||2R01CA181047-06 Interpret this number
||University Of Kansas Medical Center
||Sexual Health Empowerment for Jail-Involved Women's Health Literacy and Prevention
Over the last 35 years, there has been a 700% increase in the number of women in prisons and jails.
These women, mostly women of color, have pervasive trauma histories, mental health problems, and drug use,
all of which compromise their ability to engage in preventive health behaviors. For the last eight years, our
research team has studied women leaving jail and why they are 4-5 times more likely to develop cervical
cancer, a disparity that has remained unchanged for over 50 years. The original objective of the Sexual Health
Empowerment (SHE) for Cervical Health Literacy and Prevention program (R01 CA181047) was to assess the
effectiveness of a jail-based intervention to increase cervical health literacy and screening. SHE increased
jailed women’s cervical health literacy and rates of cancer screening after the women left jail.
While delivering SHE, we observed: 1) the cross-cutting nature of women’s health risk factors, i.e. the risks
that jailed women faced for cervical cancer also could lead to other women’s health problems; and 2)
opportunity for taking an evidence-based intervention, with a rich theoretical framing, to expand to other
women’s health issues faced by this group, around, not only cervical cancer prevention, but also breast cancer,
unintended pregnancy, and STI prevention. While following women after release from jail (85% follow-up rate
after 3 years), we also identified strategies for reaching this high-risk population through electronic
communication. SHE participants were high users of mobile phones (88%), text (76%), Web (79%), and
Facebook (70%). This renewal application presents an opportunity to holistically address health disparities
experienced by women leaving jail and test new modalities for intervention delivery given their use of electronic
communication and social media.
In our first aim, we will assess the feasibility and pilot effectiveness of ‘SHE-Women’, an electronic
women’s health literacy intervention, with women leaving jail. The second aim uses an RCT to test the
effectiveness of SHE-Women with women leaving jail on increasing women’s health literacy, screening, and
risk reduction practices (for cervical, breast cancer, unintended pregnancy, and STIs) against a standard of
care. Our third aim will be to understand the role and impact of human interaction in electronic interventions by
tracking participants and interviewing key stakeholders. Knowledge gained from this study will lead to an
understanding of: 1) how a comprehensive women’s health literacy intervention can narrow health disparities
among justice-involved women and 2) the role of human interaction in successful electronic interventions,
thereby creating a sustainable model for dissemination of health promotion interventions.
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