Emergency Medicine Peer Outreach Worker Engagement for Recovery

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

Interventions

BEHAVIORAL

Substance Misuse Assistance Response Team (SMART)

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.

OTHER

Usual Care Group

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

Sponsors & Collaborators

• Rhode Island Hospital

  collaborator OTHER

• The Miriam Hospital

  collaborator OTHER

• Brown University

  collaborator OTHER

• University of California, Los Angeles

  lead OTHER

Principal Investigators

• Elizabeth Samuels, MD, MPH, MHS · UCLA Emergency Medicine

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-07-01

Primary Completion

2026-09-30

Completion

2026-10-31

Countries

• United States

Study Locations