Women in the criminal legal system are more likely to experience substance use disorders and unintended pregnancy than women in the general public. However, they often face barriers to accessing substance use treatment and sexual and reproductive health services. This study tests the feasibility and acceptability of Women on the Road to Health (WORTH) Promoting Access to Treatment, Health, and Support (Paths), a digital intervention adapted from the evidence-based CDC Best Practice HIV prevention intervention, Women on the Road to Health (WORTH), originally developed at Columbia University School of Social Work. WORTH Paths is designed to help reproductive-aged women in the criminal legal system with substance use disorders and unmet need for contraception reduce drug use and improve contraceptive use. Participants (N=50) will be randomly assigned to one of two groups: WORTH Paths Intervention Group - Participants will attend three virtual group sessions with facilitated videoconference sessions and self-paced digital activities focused on reducing drug use and increasing contraceptive use. They will also receive guidance on how to access and navigate health services. Control Group - Participants will receive a virtual general wellness program that includes education on substance use and sexual and reproductive health but does not include skills-based training related to these topics. The focus will be on general wellness and stress reduction. Both groups will receive resources for substance use treatment and sexual and reproductive health services. Researchers will track changes in drug use and contraceptive use over three months. Participants will complete surveys and provide urine samples to confirm changes in drug use. Primary aims: Feasibility: Measured by session attendance, treatment completion, dropouts, and reasons for termination. Acceptability: Measured by participant ease of use, helpfulness, and satisfaction. Primary behavioral outcomes: Self-reported drug use confirmed by urine drug tests. Contraceptive use, including initiation and consistent use. Secondary behavioral outcome: Linkage to substance use disorder treatment (measured by appointments made and sessions attended).
Age range
18 Years – 44 Years
Sex
FEMALE
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Feasibility Measurement 1: Treatment Completion Rates
Timeframe: Immediately after Session 3 (Week 3)
Feasibility Measurement 2: Session Completion Rates
Timeframe: Immediately after each session (Week 1, Week 2, Week 3)
Feasibility Measurement 3: Dropout Rates and Reasons for Termination
Timeframe: Immediately after each session (Week 1, Week 2, Week 3)
Feasibility Measurement 4: Technical Usability
Timeframe: Immediately after each session (Week 1, Week 2, Week 3)
Feasibility Measurement 5: Qualitative Feasibility Assessment
Timeframe: 1 week after completion of Session 3 (Week 4)
Acceptability Measurement 1: Ease of Use
Timeframe: Immediately after each session (Week 1, Week 2, Week 3)
Acceptability Measurement 2: Helpfulness
Timeframe: Immediately after each session (Week 1, Week 2, Week 3)
Acceptability Measurement 3: Satisfaction
Timeframe: Immediately after each session (Week 1, Week 2, Week 3)
Acceptability Measurement 4: Qualitative Acceptability Assessment
Timeframe: 1 week after completion of Session 3 (Week 4)
Change from baseline in self-reported primary illicit drug use at 3 months
Timeframe: Baseline and 3-month follow-up
Change from baseline in biologically confirmed illicit drug use at 3 months
Timeframe: Baseline and 3-month follow-up
Change from baseline in the number of participants initiating a contraceptive method highly effective at preventing unintended pregnancy at 3 months
Timeframe: Baseline and 3-month follow-up
Change from baseline in effective contraceptive use at 3 months
Timeframe: Baseline and 3-month follow-up