Administrative Supplement for K01 Adaptation of a Digital Group-Based Intervention to Reduce Drug Use and Increase Contraceptive Use among Reproductive-Aged Women Involved in Criminal Justice System

项目摘要/摘要。这一K01奖的目的是为候选人梅丽莎·N。 Slavin，在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 侧重于性健康和生殖健康(SRH)的数字干预科学中的物质使用调查员 弱势妇女，特别是参与刑事司法系统的妇女之间的问题(WICJ)。斯莱文博士 提议调整和确定数字干预的可行性和可接受性，这将包括 通过视频会议和数字互动活动促进以群体为基础的育龄治疗 有近期监禁史或社区监督史的妇女。这一干预措施旨在减少非法 在患有物质使用障碍的妇女中使用药物和增加所有形式的避孕用具 未满足的避孕需求(即生育能力强、性生活活跃、报告不想要更多孩子或想要 推迟下一个孩子，但没有使用任何避孕方法)。WICJ，他们中的大多数是生殖的- 老年人有很高的肥皂率和未得到满足的避孕需求，受协同个体的影响， 人际和社区层面的风险因素。未得到满足的避孕需求导致意外怀孕 (UPS)在患有肥胖症的WICJ中增加，妇女及其子女的发病率和死亡率增加。 WICJ使用毒品的现有干预措施通常集中在性传播感染(STI)，包括 HIV，同时省略了UPS。在一般育龄妇女中，数字干预在以下方面有效 减少药物使用和增加避孕用具的使用，并可提高实施的可靠性、可及性、 和个性化。为使用毒品的WICJ提供数字艾滋病毒预防干预可以提供一个关键平台 解决育龄妇女中的UP问题。多媒体价值--以证据为基础的艾滋病预防 干预使用面对面小组和数字互动活动来解决WICJ中使用 药物，在增加避孕套使用方面是有效的。斯莱文博士将改编适合生育年龄的多媒体沃思 WICJ有肥皂水和未得到满足的避孕需求，使用数字干预(促进基于团体的治疗 通过视频会议和自定进度的活动)通过3个研究目标(RAS)：RA1：确定可修改 通过定性访谈对育龄妇女妇女中心的药物和避孕用具使用的决定因素；RA2： 改编多媒体值得使用系统的改编框架；RA3。评估可行性、可接受性、 并通过50例WICJ的随机对照试验(RCT)进行干预的初步效果。数据 从K01获得的结果将支持NIDA优先关注的领域，即解决现实世界中成瘾的复杂性， 通过针对与性别、年龄、社会经济地位和种族/民族有关的治疗障碍 脆弱的WICJ。这款K01将为Slavin博士提供以下方面的培训：1)适应和实施文化定制的 干预，2)对弱势妇女进行负责任的研究，3)利用数字干预来 解决健康差距，以及4)定量和定性干预评价研究方法。

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.