Pilot trial of THRIVE: A peer-delivered sexual and intimate partner violence prevention program for women in substance use treatment

Abstract

High rates of interpersonal violence exposure and trauma-related mental health concerns among women in substance use treatment underscore the need for violence prevention services in these settings. Peer support specialists can play a crucial role in increasing access to trauma-focused services and overcoming barriers, such as stigma and mistrust in formal systems. We tested the feasibility, acceptability, and preliminary efficacy of a peer-delivered sexual and intimate partner violence prevention program for women in substance use treatment (THRIVE: The Healthy Relationships and Interpersonal Violence Education program). We conducted a single-arm trial with 90 women recruited from outpatient and residential substance use treatment centers. Self-report surveys assessed risk and protective factors and violence exposure over four assessment points from baseline (T1) to 3-month follow-up (T4). Exit interviews and survey data examined feasibility and acceptability outcomes. Results from linear mixed models indicated that participants improved on knowledge of consent (M_T1 = 4.37, M_T4 = 4.52), p = .004, and resources (M_T1 = 2.09, M_T4 = 2.63), p < .001; increased sexual self-efficacy (M_T1 = 4.90, M_T4 = 5.29), p < .001; and decreased risky dating (M_T1 = 3.37, M_T4 = 2.87), p < .001, and physical and psychological intimate partner violence victimization (T1: 73.9%, T4: 42.0%), p < .001. Participants reported high satisfaction and acceptability and highlighted the strengths of peers as facilitators. In sum, THRIVE offers promise as an effective, scalable violence prevention program.