Emergency Medicine Peer Outreach Worker Engagement for Recovery

NCT06320015 | Recruiting

• 2 other identifiers: R01CE003632-01-00R01CE003632
• Study Type: observational
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

This is an observational, prospective case-control study evaluating the effects of an emergency department community health worker-peer recovery specialist program (PCHW), the Substance Misuse Assistance Response Team (SMART). Aims of this study are to 1) understand participant experiences working with a SMART PCHW and identify possible mechanisms for successful recovery linkage; 2) Evaluate SMART effectiveness on patient-centered outcomes, building recovery capital, and recovery linkage; 3) Evaluate SMART implementation and effectiveness on patient outcomes over time. Using a combination of surveys and data linkages to state administrative databases, study investigators will prospectively compare changes in addiction treatment engagement, recovery capital, health related social needs, acute care utilization, and death between people receiving a ED PCHW and those who do not. After consenting to study participation, participants will complete surveys at time of study enrollment and 3 and 6 months after their initial ED visit. Primary outcomes include engagement in addiction treatment, social services engagement, acute care utilization, and mortality will be assessed through linkages to state administrative databases.

Conditions

Substance Use Disorders; Overdose; Opioid Use Disorder; Alcohol Use Disorder

Outcome Measures

Primary Outcomes (2)

• Treatment engagement

  Investigators will measure engagement in formal addiction treatment at a state licensed addiction treatment facility and/or receipt of office-based buprenorphine through data linkages to the Rhode Island Prescription Drug Monitoring Program database and the Rhode Island Behavioral Health Online Database.

  Will compare differences in treatment engagement between study arms 3 and 6 months after study enrollment.

• Recovery Capital

  Investigators will conduct surveys with study participants at time of enrollment, three months after enrollment, and six months after enrollment. Survey Changes in individual recovery capital as measured by reported self-efficacy, social networks, and quality of life

  Will compare differences in treatment engagement between study arms 3 and 6 months after study enrollment.

Secondary Outcomes (8)

• Emergency Department Utilization

  Will compare differences in acute care utilization between study arms 3 and 6 months after study enrollment.

• Repeat Hospitalization

  Will compare differences in acute care utilization between study arms 3 and 6 months after study enrollment.

• Repeat Overdose

  Will compare differences in acute care utilization between study arms 3 and 6 months after study enrollment.

• Mortality

  Will compare differences in mortality between study arms 3 and 6 months after study enrollment.

• Social Services Engagement

  Will compare differences in health related social needs between study arms 3 and 6 months after study enrollment.

Study Arms (2)

SMART Participant

Emergency department patients at with a substance use disorder who have received SMART services

Behavioral: Substance Misuse Assistance Response Team (SMART)

Usual Care

Emergency department patients with a substance use disorder who have not received SMART services

Other: Usual Care Group

Interventions

Substance Misuse Assistance Response Team (SMART) BEHAVIORAL

The study intervention is engagement with a Substance Misuse Assistance Response Team (SMART) community health worker-peer recovery specialist (PCHW). SMART PCHWs engage ED patients with substance use disorders and facilitates ED services provision and linkages to outpatient care. Services provided include supporting ED initiation of buprenorphine, harm reduction services, social services (transportation, housing assistance, etc.), and engagement in peer recovery, behavioral health services, and addiction treatment services. Services are provided at the time of the ED visit. A subgroup of patients is provided short term case management and outpatient services navigation depending on PCHW caseload availability and individual needs.

SMART Participant

Usual Care Group OTHER

Patient not seen by a SMART community health worker in the emergency department. Care and treatment referral at discretion of emergency department treating team.

Usual Care

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study will enroll 400 people with a substance-used related visit. Individuals will be approached after receipt of ED services. 1. 200 people who have received SMART services. \- Participants will be approached for study participation after they have already received SMART services. 2. 200 people who did NOT receive SMART services. * Participants will be approached for study enrollment in this study arm when they are seen and treated on a day and time or ED site where SMART is not available.

You may qualify if:

• Adults 18 years old or older
• Seen and treated at Rhode Island or The Miriam Hospital ED for a substance use-related concern including intoxication, withdrawal, opioid overdose, opioid withdrawal, or substance use-related infection
• Able to provide informed consent
• Able to provide at least two forms of contact (personal phone, social media, email, or contact information for family or friends)
• Participants may speak languages other than English but require use of interpreter services. Consents will be available in English, Spanish, and Portuguese, the three most spoken languages in the Providence metropolitan area.

You may not qualify if:

• Unable to provide informed consent
• In police custody, incarcerated, or have a court ordered treatment enrollment

Sponsors & Collaborators

• University of California, Los Angeles: lead
• Rhode Island Hospital: collaborator
• The Miriam Hospital: collaborator
• Brown University: collaborator

Study Sites (1)

Rhode Island Hospital

Providence, Rhode Island, 02903, United States

RECRUITING

MeSH Terms

Conditions

Substance-Related Disorders; Drug Overdose; Opioid-Related Disorders; Alcoholism

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders; Prescription Drug Misuse; Drug Misuse; Narcotic-Related Disorders; Alcohol-Related Disorders

Study Officials

• Elizabeth Samuels, MD, MPH, MHS

  UCLA Emergency Medicine

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ashley Gaipo

CONTACT

(401) 444-3374; agaipo@lifespan.org

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: November 18, 2023
• First Posted: March 20, 2024
• Study Start: July 1, 2024
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): October 1, 2026
• Last Updated: October 6, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)