Sexual Health Empowerment for Women's Health
Sexual Health Empowerment for Women's Health
The purpose of this study is to expand the reach of an existing cervical cancer literacy and
 prevention intervention- the Sexual Health Empowerment (SHE) Project . As a logical extension
 of the investigators earlier work, the objective of this renewal is to expand reach of SHE to
 address women's health disparities more broadly to create a sustainable model for
 dissemination of health promotion interventions for vulnerable populations.
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, the 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, researchers 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), investigators 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 use of electronic communication and
 social media.

 The first 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. The second 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.
Inclusion Criteria:

 -Scheduled to leave jail within 3 days

 Exclusion Criteria:

 -  not actively intoxicated

 -  not show severe psychological distress