PROJECT SUMMARY/ABSTRACT
Over the past three decades, substance use disorder (SUD) has emerged as a major public health
crisis. More than 70% of overdose deaths in the U.S. involve a synthetic opioid, which makes
successful treatment critical to those with SUD. However, the relapse rate is estimated at 40-60%,
and those with SUD are also at risk for long-term medical issues. Thus, SUDs are often chronic
conditions that require early and consistent engagement in treatment to achieve long-term
recovery. One effective method of engagement that health care systems have implemented is
matching recoverees with peer recovery coaches (PRCs) to help navigate them through
treatment. These at-elbow support coaches provide consistent, non-judgmental communication
and referral to various treatment and wraparound services, including medication assisted therapy
(MAT), which is considered the most effective treatment for opioid use disorder. In this project,
we propose a randomized controlled trial to evaluate a novel technology tool: Peer PLUS (People
Leveraging Urgent Support). Peer PLUS is a standalone, HIPAA-compliant mobile app that
facilitates and tracks secure communication between PRCs and their clients, referrals to
community resources, and other recovery activities. The companion website allows a team of
PRCs to collectively manage a pool of clients, offering more comprehensive coverage. We expect
this point-of-care app to enhance communication between recoverees and their PRCs and
improve self-reported recovery outcomes. Additionally, Peer PLUS will provide a source of data
to help capture the care coordination efforts associated with peer coaching. Through our strategic
clinical trial and dissemination plan, we anticipate this intervention to be scaled for support of
recovery across different types of community partners with eventual extension to PRCs
supporting other types of mental health crises (e.g., post-suicide attempt). Implementation
science constructs infused with user-centered design strategies will be used to scaffold our Peer
PLUS evaluation and implementation toolkit development in the first phase of this project (R21),
which will provide a critical foundation for the randomized controlled trial and second site pilot
proposed in the second phase (R33). Because both the app and companion website are not tied
to any specific organization and the modular software is adaptable, this will be a low-cost, easily-
implementable option for any group that offers peer recovery support services.
