Developing SUPPORT, a Community-Driven, Recovery-Oriented System of Care

项目总结/文摘

PROJECT SUMMARY/ABSTRACT There is a lack of evidence-based SUD treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana’s Access to Recovery (ATR) program, which was closed due to lack of federal support despite positive improvements in clients’ recovery outcomes. SUPPORT builds on the limitations of ATR in that it will: focus specifically on a prison reentry population; be community-driven, rather than state administered; require direct service staff be certified peer recovery coaches; provide clients a full year of services instead of 6-months; and utilize an electronic data capture system, rather than paper surveys, to improve data-driven decision making. The ultimate goal of this project is the establishment of SUPPORT as an effective and scalable recovery- oriented system of care. A necessary step we must take before launching a large clinical trial is the development and pilot testing of the SUPPORT intervention. This study has three aims corresponding to this initial task. Aim 1 is to develop SUPPORT. We will utilize qualitative data collected from past Indiana ATR clients and providers and learning meetings with advisors to determine how to best develop and revise formal policies, procedures, and fidelity guidelines for the intervention. Aim 2 is to conduct a pilot test to assess feasibility for an R01 study. We will conduct a pilot test at a Central Indiana agency that provides services to returning inmates, using random assignment to compare SUPPORT clients to clients receiving usual treatment. We will collect quantitative data for both groups at multiple points and also collect qualitative data from SUPPORT clients to better understand their program experiences. Aim 3 is the identification of implementation barriers to inform future dissemination activities. We will conduct semi-structured phone interviews with potential adopters of the model to improve SUPPORT’s transferability by identifying possible barriers and facilitators to replicability beyond Indiana. To accomplish these aims, the study’s developmental evaluation framework uses continuous data collection and rapid response. The resulting study will investigate the effectiveness of SUPPORT for improving client recovery outcomes to a similar SUD program that is missing key elements of the model. This project will increase scientific knowledge related to recovery-oriented services, an area of research that is currently lacking. The development of such a model will also be of interests to a variety of stakeholder groups given the current focus on recovery-oriented care in policy and treatment.