3
Week 4 $50 Month 7 total $200 Week 1 $50 Week 2 $50 Week 3 $50 Week 4 $50
$50 $50
Month 8 total
Bonus: If in compliance for 90% of pregnancy
$200
$100
Maximum payment $1,300 per participant if in
compliance for 8
months
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Del Med J | February 2017 | Vol. 89 | No. 2
