Abstract
<sec> <title>BACKGROUND</title> <p>Although alcohol-related morbidity and mortality have increased disproportionately among U.S. women, utilization of evidence-based alcohol treatment (EBAT) remains lower among women compared with men. Rural women face additional barriers to treatment access, including stigma, caregiving responsibilities, geographic isolation, and limited availability of services. Social media platforms such as Facebook may offer a sustainable approach to delivering peer support and EBAT access to rural women.</p> </sec> <sec> <title>OBJECTIVE</title> <p>This study aimed to describe the development and community-engaged refinement of Women-Peer Supported Alcohol Treatment and Liaison (Women-PALS), a peer-supported Facebook intervention to promote alcohol use reduction and evidence-based alcohol treatment uptake among rural females with mild-to-moderate alcohol use disorder.</p> </sec> <sec> <title>METHODS</title> <p>Intervention content (Facebook moderator postings) was created and adapted from existing evidence-based resources. The development and refinement were informed by rural females with lived experience and other stakeholder feedback through a Community Engagement Studio (n=9) and a rural Community Advisory Board (n=12). Feedback was sought on message clarity, cultural relevance, inclusivity, and acceptability of intervention postings.</p> </sec> <sec> <title>RESULTS</title> <p>Six posts were reviewed during the CE Studio; after incorporating CE Studio feedback, four were subsequently reviewed at the CAB meeting to elicit more in-depth feedback. Across both review stages, members consistently called for shorter, scannable content; authentic rural and demographically diverse imagery; reduced reliance on statistics or prevention-style messaging; and language that did not assume a specific parenting status, abstinence goal, or recovery stage.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>Content and imagery changed considerably across the two review stages. Members favored short, action-oriented posts and peer-voiced language over statistics and top-down framing. They also asked that treatment goals not presuppose abstinence, that content avoid assumptions about parenthood and family structure, and that imagery balance local authenticity against participant privacy. These preferences have not been tested against outcomes and require further testing. Next steps include pilot testing of feasibility, acceptability, and preliminary efficacy.</p> </sec>