Peer Support Workers Feasibility Study

NCT07030192 | Recruiting DMC

• 1 other identifier: H24-03008
• Study Type: interventional
• Target: 3,181
• Locations: 1 country
• Sites: 1

Brief Summary

Many people with high-risk opioid use visit emergency departments (EDs), facing a high risk of death if they leave before completing care. Peer support workers (Peer) - people with lived experience of substance use - may improve patient comfort, reduce early departures, and potentially lower mortality rates. This study aims to evaluate how a hospital-implemented ED Peer program can enhance patient support, reduce barriers to care, and provide harm-reduction resources in a person-centred and trauma-informed manner. The study will also validate the outcome and obtain preliminary estimates of the benefits of decreasing patients who leave the ED before completing care.

Conditions

Substance Use Disorder (SUD)

Keywords

Peer support workers; Substance use; Emergency department

Outcome Measures

Primary Outcomes (6)

• Distribution of randomized Peer shifts by day of week

  Assessed by examining the distribution of scheduled Peer shifts across each day of the week over the 48-week randomized schedule period. The schedule was developed in collaboration with human resources and ED operational leadership and approved as meeting hospital employee policy. The randomization approach used block-based scheduling with built-in constraints (e.g., mandatory weekends off). This outcome evaluates whether the resulting schedule achieved an even weekday/weekend distribution. Unit of Measure: Number and percentage of Peer shifts scheduled per day of the week

  Over the 48-week randomized schedule period approved to meet hospital staffing policy

• Proportion of Peer interactions with complete standardized documentation

  Assessed by the proportion of Peer interactions that were fully recorded using the standardized Peer interaction log, with completion defined by filling all required fields. Unit of Measure: Percentage of interactions with complete logs

  Up to 15 months post-study initiation

• Identification of substance use-related ED visits for Peer and No Peer shift comparison

  Investigators will obtain regional ED data with all visit information on all ED visits made during our study period. Investigators will use randomized schedule to identify dates and times of Peer shifts and control shifts. Investigators will then assess proportion of patients who left before medically advised among those presenting with substance use-related complaints during times with ED Peers available, compared to times without Peers. Investigators will analyze patients with presenting complaints that denote common complications of substance use (localized swelling/redness, substance withdrawal, and substance misuse/intoxication). This cohort can be identified using administrative data alone, allowing investigators to identify a reliable comparator group when ED Peers are not present. .

  Up to 15 months post-study initiation

• Characterization of Patients Receiving the Peer Intervention

  Investigators will describe characteristics of patients who received the Peer intervention using information from interaction logs (including sex and gender) and linked administrative data (e.g., preceding substance use-related encounters; databases described below).

  Baseline. Up to 15 months post-study initiation.

• Patients leaving the ED prior to completing care

  Investigators will use a linear regression model to compare the shift-level percentage of visits resulting in left before medically advised(primary outcome) during intervention (Peer) and control (no Peer) shifts, among all visits made by patients with our presenting complaints of interest. Patients presenting in the Peer shifts will be included in the analysis irrespective of whether they received the Peer intervention, i.e., an intent-to-treat approach. The model will adjust for shift-level covariates including: day of week, shift type (morning/afternoon/night), and ED volume.

  Baseline. Data will be linked and assessed at the conclusion of the feasibility study, up to 15 months post-study initiation.

• "Treatment effect in the treated" analysis

  Investigators note that the shift-level analysis includes many patients who are not targets for the intervention. This is unavoidable because the absence of screening in the control arm renders it impossible to identify who would be eligible for the intervention, but including non-target patients introduces noise into the analysis and dilutes the observed effect. Hence, investigators will use a mixed-effect logistic regression at the patient level to compare the probability of left before medical advice in patients who presented with a specific complaint (e.g., substance misuse) and received the intervention, to patients in the control arm who presented with the same complaint. Investigators will use medical record numbers collected by Peers as part of the interaction logs to identify people who interacted with a Peer. The model will adjust for age, sex, time of day, day of week, month, ambulance arrival, triage acuity, and presenting complaint.

  Up to 15 months post-study initiation

Secondary Outcomes (3)

• Thematic summary of Indigenous patients' experiences with the Peer program based on storytelling and sharing circles

  Within 6 months after the patient's ED visit involving Peer interaction

• Thematic summary of healthcare providers' perceptions of the Peer program assessed through focus groups

  From 3 to 15 months after program implementation

• Patient-reported acceptability of the Peer program using the Peer patient survey

  Up to 15 months post-study initiation

Study Arms (2)

Peer support service

EXPERIMENTAL

Patients presenting with substance use related complaints during days and times where a Peer is available to provide services, as per an a priori, randomized schedule

Behavioral: Peer support service

No Peer intervention

NO INTERVENTION

Patients with substance use presentations who present to EDs on days and times when a Peer is not available, as per an a priori, randomized schedule

Interventions

Peer support service BEHAVIORAL

Peers approach identified patients who could potentially benefit from peer support services. Peers offer a range of supports tailored to individual patients' needs, which include referrals to clinical and social support services (e.g., social work, addictions specialist, Indigenous patient navigator, community-based addictions resources), resources (e.g., blankets, food, naloxone kit, sterile drug use supplies, information brochures), providing emotional support, and liaising between patients and healthcare providers to communicate information about patients' condition and ED trajectory. Peer support workers share their personal experiences to guide patients through their ED visit and to facilitate awareness and understanding of available resources.

Peer support service

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Emergency Department (ED) patient at Vancouver General Hospital (VGH)
• Age 18 years or older
• Identified as using substances
• Able to receive or decline peer support services during the ED visit

You may not qualify if:

• Under 18 years of age
• Does not report substance use

Sponsors & Collaborators

• University of British Columbia: lead
• Vancouver Coastal Health Research Institute: collaborator
• BC Centers for Disease Control: collaborator

Study Sites (1)

Vancouver General Hospital

Vancouver, British Columbia, V5Z 1M9, Canada

RECRUITING

MeSH Terms

Conditions

Substance-Related Disorders; Emergencies

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Jessica Moe, MD

  University of British Columbia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Cindy Liu, BSc

CONTACT

778-929-1281; cindy.q.liu@ubc.ca

Elle Wang, MSc

CONTACT

604-615-2538; elle.wang@ubc.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor UBC Department of Emergency Medicine

Study Record Dates

• First Submitted: June 3, 2025
• First Posted: June 22, 2025
• Study Start: November 23, 2024
• Primary Completion (Estimated): September 1, 2027
• Study Completion (Estimated): December 1, 2027
• Last Updated: November 21, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)