CHAMPION - AlCohol HArM PreventIOn iN pregnancy

Research question: What are the components of an implementation intervention to support midwives provision of recommended care addressing alcohol consumption with women attending antenatal appointments; is such an intervention feasible to implement in practice; and is it acceptable to service providers and service users?

Background Alcohol is a major risk factor for chronic diseases in the UK.

Peri-conception and pregnancy alcohol exposure is a risk factor for miscarriage, premature birth, intra-uterine growth restriction and Fetal Alcohol Spectrum Disorders - estimated to cost £2 billion/year. The NE Local Maternity System boards have prioritised reducing alcohol harms during pregnancy.

Evidence shows that alcohol screening and intervention in antenatal settings is effective in helping women reduce their alcohol consumption and is recommended by the World Health Organisation.

Barriers to implementation of alcohol assessment, advice and/or appropriate referral by midwives need to be addressed in order to facilitate practices in this important area of prevention.

Aims and objectives: To co-design a theoretically informed intervention to support midwives in assessing and recording a woman's alcohol consumption, followed by appropriate advice and/or onward referral at antenatal appointments To evaluate the feasibility of implementing such an intervention in practice; and acceptability of intervention delivery and content to maternity service users and providers.

Methods Workpackage 1: Co-design intervention development 1a) intervention mapping exercise to select Behaviour Change Techniques to underpin the intervention. 1b) Two co-production workshops with research team members and key stakeholders (6-8 midwives, 2-3 substance misuse specialist midwives, and 4–6 maternity service users) where findings from the first will be presented and feedback sought at the second, then intervention refined until final content is agreed.

Expected outputs are a working prototype of an intervention, an intervention manual and all associated resources required for intervention delivery.

Workpackage 2: – Intervention refinement 2a) Expert review of intervention manual content and associated resources by key stakeholders (service managers, midwives, and representatives from professional organisations such as the Royal College of Midwives) for feedback. 2b) Early feasibility and acceptability of the implementation intervention evaluated in two NHS Trusts through: in-depth interviews to gather experiences of the intervention, perceived utility and impact on practice (midwives ); and receiving alcohol questions and advice at antenatal appointments (womens ).

Audit of hand-held and electronic patient records for recording of alcohol assessment and advice.

Timelines for delivery Study duration: 17 months - months 0-4 - study set-up; months 4-10 – workpackage 1; months 10-15 workpackage 2; 15-17 close and write up Anticipated impact and dissemination Feasibility data to inform planning of a future pilot and definitive RCT which if proven to be effective and cost-effective could benefit women by facilitating informed choice; and reducing alcohol-related harm to maternal and infant health.