This is a 4-year randomized, controlled study to test the efficacy of the CHOICES4Health-T (C4H-T) delivered by a computerized tablet, CHOICES4Health-C (C4H-C), delivered by a counselor, and brief advice (BA), on reducing preconception substance-exposed pregnancy risk (i.e. drinking below risk levels; tobacco and marijuana cessation; effective contraception use) among women (aged 18-44) presenting to the 13 primary care clinics that serve adults within the Harris Health System. Given the natural fit between contraceptive and HIV prevention counseling the CHOICES4Health interventions will also target HIV sexual risk behaviors.
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Change in risk of alcohol-exposed pregnancy (AEP) as measured by self-reported daily standard drinks, vaginal sex, and use of contraception on the Timeline Followback calendar.
Timeframe: 3, 6, and 9 months
Change in risk of tobacco-exposed pregnancy (TEP) as measured by self-reported daily number of cigarettes, vaginal sex, and use of contraception on the Timeline Followback calendar.
Timeframe: 3, 6, and 9 months
Change in risk of marijuana-exposed pregnancy (MEP) as measured by self-reported marijuana use, vaginal sex, and use of contraception on the Timeline Followback calendar.
Timeframe: 3, 6, and 9 months
Change in risk drinking as measured by self-reported number of standard drinks on the Timeline Followback calendar.
Timeframe: 3, 6, and 9 months
Change in cigarette smoking as measured by self-reported number of cigarettes smoked each day on the Timeline Followback calendar.
Timeframe: 3, 6, and 9 months
Change in marijuana use as measured by self-reported use for each day on the Timeline Followback calendar.
Timeframe: 3, 6, and 9 months