Adaptation of a Digital Group-Based Intervention to Reduce Drug Use and Increase Contraceptive Use among Reproductive-Aged Women Involved in Criminal Justice Systems

采用基于数字群体的干预措施，以减少参与刑事司法系统的育龄妇女吸毒并增加避孕药具的使用

• 批准号: 10891840
• 负责人: Melissa N. Slavin
• 金额: $ 17.78万
• 依托单位: FAIRLEIGH DICKINSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10891840
• 关键词: AIDS prevention; Abortion Rates; Address; Adult; Age; Area; Barrier Contraception; Child; Communities; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Criminal Justice; Data; Dissemination and Implementation; Dropout; Drug usage; Effectiveness of Interventions; Ethnic Origin; Evaluation Research; Feedback; Future; Gender; Goals; HIV; Hair; Health Services Accessibility; Imprisonment; Individual; Intervention; Interview; Low Birth Weight Infant; Mentored Research Scientist Development Award; Methods; Modeling; Morbidity - disease rate; Multimedia; National Institute of Drug Abuse; Oral Contraceptives; Outcome Study; Participant; Patient Self-Report; Persons; Pharmaceutical Preparations; Population; Postpartum Depression; Pregnancy; Prenatal care; Provider; Race; Randomized; Randomized, Controlled Trials; Recording of previous events; Reduce health disparities; Reporting; Reproductive Health; Research; Research Ethics; Research Methodology; Research Personnel; Risk Factors; Schools; Science; Self Efficacy; Sexual Health; Sexually Transmitted Diseases; Social Work; Social support; Socioeconomic Status; Stress; Structure; Substance Use Disorder; Supervision; System; Testing; Training; Universities; War; Woman; acceptability and feasibility; addiction; advocacy organizations; aged; barrier to care; condoms; digital; digital intervention; drug testing; effective intervention; efficacy trial; evidence base; fitness; follow-up; health disparity; health inequalities; illicit drug use; implementation science; improved; infection risk; intimate partner violence; mortality; obstetrical complication; offspring; pilot test; power analysis; premature; prevent; preventive intervention; primary outcome; recruit; reproductive; responsible research conduct; satisfaction; secondary outcome; sexually active; skills; stress reduction; substance use; unintended pregnancy; videoconference

PROJECT SUMMARY/ABSTRACT. The purpose of this K01 Award is to provide the candidate, Dr. Melissa N. Slavin, at Columbia University School of Social Work, with the training needed to become an independent substance use investigator in digital intervention science with a focus on sexual and reproductive health (SRH) issues among vulnerable women, particularly women involved in criminal justice systems (WICJ). Dr. Slavin proposes to adapt and determine the feasibility and acceptability of a digital intervention, which will include facilitated group-based treatment via videoconference, and digital interactive activities, for reproductive-aged women with a recent history of incarceration or community supervision. This intervention aims to reduce illicit drug use and increase all forms of contraceptive use among women with substance use disorders (SUDs) and unmet contraceptive needs (i.e., fecund, sexually active, and report not wanting more children or wanting to delay the next child but are not using any method of contraception). WICJ, the majority of whom are reproductive- aged, have high rates of SUDs and unmet contraceptive needs, influenced by synergistic individual-, interpersonal-, and community-level risk factors. Unmet contraceptive needs result in unintended pregnancies (UPs) among WICJ with SUDs, and increased rates of morbidity and mortality among women and their offspring. Extant interventions among WICJ who use drugs often focus on sexually transmitted infections (STIs), including HIV, while leaving out UPs. Among reproductive-aged women in general, digital interventions are effective at reducing drug use and increasing contraceptive use, and can increase reliability of implementation, accessibility, and personalization. Digital HIV-prevention interventions for WICJ who use drugs can provide a key platform to address UPs among reproductive-aged women. Multimedia WORTH, an evidence-based HIV-prevention intervention uses in-person groups and digital interactive activities to address risk factors among WICJ who use drugs and is effective at increasing condom use. Dr. Slavin will adapt Multimedia WORTH for reproductive-aged WICJ with SUDs and unmet contraceptive needs, using a digital intervention (facilitated group-based treatment via videoconference, and self-paced activities) through 3 research aims (RAs): RA1: Identify modifiable determinants of drug and contraceptive use among reproductive-aged WICJ via qualitative interviews; RA2: Adapt Multimedia WORTH using a systematic adaptation framework; RA3. Evaluate feasibility, acceptability, and preliminary effectiveness of the intervention through a randomized controlled trial (RCT) of 50 WICJ. Data obtained from this K01 will support the NIDA priority focus area of addressing real world complexities of addiction, by targeting barriers to treatment relating to gender, age, socioeconomic status, and race/ethnicity among vulnerable WICJ. This K01 will provide Dr. Slavin training in: 1) adapting and implementing a culturally tailored intervention, 2) conducting responsible research with vulnerable women, 3) utilizing a digital intervention to address health disparities, and 4) quantitative and qualitative intervention evaluation research methodology.

项目摘要/摘要。该 K01 奖的目的是为候选人 Melissa N. Slavin，哥伦比亚大学社会工作学院，接受过成为独立人士所需的培训 数字干预科学领域的物质使用调查员，重点关注性健康和生殖健康 (SRH) 弱势妇女，特别是参与刑事司法系统的妇女 (WICJ) 的问题。斯莱文博士 提议调整并确定数字干预的可行性和可接受性，其中包括 通过视频会议和数字互动活动促进育龄群体的分组治疗 最近有被监禁或社区监管历史的妇女。这项干预措施旨在减少非法 药物滥用并增加患有物质使用障碍 (SUD) 的女性中各种形式的避孕药具的使用，以及 未满足的避孕需求（即多产、性活跃，并报告不想要更多孩子或想要 延迟生育下一个孩子但未使用任何避孕方法）。 WICJ，其中大多数是生殖- 老年人，SUD 发生率高，避孕需求未得到满足，受个体协同作用的影响， 人际和社区层面的风险因素。未满足的避孕需求导致意外怀孕 (UPs) 的 WICJ 与 SUD，以及妇女及其后代的发病率和死亡率增加。 对使用毒品的 WICJ 的现有干预措施通常侧重于性传播感染 (STI)，包括 HIV，同时忽略 UP。对于一般育龄妇女来说，数字干预措施在以下方面是有效的： 减少药物使用和增加避孕药具的使用，并可以提高实施的可靠性、可及性、 和个性化。针对吸毒者的 WICJ 的数字艾滋病毒预防干预措施可以提供一个关键平台 解决育龄妇女的 UP 问题。多媒体 WORTH，基于证据的艾滋病毒预防 干预措施利用面对面小组和数字互动活动来解决使用 WICJ 的风险因素 药物，并能有效增加安全套的使用。 Slavin 博士将为育龄人士改编多媒体 WORTH WICJ 涉及 SUD 和未满足的避孕需求，使用数字干预（促进基于群体的治疗） 通过视频会议和自定进度的活动）通过 3 个研究目标 (RA)： RA1：识别可修改的 通过定性访谈了解育龄 WICJ 中药物和避孕药具使用的决定因素； RA2： 使用系统化的适应框架来适应多媒体WORTH； RA3。评估可行性、可接受性、 通过 50 个 WICJ 的随机对照试验 (RCT) 得出干预措施的初步有效性。数据 从此 K01 获得的成果将支持 NIDA 解决现实世界成瘾复杂性的优先重点领域， 针对与性别、年龄、社会经济地位和种族/族裔相关的治疗障碍 脆弱的 WICJ。 K01 将为 Slavin 博士提供以下方面的培训：1) 适应和实施针对文化的定制 干预，2) 对弱势妇女进行负责任的研究，3) 利用数字干预 解决健康差异，4) 定量和定性干预评估研究方法。