{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:49:22Z","timestamp":1785854962139,"version":"3.56.0"},"reference-count":108,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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\u2019s usability and acceptability. Postpilot semistructured interviews (n=4) were conducted to further explore the women\u2019s reactions to the app.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A 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 \u201cat-risk\u201d for substance use disorders contacted the free treatment clinic for further evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/62915","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T13:54:40Z","timestamp":1733752480000},"page":"e62915","source":"Crossref","is-referenced-by-count":4,"title":["Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)\u2014an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4840-4656","authenticated-orcid":false,"given":"Krystyna","family":"Isaacs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2928-6019","authenticated-orcid":false,"given":"Autumn","family":"Shifflett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2417-3761","authenticated-orcid":false,"given":"Kajal","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9826-0008","authenticated-orcid":false,"given":"Lacey","family":"Karpisek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5908-9809","authenticated-orcid":false,"given":"Yi","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5139-8205","authenticated-orcid":false,"given":"Maayan","family":"Lawental","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7658-1719","authenticated-orcid":false,"given":"Golfo","family":"Tzilos Wernette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1491-7771","authenticated-orcid":false,"given":"Brian","family":"Borsari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7948-4065","authenticated-orcid":false,"given":"Katie","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3092-0572","authenticated-orcid":false,"given":"Tony","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03391702"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13985"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/add.16262"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6801a1"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.16789"},{"key":"ref6","unstructured":"Unintended pregnancy20192019-12-10Centers for Disease Control and Prevention Reproductive Healthhttps:\/\/www.cdc.gov\/reproductivehealth\/contraception\/unintendedpregnancy\/index.htm"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1994.tb00020.x"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.22.2996"},{"issue":"4","key":"ref9","first-page":"414","volume":"34","author":"Smith, JP","year":"2012","journal-title":"Alcohol Res"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.35946\/arcr.v40.1.01"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2008.10400665"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318256496e"},{"key":"ref13","unstructured":"Alcohol abuse and other sbustance use disorders: ethical issues in obstetric and gynecologic practice20152024-12-30American College of Obstetricians and Gynecologistshttps:\/\/www.acog.org\/Clinical-Guidance-and-Publications\/Committee-Opinions\/Committee-on-Ethics\/Alcohol-Abuse-and-Other-Substance-Use-Disorders-Ethical-Issues-in-Obstetric-and-Gynecologic-Practice"},{"key":"ref14","unstructured":"Screening2024-12-30Columbia University Department of Psychiatryhttps:\/\/www.columbiapsychiatry.org\/research\/research-areas\/substance-use-disorders\/education\/sbirt\/about\/screening"},{"key":"ref15","unstructured":"Physical health and mental health2024-05-23Mental Health Foundationhttps:\/\/www.mentalhealth.org.uk\/explore-mental-health\/a-z-topics\/physical-health-and-mental-health"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-023-00376-z"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.16789"},{"key":"ref18","year":"2016","journal-title":"The Surgeon General?s Report on Alcohol, Drugs, and Health"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s40352-015-0015-5"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-020-00399-8"},{"key":"ref21","unstructured":"Substance abuse reporting and pregnancy: the role of the obstetrician-gynecologist20112024-12-30American College of Obstetricians and Gynecologistshttps:\/\/www.acog.org\/clinical\/clinical-guidance\/committee-opinion\/articles\/2011\/01\/substance-abuse-reporting-and-pregnancy-the-role-of-the-obstetrician-gynecologist"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1177\/002204260603600404"},{"key":"ref23","unstructured":"More than 4 in 10 U.S. adults who needed substance use and mental health care did not get treatment20222024-12-30National Council for Mental Wellbeinghttps:\/\/www.thenationalcouncil.org\/news\/more-than-4-in-10-us-adults-who-needed-substance-use-and-mental-health-care-did-not-get-treatment\/"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05232-y"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1080\/13561820600622208"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-306-47193-3_10"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-13-261"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0b013e3181b95015"},{"key":"ref29","unstructured":"TAPS: tobacco, alcohol, prescription medication, and other substance use tool2024-12-30National Institutes of Healthhttps:\/\/www.drugabuse.gov\/taps\/#\/"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003230"},{"key":"ref31","unstructured":"Using standardized tools2024-12-30IntellectAbilityhttps:\/\/replacingrisk.com\/using-standardized-tools\/"},{"key":"ref32","unstructured":"Recommendations for curricular elements in substance use disorders training2024-12-30Substance Abuse and Mental Health Services Administrationhttps:\/\/www.samhsa.gov\/medications-substance-use-disorders\/provider-support-services\/recommendations-curricular-elements-substance-use-disorders-training"},{"key":"ref33","unstructured":"TAP 33: systems-level implementation of screening, brief intervention, and referral to treatment (SBIRT)20132024-12-30Substance Abuse and Mental Health Services Administrationhttps:\/\/library.samhsa.gov\/product\/tap-33-systems-level-implementation-screening-brief-intervention-and-referral-treatment"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2007.09.035"},{"key":"ref35","unstructured":"Implementing care for alcohol & other drug use in medical settings: an extension of SBIRT20182024-12-30National Council for Behavioral Healthhttps:\/\/www.thenationalcouncil.org\/wp-content\/uploads\/2021\/04\/Implementing_Care_for_Alcohol_and_Other_Drug_Use_In_Medical_Settings_-_An_Extension_of_SBIRT.pdf"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.681165"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2924"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1186\/s40985-017-0077-0"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1177\/11782218221146391"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2015.06.003"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2007.02072.x"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000859"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2018.1550465"},{"key":"ref44","author":"Miller, W","year":"2024","journal-title":"Motivational Interviewing: Helping People Change and Grow. Fourth"},{"key":"ref45","unstructured":"Advisory: using motivational interviewing in substance use disorder treatment (based on TIP 35)20212024-12-30Substance Abuse and Mental Health Services Administrationhttps:\/\/store.samhsa.gov\/product\/advisory-using-motivational-interviewing-substance-use-disorder-treatment-based-tip-35"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2008.05.005"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000003011"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1007\/s11414-016-9549-0"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05257-3"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1037\/pha0000445"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2019.03.032"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-056496"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000838"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-019-3551-9"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1016\/j.procs.2022.09.091"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2017.1303556"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.2196\/40789"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.2196\/33037"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.2196\/20251"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.02.005"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0204890"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000318"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20638"},{"key":"ref64","unstructured":"Mobile fact sheet20242024-12-30Pew Research Centerhttps:\/\/www.pewresearch.org\/internet\/fact-sheet\/mobile\/"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13009"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2017.03.011"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2021.0418"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2008.07.017"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.2196\/37851"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.1480"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-022-00658-w"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.2196\/62915"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181ed8290"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.7326\/M16-0317"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2018.05.029"},{"key":"ref76","unstructured":"Instrument: Patient Health Questionnaire-2 (PHQ-2)2024-12-30NIDA CTN Common Data Elementshttps:\/\/cde.nida.nih.gov\/instrument\/fc216f70-be8e-ac44-e040-bb89ad433387"},{"key":"ref77","unstructured":"Vyond products: the effortless, all-in-one AI video creation platform2024-12-30Vyondhttps:\/\/www.vyond.com\/product\/"},{"key":"ref78","unstructured":"ChatGPT 4o mini2024-12-30ChatGPThttps:\/\/chat.openai.com"},{"key":"ref79","unstructured":"Quality data. From real people. For faster breakthroughs2024-12-30Prolifichttps:\/\/www.prolific.com\/"},{"key":"ref80","unstructured":"Screening, Brief Intervention, and Referral to Treatment (SBIRT)2024-12-30Substance Abuse and Mental Health Services Administrationhttps:\/\/www.samhsa.gov\/sbirt"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.1300\/J465v25n01_05"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1017\/S1463423620000675"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.10.026"},{"key":"ref84","unstructured":"What is SBIRT?2024-12-30SBIRThttps:\/\/sites.education.miami.edu\/sbirt\/what-is-sbirt\/"},{"key":"ref85","doi-asserted-by":"publisher","DOI":"10.1080\/09638230120041254"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-015-0047-0"},{"key":"ref87","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107679"},{"key":"ref88","unstructured":"Mental Health Disorder Statistics2024-12-30Johns Hopkins Medicinehttps:\/\/www.hopkinsmedicine.org\/health\/wellness-and-prevention\/mental-health-disorder-statistics"},{"key":"ref89","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7224a1"},{"key":"ref90","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7040e3"},{"key":"ref91","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7013e2"},{"key":"ref92","unstructured":"Any Anxiety Disorder2024-12-30National Institute of Mental Healthhttps:\/\/www.nimh.nih.gov\/health\/statistics\/any-anxiety-disorder"},{"key":"ref93","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2017.1397304"},{"key":"ref94","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2022.102203"},{"issue":"4","key":"ref95","first-page":"225","volume":"55","author":"Morse, BA","year":"2000","journal-title":"J Am Med Womens Assoc (1972)"},{"key":"ref96","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2017.1280816"},{"key":"ref97","doi-asserted-by":"publisher","DOI":"10.1089\/109493103321640301"},{"key":"ref98","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7737"},{"key":"ref99","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2009.0148"},{"key":"ref100","doi-asserted-by":"publisher","DOI":"10.1089\/cyber.2018.0247"},{"key":"ref101","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2019.31.1.17"},{"key":"ref102","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2016.00186"},{"key":"ref103","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6740"},{"key":"ref104","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2011.2732"},{"key":"ref105","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.12.005"},{"key":"ref106","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12747"},{"key":"ref107","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2012.04094.x"},{"key":"ref108","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2263"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e62915","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:55:37Z","timestamp":1785851737000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e62915"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,7]]},"references-count":108,"URL":"https:\/\/doi.org\/10.2196\/62915","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,7]]}}}