ABSTRACT

Background:

The majority of persons in substance use treatment have an interpersonal violence history, with sexual and intimate partner violence disproportionately affecting women. Both violence history and substance use place women at risk for cumulative trauma exposure and adverse outcomes, including substance use disorders (SUDs), posttraumatic stress disorder (PTSD), depression, and physical health problems. There is an urgent need for interventions to reduce these health disparities by preventing victimization and revictimization among women with SUDs. The Healthy Relationships and Interpersonal Violence Education program (THRIVE) adapts evidence-based strategies for this population and is informed by the information, motivation, behavioral skills (IMB) theoretical model. Topics include the intersection of substance use and violence, consent, risk detection, protective behavioral strategies, and help-seeking. THRIVE employs a novel approach by engaging peer support specialists (PSS) to deliver the program. PSS are trained advocates with lived experience who can help overcome barriers to care, including stigma and accessibility.

Objective:

The first objective is to determine the preliminary efficacy of THRIVE, including its effect on violence-related knowledge and attitudes, protective behavior, victimization, substance use, and mental health. The second objective is to determine program acceptability and feasibility.

Methods:

The protocol entails a single arm trial of THRIVE with 60 women in behavioral and/or medication-assisted substance use treatment, recruited from three outpatient and residential treatment sites. Interview data will also be collected from ten participants and two PSS. Participants complete assessments at four time points over three months (baseline, post-intervention, one- and three-month follow-up). Self-report questionnaires assess violence prevention knowledge and attitudes, sexual self-efficacy, protective sexual/dating strategies, trauma-focused service use, sexual and intimate partner violence victimization, substance use, posttraumatic stress disorder symptoms, and depression symptoms. To determine feasibility, quantitative and qualitative data assess recruitment, retention, engagement, perceived usefulness, barriers and facilitators of participation and adoption, and working alliance with PSS.

Results:

A total of 60 participants were recruited and completed the intervention between June and October 2024.

Conclusions:

THRIVE will address critical gaps in the field by: 1) expanding violence prevention strategies to SUD treatment settings; 2) integrating sexual and intimate partner violence prevention, 3) incorporating a focus on illicit substance use, and 4) engaging PSS to overcome barriers to care. The long-term objective of this project is to develop an accessible, scalable, and efficacious prevention program that reduces incidence of sexual and intimate partner victimization, substance use, and violence-related mental health disorders for women in substance use treatment. Clinical Trial: NCT06608979