What you need to know
Researchers conducted a scoping review of studies of digital health resources for adults who have substance use concerns and who identify as female/women and/or disclose a history of trauma. They then rated the digital health resources available in Canada according to the degree to which they incorporated principles of gender- and trauma-informed care. The scoping review found that limited studies were conducted in Canada or assessed gender or trauma; evidence for effectiveness was therefore indirect. Numerous resources were found to be available in Canada, and the rating process revealed that most incorporated some principles of gender– and trauma-informed care, though critical gaps were noted.
This Research Snapshot provides a summary of the CIHR-funded project entitled “Digital Health Solutions to Support Women with Addiction During COVID-19: Applying a Gender- and Trauma-Informed Lens”.
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What is this research about?
Even before the onset of the COVID-19 pandemic, research showed that substance use and the harms associated with it are increasing among women. Troublingly, women experience a number of psychological and practical barriers to care, leading to them being under-represented in treatment settings. Best practice guidelines indicate that it is important for approaches to treatment to be both gender-informed and trauma-informed.
Because of the pandemic, clinical settings that provide substance use treatment are increasingly turning to digital health resources, such as apps and web-based tools. However, most of these settings have yet to integrate them in a way that facilitates the provision of gender- and trauma-informed care for women.
For this reason, this research team set out to identify which digital solutions are available to support substance use treatment for women, what their clinical features are, and what research has been done to support their use.
What did the researchers do?
First, the researchers conducted a scoping review. This served to evaluate the effectiveness of digital health resources for adults who have substance use concerns and who identify as female/women and/or disclose a history of trauma.
Next, the researchers identified digital health resources that are available in Canada for addressing substance use concerns. They developed a scale of questions to rate each resource they had found according to the degree to which it incorporated the following principles of gender- and trauma-informed care:
Gender-Informed Care Principles
- Consideration of differences in the roles,responsibilities, and needs of gender groups
- Recognition of gender fluidity
- Incorporation of intersectionality
- Challenging gender power imbalances and negativestereotypes
- Inclusion of sex-informed and gender-specific information and approaches
- Supportive of empowerment
- Focus on improving gender equity
Trauma-Informed Care Principles
- Trauma awareness and acknowledgement
- Safety and trustworthiness
- Emphasis on choice, control, and collaboration
- Strengths-based and skills-building care and empowerment
- Acknowledgment of cultural, historical, and gender issues
What did the researchers find?
The researchers found that the majority of digital health interventions for substance use concerns that have been studied were determined to be effective or demonstrated benefits for people who use substances. Most studies did not assess gender or conduct sex or gender-based analyses and therefore didn’t specifically report whether the interventions were effective for people who identify as female or women. Few studies reported on the number of participants who had a history of trauma or post-traumatic stress symptoms.
A total of 23 digital health resources were identified that address substance use concerns, are available in Canada, and that were available to be reviewed and rated. The rating process revealed that many of these resources provide sex- or gender-specific information, and support empowerment to some degree. However, most principles of gender-informed care were not evident in the resources. In particular, most resources did not consider differences between gender groups, did not recognize gender fluidity, did not incorporate intersectionality, and did not acknowledge or work to improve gender equity.
The rating process also revealed that most resources uphold several principles of trauma-informed care. These included safety and trustworthiness; emphasis on choice, control, and collaboration; and strength-based and skills-building care and empowerment. However, other principles of trauma-informed care were less evident. In particular, most resources lacked acknowledgment of cultural, historical, and gender issues.
How can you use this research?
Providers of substance use treatment can use this research to determine which digital health resources may benefit their clients, and to determine the extent to which various apps and web-based tools for substance use concerns may be considered gender- and trauma-informed. Next steps More research is required on the efficacy and effectiveness of digital health resources for women in Canada with substance use concerns. There is also a need for more sex- and gender-based analysis in empirical investigations of digital health resources. Finally, the researchers recommend the future development of new, innovative digital health solutions that incorporate the principles of gender- and trauma-informed care that were not found to be present in existing resources.
Digital health, women, substance use, addiction, gender, trauma
This Research Snapshot provides a summary of the CIHR-funded project entitled “Digital Health Solutions to Support Women with Addiction During COVID-19: Applying a Gender- and Trauma-Informed Lens”. Findings are being prepared for submission to a peer-reviewed journal. Access up-to-date information about the project.