# Mobile behavioral intervention to reduce maternal drinking in South Africa

> **NIH NIH R21** · RESEARCH TRIANGLE INSTITUTE · 2021 · $219,537

## Abstract

PROJECT SUMMARY/ABSTRACT
This application proposes to develop and test a technology-based behavioral intervention to address
maternal alcohol use in South Africa (SA). SA reports the highest per capita rates of alcohol consumption in
the world and has one of the world's highest rates of lifelong disorders called fetal alcohol spectrum
disorders (FASD). Prenatal alcohol use is often associated with exposure to gender-based violence, and an
increase in gender-based violence due to the uncertainty and economic impact of COVID-19 is of a major
concern. Recent evidence also showed that alcohol use during lactation significantly compromises child
development in children exposed to alcohol through breastfeeding, and the adverse effect of postpartum
alcohol use while breastfeeding was independent of prenatal alcohol exposure. Average breastfeeding
duration in SA is beyond 1 year, and over 40% of mothers with and without a history of prenatal drinking
report alcohol use while breastfeeding. A community-based behavioral intervention involving case
management helps reduce prenatal alcohol use but is labor intensive, challenging the feasibility of
widespread implementation in economically disadvantaged communities especially during the COVID-19
pandemic with limited social contact. An efficacious behavioral intervention to reduce alcohol use during
pregnancy and lactation needs to be developed that is acceptable and feasible in economically
disadvantaged communities, for women with transportation difficulties, or during the COVID-19 pandemic
with limited social contact. The proposed intervention will incorporate mobile breathalyzer technology,
contingent financial incentives, and text-based health promotion and referrals on gender-based violence,
maternal infant health, and psychosocial issues including the impact of COVID-19 in the context of maternal
alcohol use. Specific aims are (1) to develop and pretest a technology-based behavioral intervention to help
women abstain from alcohol use during pregnancy and lactation via formative qualitative research with
women who are pregnant or breastfeeding with a recent history of alcohol use, clinic and community
stakeholders, and an established Community Collaborative Board in Cape Metropole, SA, and (2) to
examine the acceptability and feasibility of the intervention on alcohol use during pregnancy and lactation by
pilot testing the mobile technology-based platform with 60 women who are pregnant or postpartum.
Acceptability will be assessed at follow-ups, and feasibility will include recruitment capability, process
measures, and intervention outcomes. With the evidence of acceptability and feasibility of the proposed
intervention, a large randomized clinical trial will become essential to establish efficacy of the intervention.
The potential settings that can remotely incorporate the proposed behavioral intervention include primary
care clinics, substance use treatment programs, and publicly funded programs for m...

## Key facts

- **NIH application ID:** 10165116
- **Project number:** 1R21AA029048-01
- **Recipient organization:** RESEARCH TRIANGLE INSTITUTE
- **Principal Investigator:** Yukiko Washio
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $219,537
- **Award type:** 1
- **Project period:** 2021-03-05 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10165116

## Citation

> US National Institutes of Health, RePORTER application 10165116, Mobile behavioral intervention to reduce maternal drinking in South Africa (1R21AA029048-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10165116. Licensed CC0.

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