Adaptation of the NIDA Standard for delivery via Facebook with justice-involved women in rural Appalachia.

Background: Rising rates of intravenous drug use (IDU) in Appalachia have necessitated new approaches to providing risk-reduction interventions in a manner which will be acceptable and accessible to specific at-risk populations-particularly those with limited access to traditional evidence-based interventions. Using the ADAPT-ITT framework, the overall goal of this study is to adapt an evidence-based HIV prevention intervention-the NIDA Standard-to meet the needs of rural drug-using women post-release from jail. Methods: Through a series of focus groups with rural incarcerated women, theater-testing with members of the target population, and iterative refinements with topical experts, we aimed to identify potential adaptations to content and context to improve the fit, feasibility, and acceptability of the NIDA Standard for this population using social media. Results: Study findings confirmed the need for a preventive risk-reduction intervention targeting this population post-release. Adaptations to intervention Conclusion: The use of Facebook for delivery of the NIDA Standard may hold promise for increasing reach, acceptability, and feasibility of intervening with rural women with IDU released from jails, particularly when compared with traditional face-to-face sessions. With minor content adaptations to meet participant needs and preferences, plus multiple context adaptations to enhance accessibility and acceptability, the adapted NIDA Standard is intended to retain its original effectiveness while improving important implementation outcomes key to scaling-up and increasing public health impact. Plain Language Summary: