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

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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.