Sex and female empowerment (SAFE): A randomized trial comparing sexual health interventions for women in treatment for opioid use disorder.
Sex and female empowerment (SAFE): A randomized trial comparing sexual health interventions for women in treatment for opioid use disorder.
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DOI：
10.1016/j.drugalcdep.2021.108634
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发表时间：
2021-04-01
影响因子：
4.2
通讯作者：
O' Grady KE
中科院分区：
文献类型：
--
作者：
Jones HE;Martin CE;Andringa KR;Ellerson RM;Johnson E;Hairston E;O' Grady KE
意外怀孕在阿片类药物使用障碍（OUD）的女性中很普遍。性和女性赋权项目开发了一种社会认知、理论驱动的干预措施，以提高接受口服避孕药治疗的妇女对避孕做法的接受程度和坚持程度。本研究评价了两种SAFE干预措施（面对面和计算机适应）与常规护理相比的可行性和可接受性，以及其提高避孕利用率的有效性。这项试点随机试验招募了90名接受MOUD的异性恋、非怀孕、育龄女性。参与者被随机分为：SAFE面对面干预，SAFE计算机适应性干预或常规护理（UC）条件（各n=30），并随访6个月。结果指标包括干预完成，干预满意度，出席避孕咨询预约，长效可逆避孕（LARC）方法的接收。广义线性模型用于推理测试并估计最小二乘均值（二元结果的预测概率）及其标准误差。与UC条件相比，SAFE面对面和SAFE计算机适应干预的干预完成率更高[平均值（标准误差）= 0.97 0.03和0.97（0.03）分别与0.53（.09）; ps<.001]，干预满意度较高[Ms（SE）= 3.7（.11）和3.8（.11）与3.1（0.11）; ps<0.001），避孕咨询访视率较高[Ms（SE）= 0.80（0.07）和0.73（0.08）vs. 0.33（0.09）; p<0.001]，以及更大的LARC接收[Ms（SE）= 0.77（0.08）和0.73（0.08）vs. 0.23（0.08）; p<0.001]。SAFE在支持妇女避孕决策方面似乎是可行和有效的。将SAFE纳入妇女全面的OUD治疗服务，有望增加避孕决策和开始选择方法。
Unintended pregnancies are prevalent among women with opioid use disorder (OUD). The Sex and Female Empowerment (SAFE) project developed a social-cognitive, theory-driven intervention to increase acceptance of and adherence to contraceptive practices among women receiving medication for OUD (MOUD). This study evaluated the feasibility and acceptability of two SAFE interventions (Face-to-face and Computer-adapted) compared to usual care as well as their efficacy to improve contraception utilization. This pilot randomized trial enrolled 90 heterosexual, non-pregnant, reproductive-age women receiving MOUD. Participants were randomized into either a: SAFE Face-to-face intervention, SAFE Computer-adapted intervention, or usual care (UC) condition (n=30 each) and followed for 6 months. Outcome measures included intervention completion, intervention satisfaction, attendance at a contraception consultation appointment, and long-acting reversible contraceptive (LARC) method receipt. A generalized linear model was used for inferential testing and to estimate least squares means (predicted probabilities for binary outcomes) and their standard errors. Compared to the UC condition, both the SAFE Face-to-face and the SAFE Computer-adapted intervention had higher intervention completion [Means (Standard Errors) = 0.97 (.03) and 0.97 (.03), respectively, vs. 0.53 (.09); ps<.001], higher intervention satisfaction [Ms (SEs) = 3.7 (.11) and 3.8 (.11), respectively, vs. 3.1 (.11); ps<0.001), higher contraception consultation visit attendance [Ms(SEs) = 0.80 (.07) and 0.73 (.08) vs. 0.33 (.09); p<.001], and greater LARC receipt [Ms(SEs) = 0.77 (.08) and 0.73 (.08) vs. 0.23 (.08); p<.001). SAFE appears feasible and efficacious for supporting women in contraception decision-making. Integrating SAFE into women’s comprehensive OUD treatment services holds promise to increase contraceptive decision-making and initiation of a chosen method.
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