2 - (SYM 74) Strategies to Support Engagement in Expecting Couple-focused Motivational Interviewing

Hazardous drinking by non-pregnant partners, often fathers, poses significant risk for negative family interactions and child outcomes. The transition to parenthood may be a time when expectant parents are potentially motivated for health behavior change, suggesting that implementing preventive interventions during this period may be a particularly effective. We will present results from qualitative analysis of skills and processes that targeted alcohol use in couple-focused motivational interviewing. Participants completed 3 dyadic check-ins (CIs) while participating in an existing group-based preventive intervention for expecting couples. Couples with light-drinking/abstaining pregnant individuals and moderate- to heavy-drinking partners are randomized to multimodal intervention or an active educational condition. Couples also receive 2 prenatal and 1 postnatal CIs (30 minutes each) conducted by an interventionist. This brief intervention component encourages the pregnant individual to avoid alcohol use and her partner to reduce alcohol use during pregnancy and supports non-hazardous drinking postnatally in both members. Because couples in this study were not seeking treatment to address alcohol use, avoiding or reducing discord and increasing engagement in a discussion of alcohol use were considered important facets of the brief intervention to examine. Qualitative analyses indicate that interventionists used several strategies to reduce potential discord and support positive, engaged discourse regarding alcohol use, including: supporting autonomy, offering dyad-focused reflections, working to evoke and understand the couple’s perspectives, and shifting focus to shared goals. Additional interventionist strategies to promote engagement included framing CIs as facilitating non-judgmental conversation around the topic of alcohol use, softened interventionist language regarding alcohol patterns and potential changes (e.g., “lower-risk drinking”), and affirmations and reflections emphasizing the dyad or family as well as shared goals and values. Elucidating the processes and methods used to promote positive outcomes is critical for future dissemination efforts, particularly for dyadic health behavior interventions with non-treatment seeking populations.