WEB-BASED intervention showed no added effect on pregnancy sexually transmitted infection risk or substance use in a randomized trial.
Web-Based Intervention Tested in Prenatal Care
A fully automated web-based intervention designed to reduce sexually transmitted infection (STI) risk and substance use during pregnancy did not significantly outperform a matched control condition, according to findings from a randomized controlled trial of pregnant women seeking prenatal care.
The study evaluated the Health Check-Up for Expectant Moms, a theory-driven, technology-delivered brief intervention designed to provide private, convenient behavioral health support during pregnancy. The intervention was consistent with motivational interviewing principles and was compared with an attention, time, and information-matched control condition delivered through the same technology platform.
Researchers recruited 176 pregnant women in Michigan who were at risk for alcohol use, drug use, or STIs during pregnancy. Participants were recruited through clinics and social media campaigns on Facebook and Instagram, then randomized equally to the intervention or control group. Follow-up assessments were conducted at 2 and 6 months after the initial intervention visit.
Substance Use Declined Across Both Groups
Cannabis use was the most common substance reported at baseline. Overall, 35.2% of participants reported cannabis use within the previous 90 days, and 10.2% reported use in the month before enrollment.
Alcohol and cannabis use declined significantly over time during pregnancy in both the web-based intervention and control groups. However, the reductions were not significantly different between trial arms, meaning the intervention did not demonstrate a clear added benefit over the matched control condition. The investigators noted that many reductions appeared to reflect spontaneous self-change reported in the month before study enrollment, which may have limited the ability to detect an intervention effect.
STI Risk Findings Show No Group Difference
The study also found no statistically significant differences between groups in changes in condomless sex at either follow-up point. Primary outcomes included self-reported alcohol, drug, and cannabis use, along with unprotected sexual occasions during pregnancy.
The findings suggest that technology-delivered behavioral health support may remain promising for pregnant women because of its privacy, convenience, and scalability. However, the largely low-risk sample may have made it difficult to observe measurable effects. The authors concluded that future trials should evaluate efficacy in pregnant women with higher current risk for alcohol or drug use.
Reference
Tzilos Wernette G et al. A web-based intervention for reducing sexually transmitted infections and substance use during pregnancy: randomized controlled trial. J Med Internet Res. 2026;28.
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