Quilty Lena, Agic Branka, Coombs Michelle, Kristy Betty-Lou, Shakespeare Jill, Spafford Adrienne, Besa Reena, Dematagoda Shadini, Patel Alina, Persaud Rebecca, Buckley Leslie
Centre for Addiction and Mental Health, Toronto, ON, Canada.
University of Toronto, Toronto, ON, Canada.
JMIR Ment Health. 2021 Jun 7;8(6):e25952. doi: 10.2196/25952.
Digital health resources are being increasingly used to support women with substance use concerns. Although empirical research has demonstrated that these resources have promise, the available evidence for their benefit in women requires further investigation. Evidence supports the capacity of interventions that are sex-, gender-, and trauma-informed to improve treatment access and outcomes and to reduce health system challenges and disparities. Indeed, both sex- and gender-specific approaches are critical to improve health and gender equity. Violence and trauma are frequent among those with substance use concerns, but they disproportionately affect those who identify as female or women, further underscoring the need for trauma-informed care as well.
The objective of this investigation was to evaluate the evidence supporting the efficacy or effectiveness of online or mobile interventions for risky or harmful substance use in adults who identify as female or women, or who report a history of trauma.
This scoping review is based on an academic search in MEDLINE, APA PsycINFO, Embase, Cochrane Central, and CINAHL, as well as a grey literature search in US and Canadian government and funding agency websites. Of the 7807 records identified, 465 remained following title and abstract screening. Of these, 159 met all eligibility criteria and were reviewed and synthesized.
The 159 records reflected 141 distinct studies and 125 distinct interventions. Investigations and the interventions evaluated predominantly focused on alcohol use or general substance use. Evaluated digital health resources included multisession and brief-session interventions, with a wide range of therapeutic elements. Multisession online and mobile interventions exhibited beneficial effects in 86.1% (105/122) of studies. Single-session interventions similarly demonstrated beneficial effects in 64.2% (43/67) of study conditions. Most investigations did not assess gender identity or conduct sex- or gender-based analyses. Only 13 investigations that included trauma were identified.
Despite the overall promise of digital health interventions for substance use concerns, direct or quantitative evidence on the efficacy or effectiveness of interventions in females or women specifically is weak.
数字健康资源正越来越多地用于为有物质使用问题的女性提供支持。尽管实证研究表明这些资源具有潜力，但关于其对女性有益的现有证据仍需进一步调查。有证据支持采用性别和创伤知情的干预措施能够改善治疗机会和结果，并减少卫生系统面临的挑战和差异。事实上，针对性别和性别的特定方法对于改善健康和性别平等至关重要。暴力和创伤在有物质使用问题的人群中很常见，但它们对认定为女性的人群影响尤为严重，这进一步凸显了采用创伤知情护理的必要性。
本调查的目的是评估支持在线或移动干预对认定为女性或有创伤史的成年人中危险或有害物质使用的疗效或有效性的证据。
本范围综述基于对MEDLINE、美国心理学会心理学文摘数据库（APA PsycINFO）、Embase、考科蓝中心对照临床试验注册库（Cochrane Central）和护理学与健康领域数据库（CINAHL）的学术搜索，以及对美国和加拿大政府及资助机构网站的灰色文献搜索。在识别出的7807条记录中，经过标题和摘要筛选后还剩下465条。其中，159条符合所有纳入标准并进行了审查和综合分析。
159条记录反映了141项不同的研究和125种不同的干预措施。所评估的调查和干预措施主要集中在酒精使用或一般物质使用上。评估的数字健康资源包括多疗程和短疗程干预措施，具有广泛的治疗要素。多疗程在线和移动干预措施在86.1%（105/122）的研究中显示出有益效果。单疗程干预措施在64.2%（43/67）的研究条件下同样显示出有益效果。大多数调查没有评估性别认同，也没有进行基于性别的分析。仅识别出13项包含创伤因素的调查。
尽管数字健康干预措施对物质使用问题总体上具有潜力，但关于这些干预措施对女性的疗效或有效性的直接或定量证据薄弱。
