Department of Psychology, University of Maryland, College Park, MD, USA.
Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, USA.
Subst Abus. 2021;42(4):726-734. doi: 10.1080/08897077.2020.1846663. Epub 2020 Dec 3.
Low-income, racial/ethnic minority individuals face significant barriers in access to substance use (SU) treatment. Peer recovery coaches (PRCs), individuals with lived experience with substance use disorder (SUD), may be uniquely well suited to assist those encountering barriers to treatment. PRCs can also help reach those not engaged in treatment to promote harm reduction and support linkage-to-care when embedded in community rather than clinical settings. This study evaluated a community-based program in which a PRC facilitated linkage to and supported retention in SU treatment. Guided by the RE-AIM framework, we evaluated implementation of the intervention in a community resource center (CRC) serving homeless and low-income residents of Baltimore City. We examined the reach, effectiveness, adoption, and implementation of this PRC model. Of 199 clients approached by or referred to the PRC, 39 were interested in addressing their SU. Of those interested in addressing SU, the PRC linked 64.1% ( = 25) to treatment and was able to follow up with 59.0% ( = 23) at prespecified time points after linkage (24-48 hours, 2 weeks, and 1 month). Fifty-two percent ( = 13) of clients linked to SU treatment remained in treatment at 30 days post-linkage. Of clients who did not remain in treatment, 77% ( = 10) continued contact with the PRC. Results indicate the utility of the CRC's approach in linking people to treatment for SU and addressing barriers to care through work with a PRC. Findings also highlight important barriers and facilitators to implementation of this model, including the need for adaptation based on individual goals and fluctuations in readiness for treatment.
低收入、少数族裔个体在获得物质使用（SU）治疗方面面临重大障碍。同伴康复教练（PRC），即有物质使用障碍（SUD）生活经历的个体，可能非常适合帮助那些遇到治疗障碍的人。PRC 还可以帮助那些没有接受治疗的人减少伤害，并在社区环境中而不是临床环境中促进与治疗的联系和支持。本研究评估了一个基于社区的项目，其中一名 PRC 协助与 SU 治疗建立联系并支持其保留。本研究以 RE-AIM 框架为指导，在巴尔的摩市为无家可归和低收入居民提供服务的社区资源中心（CRC）中评估了该干预措施的实施情况。我们检查了该 PRC 模型的覆盖范围、效果、采用和实施情况。在被 PRC 联系或转介的 199 名客户中，有 39 人有兴趣解决他们的 SU 问题。在有兴趣解决 SU 问题的人中，PRC 将 64.1%（=25）与治疗联系起来，并能够在链接后的规定时间点（24-48 小时、2 周和 1 个月）与 59.0%（=23）进行跟进。52%（=13）链接到 SU 治疗的客户在链接后 30 天仍在治疗中。在没有继续治疗的客户中，有 77%（=10）继续与 PRC 保持联系。结果表明，CRC 方法在将人们与 SU 治疗联系起来以及通过与 PRC 合作解决护理障碍方面具有实用性。研究结果还突出了实施该模型的重要障碍和促进因素，包括需要根据个人目标和治疗准备情况的波动进行调整。
