Dr. Esther K. Choo is Assistant Professor in the Department of Emergency Medicine at Warren Alpert Medical School of Brown University. Her long-term goal is to become an independent investigator with a focus on developing effective interventions for high-risk women with substance use disorders. The overall aim of Dr. Choo's proposal is to target co-occurring problems of substance use and intimate partner violence (IPV) using a computer-based intervention, B-SAFER (Brief intervention for Substance use and partner Abuse for Females in the Emergency Room). This K23 Mentored Patient-Oriented Career Development Award proposal is in keeping with NIDA's mission, with great potential to significantly improve treatment of drug abuse through an intervention that could be rapidly and effectively disseminated to other emergency departments (EDs) and to other clinical settings. Substance use and IPV have a close, bidirectional relationship, and the coexisting disorders place women at high risk for poor mental and physical health outcomes. The ED presents a great opportunity to intervene in this population, as coexisting problems are highly prevalent, while adequate assessment, intervention and referrals are not routinely available. Further, no resource is available in the ED to address related problems of substance use and IPV in an integrated manner. As a computer-based intervention, B-SAFER has great potential as a feasible and acceptable ED resource. The research project has two phases. The Development Phase will use focus groups to inform and refine the development of the computer-based intervention, and will conclude with a small open trial. The Testing Phase will be a pilot RCT of the intervention in a high-volume urban ED, examining primary outcomes of substance use and utilization of relationship safety resources. In completing this research and associated training activities, Dr. Choo plans to gain the skills, knowledge and experience needed to become a national leader in research on technology-based interventions for women with substance use. Her goals are to gain skills in: 1) using qualitative health research methodology to inform the development of interventions;2) developing and testing computerized interventions for substance use and IPV;3) conducting clinical trials of substance use and IPV interventions;4) analyzing longitudinal data;and 5) addressing the ethical issues related to research using computerized interventions for individuals with substance use and victimization.

Public Health Relevance

This project seeks to address the health care of women with coexisting substance use and IPV presenting to the ED setting, a population at high risk and with high health care needs and yet few available resources. The results of this research could contribute to national models of care in ED settings and will provide opportunities for Dr. Choo to develop, test and disseminate similar interventions for women with substance use and IPV in other clinical and community settings.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
Application #
Study Section
AIDS Behavioral Research Subcommittee (NIDA)
Program Officer
Chambers, Jessica Campbell
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Rhode Island Hospital
United States
Zip Code
Beaudoin, Francesca L; Janicki, Adam; Zhai, Wanting et al. (2018) Trends in opioid prescribing before and after implementation of an emergency department opioid prescribing policy. Am J Emerg Med 36:329-331
Choo, Esther; Guthrie, K Morrow; Mello, Michael et al. (2016) ""I need to hear from women who have 'been there'"": Developing a woman-focused intervention for drug use and partner violence in the emergency department. Partner Abuse 7:193-220
Gardner, Rebekah; Choo, Esther K; Gravenstein, Stefan et al. (2016) ""Why Is This Patient Being Sent Here?"": Communication from Urgent Care to the Emergency Department. J Emerg Med 50:416-21
Choo, Esther K; Zlotnick, Caron; Strong, David R et al. (2016) BSAFER: A Web-based intervention for drug use and intimate partner violence demonstrates feasibility and acceptability among women in the emergency department. Subst Abus 37:441-449
Choo, Esther K; Tapé, Chantal; Glerum, Kimberly M et al. (2016) ""That's Where the Arguments Come in"": A Qualitative Analysis of Booster Sessions Following a Brief Intervention for Drug Use and Intimate Partner Violence in the Emergency Department. Subst Abuse 10:77-87
Choo, Esther K; Feldstein Ewing, Sarah W; Lovejoy, Travis I (2016) Opioids Out, Cannabis In: Negotiating the Unknowns in Patient Care for Chronic Pain. JAMA 316:1763-1764
Choo, Esther; Ranney, Megan; Wetle, Terrie et al. (2015) Attitudes Toward Computer Interventions for Partner Abuse and Drug Use Among Women in the Emergency Department. Addict Disord Their Treat 14:95-104
Ranney, Megan L; Meisel, Zachary F; Choo, Esther K et al. (2015) Interview-based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting. Acad Emerg Med 22:1103-12
McGregor, Alyson J; Choo, Esther (2015) The emerging science of gender-specific emergency medicine. R I Med J (2013) 98:23-6
Choo, Esther K; Garro, Aris C; Ranney, Megan L et al. (2015) Qualitative Research in Emergency Care Part I: Research Principles and Common Applications. Acad Emerg Med 22:1096-102

Showing the most recent 10 out of 18 publications