Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults With Polysubstance Use: Feasibility, Acceptability, and Scaling up of Launch
Overview
- Phase
- Not Applicable
- Intervention
- Contingency Management for Emerging Adults (CM-EA)
- Conditions
- Polysubstance Drug Use (Indiscriminate Drug Use)
- Sponsor
- Chestnut Health Systems
- Enrollment
- 48
- Locations
- 8
- Primary Endpoint
- Levels of Emerging Adult Perceptions of Acceptability of the Launch Intervention (measured at 6 months).
- Status
- Recruiting
- Last Updated
- 2 months ago
Overview
Brief Summary
Emerging adults (EAs; aged 18-26) are the highest-risk population for poly-substance use (misuse of more than one drug), compared to all other age groups and are the least-served population for substance use services. The overarching purpose of this pilot study is to assess whether an innovative services package, Launch, can reasonably work (is feasible) and whether providers and participants like it (acceptability). Launch works with both EAs and a supportive parent (or parental figure) and delivers peer recovery support services (PRSS) to EAs while helping parents use an effective, evidence-based program called contingency management, adapted for EAs, at home with their EA child. This study will also lay the groundwork for a future large-scale trial of Launch services.
Detailed Description
The objective of the study is to investigate a scalable service that can be used in rural communities called Launch. Launch is an innovative adaptation of current evidence-based services for Emerging Adults (EAs), ages 18-26 years old with polysubstance use (poly-SU); with a particular emphasis on increasing their recovery capital. Recovery capital is the resources available to promote substance use recovery (e.g., vocational/educational skills, recovery-supportive community). Launch leverages (1) parents of EAs and (2) peer recovery support services (PRSS), while ensuring services are equitable and scalable by using digital technology and existing substance use services infrastructure. Participants will be 48 families that include an EA struggling with poly-SU and a parent or parental figure supportive of their EA child's recovery journey. Families will be randomized to one of three conditions detailed further in the attached materials that include either: (1) Virtual Parent Contingency Management for Emerging Adults (CM-EA) Coach for parents only, (2) In-Person and/or Virtual PRSS for EAs only, or (3) a combination of Virtual Parent CM-EA Coach for parents and In-Person and/or Virtual PRSS for EAs. Quantitative and qualitative measures will assess the feasibility and acceptability of Launch. Additionally, payors/providers of substance use services will be interviewed in this study with the aim of improving future uptake and implementation of the service should it be deemed effective. The aims of the study are as follows: 1. Adapt and evaluate the Launch parent coach and PRSS training protocols/adherence tools. 2. Assess the feasibility and acceptability of (a) a virtual study protocol for recruiting, assessing, and retaining parents and EAs and (b) Launch components. 3. Determine from payors and providers the data needed for future funding and delivery of Launch, as well as develop a site recruitment pool for a rigorous R01 trial.
Investigators
Tess Drazdowski
Principal Investigator
Chestnut Health Systems
Eligibility Criteria
Inclusion Criteria
- •This study has four different participants: (1) Emerging Adult (EA)/Parent Pairs, (2) Peer Workers, (3) Parent Coaches, and (4) Payors/Providers of Recovery Services.
- •Emerging Adult (EA)/Parent Pairs
- •Inclusion Criteria:
- •EA (aged 18-26) who reports (1) misuse of opioids and/or stimulants and at least one other substance in the same week during the past year, (2) at least one SU disorder reported by EA or parent as assessed via the DSM-V Checklist, and (3) has a supportive parent willing to be virtually coached to deliver CM-EA. Participating "parents" can include any supportive adult who is in a financially supportive caregiving role for the EA and has the desire and ability to implement the CM-EA program
Exclusion Criteria
- •Only EAs that present with unstable conditions requiring intensive treatment, such as hospital interventions, will be excluded from the sample. Examples of these conditions include participant reports of active suicidal or homicidal intentions or requests for medically supervised detox services.
- •Peer Workers
- •Inclusion Criteria:
- •Certified peer worker (aged 18+) willing to be trained in vocational/educational skill building and participate in research protocols with study-enrolled emerging adult clients.
- •Exclusion Criteria:
- •Parent Coaches
- •Inclusion Criteria:
- •Individual (18+) with a background in clinical work willing to be trained in Contingency Management for Emerging Adults (CM-EA) and participate in research protocols with study-enrolled parent clients.
- •Exclusion Criteria:
- •.Payors/Providers of Recovery Services
Arms & Interventions
Contingency Management for Emerging Adults (CM-EA) Only
The parents in this group will receive CM-EA delivered virtually by a parent coach approximately weekly (20-40 minute sessions) for 6 months.
Intervention: Contingency Management for Emerging Adults (CM-EA)
Standard Peer Recovery Support Services (PRSS)+Vocational/Educational (V/E) Skill Building
The EAs in this group will receive PRSS+Vocational/Educational (V/E) Skill Building delivered by peer workers in-person in the local community and/or virtually, for approximately weekly (1 hour sessions) for 6 months.
Intervention: Standard Peer Recovery Support Services (PRSS) +Vocational/Educational (V/E) Skill Building services
CM-EA and PRSS+V/E
Families receive both CM-EA and PRSS + V/E as described above.
Intervention: Contingency Management for Emerging Adults (CM-EA)
CM-EA and PRSS+V/E
Families receive both CM-EA and PRSS + V/E as described above.
Intervention: Standard Peer Recovery Support Services (PRSS) +Vocational/Educational (V/E) Skill Building services
Outcomes
Primary Outcomes
Levels of Emerging Adult Perceptions of Acceptability of the Launch Intervention (measured at 6 months).
Time Frame: 6 months
Levels of acceptability of the Launch intervention, such as if participants like the intervention, as reported by emerging adults on the Acceptability of Intervention Measure. Scores range from 4-20. Higher scores indicate higher levels of intervention acceptability.
Levels of Parent Perceptions of Acceptability of the Launch Intervention (measured at 6 months).
Time Frame: 6 months
Levels of acceptability of the Launch intervention, such as if participants like the intervention, as reported by parents on the Acceptability of Intervention Measure. Scores range from 4-20. Higher scores indicate higher levels of intervention acceptability.
Levels of Parent Perceptions of Launch Intervention Appropriateness (measured 6 months).
Time Frame: 6 months
Levels of Launch intervention appropriateness, such as if the intervention is a good match, as reported by parents on the Intervention Appropriateness Measure. Scores range from 4-20. Higher scores indicate higher levels of intervention appropriateness.
Levels of Emerging Adult Client Satisfaction with Launch Services (measured at 6 months).
Time Frame: 6 months
Levels of satisfaction with the Launch services reported by emerging adult clients on the Client Satisfaction Questionnaire 8-item scale adapted to reflect receipt of Launch services.
Levels of Parent Client Satisfaction with Launch Services (measured at 6 months).
Time Frame: 6 months
Levels of satisfaction with the Launch services reported by parent clients on the Client Satisfaction Questionnaire 8-item scale (CSQ-8) adapted to reflect receipt of Launch services.
Levels of Parent Perceptions of Feasibility of the Launch Intervention (measured at 6 months).
Time Frame: 6 months
Levels of Launch intervention feasibility, such as if the intervention is easy to use, as reported by parents on the Feasibility of Intervention Measure. Scores range from 4-20. Higher scores indicate higher levels of intervention feasibility.
Levels of Emerging Adult Perceptions of Launch Intervention Appropriateness (measured 6 months).
Time Frame: 6 months
Levels of Launch intervention appropriateness, such as if the intervention is a good match, as reported by emerging adults on the Intervention Appropriateness Measure. Scores range from 4-20. Higher scores indicate higher levels of intervention appropriateness.
Levels of Emerging Adult Perceptions of Feasibility of the Launch Intervention (measured at 6 months).
Time Frame: 6 months
Levels of Launch intervention feasibility, such as if the intervention is easy to use, as reported by emerging adults on the Feasibility of Intervention Measure. Scores range from 4-20. Higher scores indicate higher levels of intervention feasibility.
Secondary Outcomes
- Changes from baseline to 6 months post-baseline in Emerging Adult Service Utilization (measured at 0 and 6 months).(Baseline to 6 months)
- Levels of Emerging Adult Session Attendance with Peer Worker (measured weekly from baseline to 6 months).(Duration of services until 6 months after baseline)
- Changes from baseline to 6 months post-baseline in Emerging Adult Substance Use Disorders (measured at 0 and 6 months).(Baseline to 6 months)
- Changes from baseline to 6 months post-baseline in Emerging Adult Substance Use and Problems (measured at 0 and 6 months).(Baseline to 6 months)
- Changes from baseline to 6 months post-baseline in Recovery Capital (measured at 0 and 6 months).(Baseline to 6 months)
- Levels of Parent Session Attendance with CM-EA Parent Coach (measured weekly from baseline to 6 months).(Duration of services until 6 months after baseline)
- Attitudes at 6 months post-baseline in Parent Attitudes Toward the Services Provided, Research Protocol, and Parent/Emerging Adult Relationship (measured at 6 months).(6 months)
- Changes from baseline to 6 months post-baseline in Emerging Adult Polysubstance Use (measured at 0 and 6 months).(Baseline to 6 months)
- Changes from baseline to 6 months post-baseline in Emerging Adult Recovery Capital (measured at 0 and 6 months).(Baseline to 6 months)
- Levels of Emerging Adult Client Quality of Relationship with Parent (measured at 0 and 6 months).(Baseline to 6 months)
- Levels of Emerging Adult Client Quality of Relationship with Peer Worker (measured at 6 months).(6 months)
- Attitudes at 6 months post-baseline in Emerging Adult Attitudes Toward the Services Provided, Research Protocol, and Parent/Emerging Adult Relationship (measured at 6 months).(6 months)
- Changes from baseline to end fo services in Parent Contingency Management for Emerging Adults (CM-EA) Adherence (measured monthly throughout services duration).(Duration of services, after each session with a parent until 6 months after baseline)
- Changes from baseline to 6 months post-baseline in Emerging Adult Quality of Life (measured at 0 and 6 months).(Baseline to 6 months)
- Changes from baseline to 6 months post-baseline in Emerging Adult Abstinence Self Efficacy (measured at 0 and 6 months).(Baseline to 6 months)
- Attitudes at end of services in Peer Worker Attitudes Toward the Services Provided, Impacts on Emerging Adult Clients, and Services Improvement (measured at 6 months).(From date of consent until the date of two months past last client session completed, assessed up to 2 years)
- Descriptions of Economic-Related Information for Future Large-Scale Study from Payors/Providers of Recovery Services (measured once at any point during the study period).(Up to 2 years)
- Attitudes at end of services in Parent Coach Attitudes Toward the Services Provided, Impacts on Parent Clients, and Services Improvement (measured at 6 months).(From date of consent until the date of two months past last client session completed, assessed up to 2 years)
- Changes from baseline to end fo services in Peer Worker Services and Vocational/Educational Activity Completion (measured monthly throughout services duration).(Duration of services, after each session with an emerging adult until 6 months after baseline)