Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)—an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study

BackgroundWomen of childbearing age (aged 18-44 years) face multiple barriers to receiving screening and treatment for unhealthy alcohol and substance use, depression, and anxiety, including lack of screening in the primary care setting and lack of support in accessing care....

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Main Authors: Krystyna Isaacs, Autumn Shifflett, Kajal Patel, Lacey Karpisek, Yi Cui, Maayan Lawental, Golfo Tzilos Wernette, Brian Borsari, Katie Chang, Tony Ma
Format: Article
Language:English
Published: JMIR Publications 2025-02-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e62915
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author Krystyna Isaacs
Autumn Shifflett
Kajal Patel
Lacey Karpisek
Yi Cui
Maayan Lawental
Golfo Tzilos Wernette
Brian Borsari
Katie Chang
Tony Ma
author_facet Krystyna Isaacs
Autumn Shifflett
Kajal Patel
Lacey Karpisek
Yi Cui
Maayan Lawental
Golfo Tzilos Wernette
Brian Borsari
Katie Chang
Tony Ma
author_sort Krystyna Isaacs
collection DOAJ
description BackgroundWomen of childbearing age (aged 18-44 years) face multiple barriers to receiving screening and treatment for unhealthy alcohol and substance use, depression, and anxiety, including lack of screening in the primary care setting and lack of support in accessing care. The Women Empowered to Connect with Addiction Resources and Engage in Evidence-based Treatment (WE-CARE) mobile app was developed to test universal screening with women of childbearing age and linkage to care after an anonymous assessment. ObjectiveIn this study, we aimed to investigate the feasibility and acceptability of providing anonymous screening instruments through mobile phones for alcohol and substance use, as well as depression and anxiety, for women of childbearing age. MethodsWe used agile development principles based on previous formative research to test WE-CARE mobile health app with women of childbearing age (N=30) who resided in 1 of 6 counties in central Florida. WE-CARE included screening instruments (for alcohol, substance use, depression, and anxiety), a moderated discussion forum, educational microlearning videos, a frequently asked questions section, and resources for linkage to treatment. Individuals were recruited using flyers, academic listserves, and a commercial human subject recruiting company (Prolific). Upon completion of the screening instruments, women explored the educational and linkage to care features of the app and filled out a System Usability Scale to evaluate the mobile health app’s usability and acceptability. Postpilot semistructured interviews (n=4) were conducted to further explore the women’s reactions to the app. ResultsA total of 77 women downloaded the application and 30 completed testing. Women of childbearing age gave the WE-CARE app an excellent System Usability Scale score of 86.7 (SD 12.43). Our results indicate elevated risk for substance use in 18 of the 30 (60%) participants, 9/18 (50%) also had an elevated risk for anxiety or depression, and 11/18 (61%) had an elevated risk for substance use, anxiety, or depression. Participants reported that WE-CARE was easy to navigate and use but they would have liked to see more screening questions and more educational content. Linkage to care was an issue; however, as none of the women identified as “at-risk” for substance use disorders contacted the free treatment clinic for further evaluation. ConclusionsThe mobile health app was highly rated for acceptability and usability, but participants were not receptive to seeking help at a treatment center after only a few brief encounters with the app. The linkage to care design features was likely insufficient to encourage them to seek treatment. The next version of WE-CARE will include normative scores for participants to self-evaluate their screening status compared with their age- and gender-matched peers and enhanced linkages to care features. Future development will focus on enhancing engagement to improve change behaviors and assess readiness for change.
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spelling doaj-art-2201db5bf6c648f499a412d23c8361222025-02-07T13:45:58ZengJMIR PublicationsJMIR Formative Research2561-326X2025-02-019e6291510.2196/62915Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)—an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility StudyKrystyna Isaacshttps://orcid.org/0000-0003-4840-4656Autumn Shiffletthttps://orcid.org/0009-0005-2928-6019Kajal Patelhttps://orcid.org/0009-0001-2417-3761Lacey Karpisekhttps://orcid.org/0000-0002-9826-0008Yi Cuihttps://orcid.org/0009-0005-5908-9809Maayan Lawentalhttps://orcid.org/0000-0001-5139-8205Golfo Tzilos Wernettehttps://orcid.org/0000-0001-7658-1719Brian Borsarihttps://orcid.org/0000-0002-1491-7771Katie Changhttps://orcid.org/0000-0002-7948-4065Tony Mahttps://orcid.org/0000-0003-3092-0572 BackgroundWomen of childbearing age (aged 18-44 years) face multiple barriers to receiving screening and treatment for unhealthy alcohol and substance use, depression, and anxiety, including lack of screening in the primary care setting and lack of support in accessing care. The Women Empowered to Connect with Addiction Resources and Engage in Evidence-based Treatment (WE-CARE) mobile app was developed to test universal screening with women of childbearing age and linkage to care after an anonymous assessment. ObjectiveIn this study, we aimed to investigate the feasibility and acceptability of providing anonymous screening instruments through mobile phones for alcohol and substance use, as well as depression and anxiety, for women of childbearing age. MethodsWe used agile development principles based on previous formative research to test WE-CARE mobile health app with women of childbearing age (N=30) who resided in 1 of 6 counties in central Florida. WE-CARE included screening instruments (for alcohol, substance use, depression, and anxiety), a moderated discussion forum, educational microlearning videos, a frequently asked questions section, and resources for linkage to treatment. Individuals were recruited using flyers, academic listserves, and a commercial human subject recruiting company (Prolific). Upon completion of the screening instruments, women explored the educational and linkage to care features of the app and filled out a System Usability Scale to evaluate the mobile health app’s usability and acceptability. Postpilot semistructured interviews (n=4) were conducted to further explore the women’s reactions to the app. ResultsA total of 77 women downloaded the application and 30 completed testing. Women of childbearing age gave the WE-CARE app an excellent System Usability Scale score of 86.7 (SD 12.43). Our results indicate elevated risk for substance use in 18 of the 30 (60%) participants, 9/18 (50%) also had an elevated risk for anxiety or depression, and 11/18 (61%) had an elevated risk for substance use, anxiety, or depression. Participants reported that WE-CARE was easy to navigate and use but they would have liked to see more screening questions and more educational content. Linkage to care was an issue; however, as none of the women identified as “at-risk” for substance use disorders contacted the free treatment clinic for further evaluation. ConclusionsThe mobile health app was highly rated for acceptability and usability, but participants were not receptive to seeking help at a treatment center after only a few brief encounters with the app. The linkage to care design features was likely insufficient to encourage them to seek treatment. The next version of WE-CARE will include normative scores for participants to self-evaluate their screening status compared with their age- and gender-matched peers and enhanced linkages to care features. Future development will focus on enhancing engagement to improve change behaviors and assess readiness for change.https://formative.jmir.org/2025/1/e62915
spellingShingle Krystyna Isaacs
Autumn Shifflett
Kajal Patel
Lacey Karpisek
Yi Cui
Maayan Lawental
Golfo Tzilos Wernette
Brian Borsari
Katie Chang
Tony Ma
Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)—an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study
JMIR Formative Research
title Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)—an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study
title_full Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)—an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study
title_fullStr Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)—an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study
title_full_unstemmed Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)—an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study
title_short Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)—an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study
title_sort women empowered to connect with addiction resources and engage in evidence based treatment we care an mhealth application for the universal screening of alcohol substance use depression and anxiety usability and feasibility study
url https://formative.jmir.org/2025/1/e62915
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