Using Implementation Interventions and Peer Recovery Support to Improve Opioid Treatment Outcomes in Community Supervision

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PROJECT ABSTRACT Initiating and/or continuing medications for OUD (MOUDs) in the correctional setting improves health outcomes among persons with OUD. Despite this evidence, barriers remain to MOUD programming in the correctional system. Efforts have been made to address barriers preventing systematic implementation of MOUD treatment programs in correctional settings. Nationwide, there is progress in the availability of technical assistance for jurisdictions seeking to implement MOUD but barriers continue to exist and critical pragmatic tools are needed. The main objective of this supplement application is to validate two separate but related tools used to evaluate MOUD programs in the criminal justice system. We will utilize real-world data to validate a budget impact tool for MOUD programs in prisons and jails and self-reported healthcare utilization for recently released MOUD program participants. We will use data primarily based on our experiences in RI for the past five years, but this research has broad applicability beyond RI and JCOIN. Our first aim is to validate a budget impact tool developed with national metrics using observed cost values from five years of a comprehensive MOUD program in a statewide prison and jail system, as well as to test the tool with naïve users to obtain feedback for tool improvement and adaptation for a community provider end user. Our second aim is to assess the validity of self-reported healthcare utilization using billing claims among justice-involved clients on probation/parole with OUD, identify and quantify systematic discrepancies, and develop and validate a predictive model to adjust and improve self-reported utilization in this population. Although we will utilize real- world data primarily based on our experiences in RI for the past five years, this research has broad applicability beyond RI and JCOIN. This research is significant and highly innovative because justice-involved individuals account for the majority of persons who use drugs in the US and the leading cause of death among former prisoners is opioid overdose. The challenge of MOUD in corrections is one of implementation and our proposed research will provide needed critical pragmatic resources. This research will leverage the resources of our parent JCOIN award, while simultaneously expanding and enhancing our investigative team by the addition of Weill Medical College faculty with cutting edge expertise in health economics and an exceptional junior faculty member with expertise in cost modeling and health.