SSTAR leading effort to bring mobile health recovery apps to Russian women

Stanley Street Treatment and Resources (SSTAR) of Fall River, Massachusetts, was among the first organizations to test the NIATx model as a grantee of the Robert Wood Johnson Foundation-funded Paths to Recovery program (Round II, 2005-2006). One of SSTAR’s initial NIATx change projects project increased the daily census and created a financial surplus for an inpatient dual diagnosis program—for the first time in a decade.

 “Those first NIATx projects lit a fire under us to keep going and keep making changes,” says CEO Nancy Paull.

SSTAR operates programs at four sites, two in Massachusetts and two in Rhode Island. It offers a full continuum of care, with services for treatment of addiction, women’s issues, HIV/AIDS and trauma, along with primary and preventative medical care. The organization has used the NIATx model over the past decade to make a variety of changes throughout the organization.  

“Offering open access in all of our outpatient programs is our NIATx change project of the moment, and we continue to work on refine it,” says Patricia Emsellem, Chief Operations Officer. “We’ve eliminated wait times so that clients can now start individual or group therapy immediately.” 

SSTAR has plans to implement open access in its inpatient programs as well.

At SSTAR, improvements in access and retention and overall service delivery have accompanied innovations in other areas, including healthcare integration. SSTAR opened its first “Family Health Care Center” in the mid-1990’s. This clinic offered primary care for people with substance abuse disorders who were also HIV/AIDS positive. And in 2013, it opened the state’s first integrated primary, behavioral, and methadone clinic, SSTAR South End Clinic. All methadone patients served also have primary care, so the clinic can monitor all their care.

SSTAR’s evolution over the past decade has also included international activities. The organization’s work on improving substance abuse treatment in the former soviet republic of Georgia and Armenia led to the Robert Wood Johnson Foundation’s nominating SSTAR to work on the United Nation’s Treatnet initiative—a project to help under-resourced countries develop drug abuse treatment programs.  

This international experience, combined with SSTAR’s pioneering work to integrate health care for HIV/ADS patients, attracted the attention of the United Nations in Russia, where IV drug use and resulting HIV/AIDs infections have become a public health crisis.

“We were asked to talk to physicians about how we had integrated drug abuse treatment and HIV care,” says Paull. Through visits to Russia to meet with physicians, Paull was introduced to the Moscow-based Health and Development Foundation.

“The Health and Development leaders had some success developing a mobile app called “Text for Babies,” a mobile app that sends health messages to pregnant women that match each stage of the baby’s development. They now want to further their work for at-risk women and asked SSTAR to work with them,” says Paull.

Now, SSTAR is collaborating with the Center for Health Enhancement Systems Studies (CHESS) on the project. Funded by The Eurasia Foundation, the project will produce a manual on mobile health applications to help Russian women with substance use disorders who have been in prison. Kim Johnson, Deputy Director of NIATx, is working with the SSTAR team and their partners in Russia to develop the manual, slated for completion by summer 2014.  A-CHESS will be used throughout the manual as an example of an application that has been proven effective.

“We want to parse out what has been most effective in A-CHESS and could apply in other countries,” says Paull. “This will be a “how-to” to for agencies that are considering using any mobile health technology, not just A-CHESS, for high-risk women,” says Paull. 

“Access to treatment is very limited in Russia as compared to the United States, and even more so for women,” says Paull.

One challenge to the project is the challenge of adapting mobile applications developed in the United States to a different language, cultural, and even different technical requirements. “The partners in Russia have developed and disseminated mobile technology, and we’re combining their experience with ours to create the manual,” says Johnson.

“We will present the manual at a conference in ST. Petersburg in June, says Paull. The trip will also be a chance to meet Russian women the project aims to help. Adds Emsellem, “It all comes back to the most important NIATx principle, to understand and involve the customer. We want to find out more about the daily lives of these women and what they want and need.”

The long-term goal is to continue to work with people to develop mobile apps for Russia, says Paull.  “SSTAR is a women-minority business enterprise and we have always been interested in improving women’s health and quality of life. We’re very glad to be bringing attention to this much-needed service.”