The Link Study cross-training intervention showed promising gains in provider knowledge, improvements in screening practices, and lasting collaboration across SRH and SUD service sectors.
Key Findings
Results
Providers demonstrated consistent increases in self-reported knowledge across key domains following the cross-training intervention.
35 providers from three SRH and SUD site pairs participated in the training
Evaluation included pre- and post-training knowledge surveys to measure knowledge changes
The curriculum covered core elements of SRH and SUD care, emphasizing person-centered practices, trauma-informed approaches, and evidence-based screening and referral tools
Confidence intervals were used to assess changes in quantitative outcomes
Results
Two of the three SRH and SUD site pairs showed statistically significant improvements in screening practices following the intervention.
Three site pairs (SRH and SUD paired sites) participated in the study
Site-level screening and referral data were collected as part of the evaluation
One of the three site pairs did not show statistically significant improvements in screening practices
Statistical significance was assessed using confidence intervals
Results
Referral rates did not change significantly across sites, though sites reported meaningful updates to workflows, tools, and policies to support integration.
Despite non-significant changes in referral rates, qualitative data from provider focus groups documented workflow and policy-level changes
Sites updated tools and policies to support cross-sector integration
Thematic analysis of qualitative data from provider focus groups was used to capture these process-level changes
Results
All three sites sustained cross-sector provider relationships for at least 6 months post-training.
Sustainability of relationships was tracked for a minimum of 6 months after the training intervention
All three SRH and SUD site pairs maintained these collaborative relationships through the follow-up period
This finding suggests the cross-training model produced durable inter-organizational connections
Background
Individuals with substance use disorder face significant barriers to accessing sexual and reproductive health services, and vice versa, creating a gap that integrated care pathways can address.
SRH settings were identified as important opportunities to identify and address SUD needs through screening and referral
SUD treatment settings were identified as key access points for SRH care
The Link Study was developed specifically as a cross-training intervention to strengthen collaboration and care coordination between SRH and SUD providers
The study design addressed both directions of the care gap: SRH-to-SUD and SUD-to-SRH referral pathways
What This Means
This research describes a training program called the Link Study, which was designed to improve collaboration between providers who work in sexual and reproductive health (SRH) and those who work in substance use disorder (SUD) treatment. The study recognized that people dealing with substance use issues often struggle to get reproductive health care, and people seeking reproductive health services may have unmet substance use treatment needs. To address this, the researchers created a shared curriculum and brought together 35 providers from three pairs of SRH and SUD organizations to learn from each other and build working relationships.
The study found that after the training, providers reported knowing more about both fields, and two out of three site pairs showed measurable improvements in how consistently they screened patients for the other type of need. While the rate at which providers actually referred patients to partner services did not significantly increase, organizations did update their internal processes, forms, and policies to better support cross-sector care. Importantly, all three site pairs were still maintaining active working relationships at least six months after the training ended, suggesting the collaboration had lasting effects beyond the training itself.
This research suggests that cross-training programs for health providers working in different but related fields can be a practical way to build more connected, community-based health systems. By helping SRH and SUD providers understand each other's work and establish referral pathways, patients with overlapping needs may have an easier time accessing comprehensive care. The findings point to knowledge gains and structural changes at organizations as early wins, while also highlighting that increasing actual referral rates may require additional supports beyond a single training intervention.
Rogers J, McDuff J, Black-Watson M, McGovern L, Osei A. (2025). Linkage Matters: Integrating Sexual and Reproductive Health and Substance Use Treatment.. Perspectives on sexual and reproductive health. https://doi.org/10.1111/psrh.70032