Alcohol Use in the Early Postpartum Period: An Ecological Momentary Assessment Study to Understand the Role of Self-Efficacy

Introduction: This study investigated daily associations between maternal self-efficacy (MSE), drinking self-efficacy (DSE), alcohol urges and alcohol use in the first 6 weeks postpartum, with the goal of informing a tailored just-in-time adaptive intervention for postpartum alcohol use. Methods: Ecological momentary assessment was conducted with 37 postpartum mothers with pre-pregnancy at-risk alcohol use. Participants completed surveys on their smartphones five times a day for 14 days and reported on MSE, DSE, urge to drink and alcohol use. Results: Both MSE and DSE demonstrated within-subject variability. MSE and DSE were significantly positively correlated. MSE reported in the morning significantly predicted the likelihood of drinking that day. DSE was not associated with daily drinking. Neither MSE nor DSE were associated with the urge to drink. Discussion and Conclusions: Both MSE and DSE demonstrated greater within-person change across days than within a single day, and MSE showed more stability than DSE at the within-person level. Lower reported MSE in the morning was associated with a greater likelihood of drinking that day. MSE may be a more important intervention target than DSE in the postpartum population. These findings will directly inform just-in-time adaptive intervention development. Future research will examine momentary associations among these constructs and explore contextual factors influencing MSE and DSE fluctuations.