Implementation Factors Influencing Peer-Delivered Behavioral Evidence-Based Interventions for Substance Use Disorders: A Scoping Review.

Peer recovery specialists (PRS) are increasingly recognized as key members of the substance use disorder (SUD) treatment workforce. Recent efforts have focused on expanding PRS roles to include the delivery of behavioral evidence-based interventions (EBIs), such as motivational interviewing, cognitive-behavioral therapy techniques, and brief interventions. This scoping review aims to identify the determinants that influence the implementation of PRS-delivered behavioral EBIs and the strategies used to optimize their delivery within diverse SUD treatment contexts. A systematic search was conducted in APA PsycINFO, Web of Science, Scopus, PubMed, and Google Scholar, following PRISMA-ScR guidelines. Studies were included if they examined PRS delivering behavioral EBIs for SUD and reported on at least one implementation outcome as defined by Proctor et al. (2011). Data extraction and thematic synthesis were conducted using a hybrid deductive-inductive coding framework. Twelve studies met inclusion criteria. The most commonly studied interventions included behavioral activation, motivational interviewing, and Screening, Brief Intervention, and Referral to Treatment (SBIRT). PRS-delivered behavioral EBIs demonstrated high acceptability, appropriateness, and feasibility, with strong participant engagement and satisfaction. Facilitators of implementation included the integration of PRS within existing service structures, the adaptability of interventions, and the unique relatability of PRS. Barriers included PRS role ambiguity, gaps in training, and systemic challenges such as lack of funding and limited access to adjunctive support services. Implementation outcomes such as adoption, sustainability, and cost were infrequently assessed, highlighting gaps in the current literature. The findings suggest that PRS-delivered behavioral EBIs hold promise in expanding access to evidence-based care for individuals with SUD. However, structured training, supervision, and organizational support are critical for successful implementation. Future research should prioritize evaluating long-term sustainability, supervision, and strategies to enhance the integration of PRS within healthcare systems. Incorporating methods to address systemic barriers faced by service recipients will be essential for maximizing the impact of PRS-delivered interventions in SUD treatment.