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

项目总结/摘要。这个K 01奖的目的是提供候选人，梅丽莎N。 斯莱文在哥伦比亚大学社会工作学院接受了成为一名独立工作者所需的培训， 数字干预科学中的物质使用调查员，重点关注性健康和生殖健康（SRH） （c）在弱势妇女，特别是刑事司法系统中的妇女中存在的问题。斯莱文博士 建议调整和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，为育龄妇女提供基于小组的治疗 最近有监禁或社区监督史的妇女。这一举措旨在减少非法 药物使用，增加患有药物使用障碍的妇女使用各种形式的避孕药具， 未满足的避孕需求（即，多产，性活跃，报告不想要更多的孩子或想 推迟下一个孩子，但不使用任何避孕方法）。WICJ，其中大多数是生殖- 老年人，SUD和避孕需求未得到满足的比率高，受协同个体的影响， 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)在患有SUD的WICJ中，妇女及其后代的发病率和死亡率增加。 对吸毒的妇女国际司法工作者的现有干预措施往往侧重于性传播感染，包括 艾滋病毒，而不包括UPs。在一般育龄妇女中，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，并可提高执行的可靠性、可获得性， 和个性化。针对吸毒妇女和青年的数字艾滋病毒预防干预措施可以提供一个关键平台， 解决育龄妇女的不平等问题。多媒体价值，一个基于证据的艾滋病毒预防 干预使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，并有效地增加避孕套的使用。斯莱文博士将适应多媒体价值为生殖年龄 有SUD和未满足避孕需求的WICJ，使用数字干预（促进基于小组的治疗） 通过视频会议和自定进度的活动）通过3个研究目标（RA）：RA 1：确定可修改的 通过定性访谈确定育龄WICJ中药物和避孕药具使用的决定因素; RA 2： 适应多媒体价值使用系统的适应框架; RA 3。评估可行性，可接受性， 通过对50例WICJ患者的随机对照试验（RCT）评估干预的初步有效性。数据 从这个K 01获得的信息将支持NIDA解决成瘾的真实的世界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/民族有关的治疗障碍， 脆弱的WICJ这K 01将提供斯莱文博士培训：1）适应和实施文化定制 干预，2）对弱势妇女进行负责任的研究，3）利用数字干预， 解决健康差距，以及4）定量和定性干预评估研究方法。

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.