Authors
Sugarman DE, Levine EA, Wang CL, et al.
Purpose
This study aimed to inform and support the development of Healthy Women, a gender-specific digital intervention designed to deliver care tailored to women with opioid use disorder to enhance engagement in medications for opioid use disorder (MOUD) treatment. Specific aims included collecting data from treatment providers and women with lived experience of OUD to design and subsequently beta-test and refine the digital intervention.
Methods
The three phases of this study followed the principals of the Discover, Design and Build, and Test framework: (1) formative, (2) development, and (3) pilot study. Phases 1 and 2 have been completed; the phase 3 pilot study is underway. Phase 1 included qualitative interviews with women with OUD (n=20) and treatment providers (n=8). The interviews covered treatment barriers and facilitators, key topics of interest, and provider perceived barriers to treatment initiation and sustainment. In addition, a self-report survey with treatment providers (n=55) assessed frequency of advising women about MOUD, barriers to treatment, and the utility of intervention features and content. In Phase 2 the digital intervention was designed based on previously adapted materials and the insights from Phase 1, refined following an initial expert review, and beta-tested with five end-users engaged in a “think aloud” process (i.e., describing experiences and challenges as they navigated through).
Findings
- Qualitative interview findings with women with lived experience and providers resulted in data that fell into six main thematic categories: Barries to treatment, facilitators to successful recovery, important issues to address in treatment, positives of using technology as a component of treatment, suggested technology features, and barriers to using technology.
- Across the treatment-related categories, several themes were identified as women-specific factors that should be addressed in treatment: family responsibilities, intimate partner abuse, stigma, and motivation for treatment (e.g., pregnancy).
- Provider interviews revealed six key features that would be beneficial to include in digital content for women with OUD (i.e., features scored over a 4 out of 5, with 5 being the highest possible score): peer support, appointment reminders, connection with treatment providers, crisis resources, rewards, and coping skills practice.
- The Healthy Women intervention included several components based on phase 1 qualitative interviews and polished by experts and end-users in phase 2: motivational messages, skills practice activities, weekly check-ins, and resources.
Relevance
- While some limited previous research has examined gender-specific digital interventions for OUD, the focus has been on specific populations (e.g., racial/ethnic minorities, rural areas, people mandated to treatment). This study served to fill the gap for a more generalized gender-specific digital intervention for women with SUDs.
- The findings from phase 1 emphasize the need to focus research on women with OUD more generally and resulted in several areas of expansion on the current literature, including the identification of family responsibilities, MOUD-specific barriers, stigma, and factors that motivate treatment (e.g., pregnancy) that were specific to women.
- The inclusion of expert and end-user feedback provided the groundwork for the Healthy Women Intervention, while data from the ongoing pilot study will garner information on feasibility, satisfaction, and engagement.
Read More
Sugarman DE, Levine EA, Wang CL, et al. (2026). Development of the Healthy Women Intervention to Increase Women’s Engagement in Medication Treatment for Opioid Use Disorder: Mixed Methods, User-Centered Design Approach. JMIR Form Res. 10:e85195. doi:10.2196/85195