Addressing Racial Disparities in Opioid Overdose Using Peer Recovery Coach Training and MHealth Platform
- Conditions
- Opioid Use Disorder
- Interventions
- Behavioral: AI driven CSDH-enhanced text onlyBehavioral: PRC supported text + AI driven CSDH-enhanced textBehavioral: Treatment as Usual (TAU)
- Registration Number
- NCT06573476
- Lead Sponsor
- Friends Research Institute, Inc.
- Brief Summary
The study aims to adapt an existing Cultural Structural Humility (CSH) training into a video format for peer recovery coaches (PRCs) and refine an AI-driven texting tool to reinforce the training. After refining these tools using user-centered design, a pilot test will be conducted to assess their impact on the uptake of opioid treatment and social services. The study will also evaluate the feasibility and effectiveness of the intervention to inform future large-scale trials.
- Detailed Description
The purpose of this study is to adapt an evidence-supported, currently staff-led Cultural Structural Humility (CSH) training to an interactive video format (7 brief video modules) for PRCs (Aim 1) while concurrently, refining a validated AI-driven texting tool that will newly reinforce core CSH training principles (Aim 2) that focus upon cultural and structural determinants of health (CSDH). After completing iterative refinement per user-centered design strategies based on the Technology Acceptance Model (TAM) for Aim 1 and 2, the investigators will pilot test CSH-trained PRCs delivering telephone based care/services coordination combined with refined AI-driven texting to enhance uptake of MOUD services, and social services (Aim 3). Aim 3 is sized for feasibility testing, final 'de-bugging' of the platform, and informing study conceptualization for a future large-scale efficacy trial. In this R34, the intervention effects will be assessed on the primary clinical outcome (i.e., receipt of buprenorphine), secondary outcome (i.e., uptake of social services), and implementation of the proposed multimodal intervention platform per the RE-AIM framework.
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 180
- ≥18 years of age
- fluent in English
- self-reported non-prescription opioid use <30 days prior to consent
- provision of informed consent
- planned stay in NYC ≥3 months
- Black and/or Latinx race/ethnicity
- positive urine toxicology for opioids per EMR records or study staff administered random saliva drug testing
- diagnosis of OUD per the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)
- self-reported interest in initiating buprenorphine in primary care, or elsewhere.
- inability to comprehend text content written at a 3rd grade reading level
- physical or visual disability preventing mobile phone use
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention Arm-2: AI driven CSDH-enhanced text only AI driven CSDH-enhanced text only Individuals randomized to Arm-2 will receive the AI-driven CSDH-enhanced text messaging only Intervention Arm-1: PRC supported text+ AI driven CSDH-enhanced text PRC supported text + AI driven CSDH-enhanced text Individuals randomized to Arm-1 will receive PRC-supported text check-ins and AI-driven CSDH-enhanced text messaging. Control Arm 3- Treatment as Usual Treatment as Usual (TAU) Individuals randomized to the control arm will receive treatment as usual.
- Primary Outcome Measures
Name Time Method Rate of AI-Driven Texting Use Among PWUO 3 months The frequency of AI-driven text interactions initiated by PWUO, captured through software logs.
Change in Felt and/or Anticipated Stigma 3 months The change in felt and/or anticipated stigma pre- and post-intervention, measured by a validated stigma assessment questionnaire.
The Amount of Self-Reported Social Services Use 3 months The self-reported utilization of social services at baseline, 1 month, and 3 months, addressing social determinants of health (SDH) to assess intervention effect sizes.
Estimated Rate of PRC-PWUO Contact 3 months The number of contacts between Peer Recovery Coaches (PRC) and People Who Use Opioids (PWUO), measured through communication logs.
Amount of time to Initial Receipt of Buprenorphine (Self-Reported) 3 months The time (in days) to the initial receipt of buprenorphine, as self-reported by participants.
Cost (Amount of Money) of Implementing and Sustaining the Multimodal Intervention 3 months The associated cost of implementing and sustaining the multimodal intervention, including cost-per quality-adjusted life year (QALY) and cost-per opioid use disorder (OUD) treatment days.
- Secondary Outcome Measures
Name Time Method The Amount of Participants That Retain in Treatment 3 months The number of participants continuously retained in buprenorphine treatment over a 12-week period, assessed at the 12-week mark.
Trial Locations
- Locations (1)
START Treatment and Recovery
🇺🇸New York City, New York, United States