{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:36:33Z","timestamp":1784248593656,"version":"3.55.0"},"reference-count":33,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Rates of opioid use disorder (OUD) have increased among women over the past 2 decades. Medication treatment for opioid use disorder (MOUD) is effective but underused. Gender-specific treatments for women have been associated with improved substance use outcomes. However, these treatments have not specifically targeted women\u2019s engagement in MOUD, and the impact of existing gender-specific treatments is restricted by in-person delivery.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aim of this study was to develop a digital intervention to feasibly deliver gender-specific care that addresses the individualized needs of women with OUD to increase engagement in MOUD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A mixed methods, user-centered design approach was used to inform the development of a digital intervention. In phase 1, qualitative interviews were conducted with women with lived experience of OUD (n=20) and providers who treat women with OUD (n=8). Interviews were recorded, transcribed, and coded for themes. In addition, a larger sample of treatment providers (n=55) completed an online survey to further inform the content of the digital intervention. Phase 2 consisted of designing, beta-testing (n=5), and refining the intervention.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The age of women with lived experience ranged from 21 to 59 (mean 38.5, SD 9.4) years; 63% (5\/8) of providers interviewed were female participants. The qualitative interview data from women with lived experience and providers were grouped into 6 thematic categories: 3 treatment-related (1) barriers to treatment, (2) facilitators to successful recovery, and (3) important issues to address in treatment, and 3 technology-related (4) positives of using technology as part of treatment, (5) suggested technology features, and (6) barriers to using technology. Across the treatment-related categories, several themes touched on women-specific factors including family responsibilities, abusive partners, stigma, and motivation for treatment (eg, pregnancy). The technology-related categories provided information for designing the features of the intervention, as well as revealing barriers to technology use, which could be helpful in developing implementation strategies. Provider survey participants were primarily female participants (40\/55, 73%), with a mean age of 42.5 (SD 12.5) years. Survey data provided additional information on barriers to treatment and suggested technology features. Based on these data and preliminary work, the\n Healthy Women<\/jats:italic>\n intervention was created. Minor edits to content and visual design were made in the beta-testing phase. The final version includes a web-based component with 6 topic modules and a mobile component. Topics in the web-based component are presented through infographics, text, videos, and interactive questions. The mobile component includes daily motivational messages, skills practice activities (2\/wk), weekly check-ins, and resources (always available).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Important themes and suggested features from women with lived experience and providers were incorporated into a digital intervention for women with OUD. Data on feasibility, satisfaction, and engagement with the\n Healthy Women<\/jats:italic>\n intervention are currently being collected in phase 3, a pilot randomized controlled trial.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/85195","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T16:12:25Z","timestamp":1774973545000},"page":"e85195-e85195","source":"Crossref","is-referenced-by-count":1,"title":["Development of the Healthy Women Intervention to Increase Women\u2019s Engagement in Medication Treatment for Opioid Use Disorder: Mixed Methods, User-Centered Design Approach"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8390-4755","authenticated-orcid":false,"given":"Dawn E","family":"Sugarman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6928-0336","authenticated-orcid":false,"given":"Emily A","family":"Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4144-1617","authenticated-orcid":false,"given":"Callie L","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8420-2966","authenticated-orcid":false,"given":"Francesca M","family":"Korte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7892-8662","authenticated-orcid":false,"given":"Nicole A","family":"Barbaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7503-828X","authenticated-orcid":false,"given":"Roger D","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6429-0965","authenticated-orcid":false,"given":"Lisa A","family":"Marsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4247-9980","authenticated-orcid":false,"given":"Aimee NC","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-1416","authenticated-orcid":false,"given":"Shelly F","family":"Greenfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"R1","unstructured":"Key substance use and mental health indicators in the United States: results from the 2024 national survey on drug use and health. Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services; 2025. URL: https:\/\/nhcenterforexcellence.org\/wp-content\/uploads\/2025\/08\/2024-nsduh-annual-national-report-1.pdf [Accessed 06-03-2026]"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2023.209188","article-title":"Gender differences in receipt of telehealth versus in person behavioral therapy, medication for opioid use disorder (MOUD), and 90-day MOUD retention during the pandemic: a retrospective veteran cohort study","volume":"156","author":"Livingston","journal-title":"J Subst Use Addict Treat"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108399","article-title":"Gender disparities in access and retention in outpatient methadone treatment for opioid use disorder in low-income urban communities","volume":"127","author":"Marsh","journal-title":"J Subst Abuse Treat"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.jsat.2006.06.013","article-title":"Does gender-specific substance abuse treatment for women promote continuity of care?","volume":"32","author":"Claus","journal-title":"J Subst Abuse Treat"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.drugalcdep.2007.02.009","article-title":"The women\u2019s recovery group study: a stage I trial of women-focused group therapy for substance use disorders versus mixed-gender group drug counseling","volume":"90","author":"Greenfield","journal-title":"Drug Alcohol Depend"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.06.035","article-title":"Group therapy for women with substance use disorders: results from the women\u2019s recovery group study","volume":"142","author":"Greenfield","journal-title":"Drug Alcohol Depend"},{"issue":"3","key":"R7","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1016\/j.jsat.2013.09.005","article-title":"Gender-sensitive substance abuse treatment and arrest outcomes for women","volume":"46","author":"Kissin","journal-title":"J Subst Abuse Treat"},{"key":"R8","unstructured":"Treatment episode data set (TEDS) 2022: admissions to and discharges from substance use treatment services reported by single state agencies. Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services; 2024. URL: https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt53160\/2022-teds-annual-report.pdf [Accessed 20-01-2026]"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1176\/appi.ajp.20230055","article-title":"Effects of bundling medication for opioid use disorder with an mHealth intervention targeting addiction: a randomized clinical trial","volume":"181","author":"Gustafson","journal-title":"Am J Psychiatry"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-022-00296-4","article-title":"Six-month outcomes of the HOPE smartphone application designed to support treatment with medications for opioid use disorder and piloted during an early statewide COVID-19 lockdown","volume":"17","author":"Hodges","journal-title":"Addict Sci Clin Pract"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-018-0122-4","article-title":"MySafeRx: a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing for enhancing buprenorphine\/naloxone adherence during opioid use disorder treatment: a pilot study","volume":"13","author":"Schuman-Olivier","journal-title":"Addict Sci Clin Pract"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-05007-0","article-title":"Blended smartphone intervention for patients in opioid maintenance treatment in Iran: protocol for a randomized controlled trial","volume":"23","author":"Boumparis","journal-title":"BMC Psychiatry"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.2196\/48068","article-title":"Development and evaluation of a digital app for patient self-management of opioid use disorder: usability, acceptability, and utility study","volume":"8","author":"King","journal-title":"JMIR Form Res"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-020-00189-4","article-title":"Development of an integrated digital health intervention to promote engagement in and adherence to medication for opioid use disorder","volume":"15","author":"Langdon","journal-title":"Addict Sci Clin Pract"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.2196\/49751","article-title":"Users\u2019 acceptability and perceived efficacy of mHealth for opioid use disorder: scoping review","volume":"12","author":"Lyzwinski","journal-title":"JMIR mHealth uHealth"},{"issue":"10","key":"R16","doi-asserted-by":"publisher","DOI":"10.2196\/37474","article-title":"Acceptability and usability of a reward-based mobile app for opioid treatment settings: mixed methods pilot study","volume":"6","author":"Proctor","journal-title":"JMIR Form Res"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-023-07213-3","article-title":"Smartphone intervention to optimize medication-assisted treatment outcomes for opioid use disorder: study protocol for a randomized controlled trial","volume":"24","author":"Thompson","journal-title":"Trials"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2024.111352","article-title":"Digital health interventions to support women with opioid use disorder: a scoping review","volume":"261","author":"Ward","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1089\/whr.2022.0046","article-title":"Project BETTER: preliminary feasibility and acceptability of a technology-delivered educational program for pregnant and postpartum people with opioid use disorder","volume":"3","author":"Martin","journal-title":"Womens Health Rep (New Rochelle)"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1177\/1178221819861377","article-title":"Using smartphones to improve treatment retention among impoverished substance-using Appalachian women: a naturalistic study","volume":"13","author":"Johnston","journal-title":"Subst Abuse"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2024.209396","article-title":"Wiidookaage\u2019win: beta-test of a Facebook group intervention for Native women to support opioid use recovery","volume":"163","author":"Roche","journal-title":"J Subst Use Addict Treat"},{"key":"R22","unstructured":"Greenfield SF . Treating Women with Substance Use Disorders The Women\u2019s Recovery Group Manual. The Guilford Press; 2016. URL: https:\/\/www.guilford.com\/books\/Treating-Women-with-Substance-Use-Disorders\/Shelly-Greenfield\/9781462525768 [Accessed 06-03-2026] ISBN: 9781462525768"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1089\/jwh.2018.7519","article-title":"Feasibility and acceptability of a web-based, gender-specific intervention for women with substance use disorders","volume":"29","author":"Sugarman","journal-title":"J Womens Health (Larchmt)"},{"issue":"10","key":"R24","doi-asserted-by":"publisher","DOI":"10.2196\/14990","article-title":"Use of human-centered design to improve implementation of evidence-based psychotherapies in low-resource communities: protocol for studies applying a framework to assess usability","volume":"8","author":"Lyon","journal-title":"JMIR Res Protoc"},{"key":"R25","unstructured":"NVivo. Lumivero. URL: https:\/\/lumivero.com\/products\/nvivo\/ [Accessed 06-03-2026]"},{"issue":"2","key":"R26","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","journal-title":"Qual Res Psychol"},{"key":"R27","unstructured":"Opioids. National Institute on Drug Abuse. URL: https:\/\/nida.nih.gov\/research-topics\/opioids [Accessed 25-12-2024]"},{"key":"R28","unstructured":"Medications for opioid use disorder: treatment improvement protocol (TIP) series 63. Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services; 2021. URL: https:\/\/library.samhsa.gov\/product\/tip-63-medications-opioid-use-disorder\/pep21-02-01-002 [Accessed 20-10-2025]"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2017.10.012","article-title":"Sex and gender differences in substance use disorders","volume":"66","author":"McHugh","journal-title":"Clin Psychol Rev"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1007\/s40429-023-00515-1","article-title":"Alcohol treatment access and engagement among women in the USA: a targeted review of the literature 2012-2022","volume":"10","author":"Levine","journal-title":"Curr Addict Rep"},{"issue":"7","key":"R31","doi-asserted-by":"publisher","DOI":"10.2196\/38684","article-title":"Smartphone ownership, smartphone utilization, and interest in using mental health apps to address substance use disorders: literature review and cross-sectional survey study across two sites","volume":"6","author":"Hsu","journal-title":"JMIR Form Res"},{"issue":"5","key":"R32","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1111\/ajad.13207","article-title":"Patients\u2019 perceptions of telehealth services for outpatient treatment of substance use disorders during the COVID-19 pandemic","volume":"30","author":"Sugarman","journal-title":"Am J Addict"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2020.102433","article-title":"Making mental health more accessible in light of COVID-19: scalable digital health with digital navigators in low and middle-income countries","volume":"54","author":"Rodriguez-Villa","journal-title":"Asian J Psychiatr"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e85195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:13:36Z","timestamp":1782839616000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e85195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":33,"URL":"https:\/\/doi.org\/10.2196\/85195","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]},"article-number":"v10i1e85195"}}