The Efficacy of Technology-Based Interventions for Alcohol and Illicit Drug Use Among Women of Childbearing Age: A Systematic Review and Meta-Analysis

Background and Purpose: Alcohol and illicit drug use is prevalent among adult women of childbearing age (18-45 years old) and may lead to higher risk for substance-exposed pregnancy and related health consequences for both women and their offspring. Technology-based interventions are increasingly used to prevent or reduce substance use among women of childbearing age. However, its efficacy is unclear. This study critically reviewed existing research evidence from randomized controlled trials on the efficacy of technology-based interventions in preventing and reducing alcohol and illicit drug use among childbearing-aged women.

Methods: We searched in seven electronic databases and the reference lists of relevant studies and reviews to identify eligible studies. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Robust variance estimation in meta-regression was used to estimate effect sizes and conduct moderator analysis.

Results: Fifteen RCTs including 3,488 participants were included in the systematic review. Meta-analysis results based on 13 RCTs suggest that technology-based interventions were efficacious relative to control conditions in preventing and reducing substance use among women of childbearing age (d=0.19, 95% CI= 0.02, 0.35). Preliminary moderator analysis results suggest that the efficacy oftechnology-based interventions might not vary by participant age, race/ethnicity, the type of technology used, or whether a virtual health assistant was used. Technology-based interventions’ efficacy in terms of specific substance use types (alcohol use and illicit drug use), intervention purpose (prevention and treatment), or control types (inactive control and active controls) was inconclusive, due to the limited number of studies in each category.

Conclusions and Implications: This systematic review and meta-analysis found evidence of technology-based interventions’ efficacy in reducing alcohol and illicit drug use among women of childbearing age. Although the intervention effect was small when compared with control conditions, technology-based interventions' impact on public health can be substantial given its potential to reach a large number of women of childbearing age as well as its potential to be cost-effective. More high-quality research is needed in this area.