The Competencies of Telehealth Peer Support: Perceptions of Peer Support Specialists and Supervisors During the COVID-19 Pandemic

Evaluation of post-discharge engagement for emergency department patients with opioid use history who received telehealth recovery coaching services

BACKGROUND

In recent years, emergency departments (EDs) across the nation have implemented peer recovery coach (PRC) services to support patients who use opioids. The majority of such interventions discussed in the literature follow an in-person modality where PRCs engage patients directly at the ED bedside. However, the use of telehealth services in EDs is becoming more popular. These services connect PRCs with ED patients in real-time via secure communications technology, and very little is known about the service- and clinical-based outcomes with which they are associated. The current study sought to assess factors associated with successful post-discharge follow-up of patients with a history of opioid use who received PRC telehealth services while in the ED.

METHOD

Data come from records for 917 patients who engaged with a telehealth PRC one or more times (1208 total engagements) at 1 of 13 EDs within the same health system. A multilevel Poisson regression model was used to assess the degree to which variables predicted successful post-discharge follow-up, defined as the number of times a PRC successfully spoke with the patient each month after ED discharge.

RESULTS

At least one follow-up was successfully completed by a PRC for 23% of enrolled patients. Significant predictors of successful follow-up included patient employment at baseline (Incidence Rate Ratio [IRR]: 2.8, CI: 2.05-3.9), living in a rural area (IRR: 1.8, CI: 1.04-3.2), PRC provision of referrals (IRR: 1.7, CI: 1.2-2.2), number of ED encounters in the previous 365 days (IRR: 0.99, CI: 0.98-0.99), and duration of the initial PRC telehealth interaction (IRR: 0.87, CI: 0.85-0.88).

CONCLUSION

Given that relationship development is a key tool in the PRC profession, understanding successful follow-up associated with telehealth engagement has unique importance. The results have potential utility for planning and implementing peer telehealth services in EDs and other locations, which is needed for the development of the PRC profession and the likely expansion of peer telehealth services.

Qualitative Study of Certified Peer Specialists' Experiences Delivering Peer Support Services During the COVID-19 Pandemic

OBJECTIVE

The purpose of this qualitative study was to examine the experiences of certified peer specialists (CPSs) in delivering telehealth services during the COVID-19 pandemic.

METHODS

Fourteen semistructured interviews with CPSs were conducted from August to November 2020. Data were analyzed by using thematic analysis.

RESULTS

Helpful support from employers during the transition to telehealth included clear communication and access to training on telehealth technologies. Main barriers and facilitators were related to interpersonal relationships and logistical factors. CPSs reported that telehealth allowed them to continue to support the peers they serve but that the quality of interactions was not as good as with in-person services. Logistical challenges included inadequate equipment and Internet access.

CONCLUSIONS

To support CPSs in delivering telehealth, employers can engage them in open and transparent communication about guidelines for service delivery, provide training and equipment, and allow them the flexibility to tailor service delivery modalities to the peers they serve.

Providing peer navigation services to women with a history of opioid misuse pre- and post-release from jail: A program description

Background:

Justice system-involved women with opioid use disorder (OUD) experience layered health risks and stigma, yet peer navigation services during reentry may support positive outcomes. This manuscript offers a program description of a women’s peer navigation intervention delivered pre- and post-release from jail to remove barriers to women’s access to OUD treatment, including medications for opioid use disorder (MOUD).

Methods:

All data were collected as part of a NIH/NIDA-funded national cooperative, the Justice Community Opioid Innovation Network (JCOIN) project. Through the larger study’s intervention, women in jail with OUD are connected via videoconference to a peer navigator, who provides an initial reentry recovery assessment and 12+ weeks of recovery support sessions post-release. Qualitative analyses examined peers’ notes from initial sessions with women (N = 50) and in-depth interviews with peers (N = 3).

Results:

Peers’ notes from initial sessions suggest that women anticipate challenges to successful recovery and community reentry. More than half of women (51.9%) chose OUD treatment as their primary goal, while others selected more basic needs (e.g. housing, transportation). In qualitative interviews, peers described women’s transitions to the community as unpredictable, creating difficulties for reentry planning, particularly for rural women. Peers also described challenges with stigma against MOUD and establishing relationships via telehealth, but ultimately believed their role was valuable in providing resource referrals, support, and hope for recovery.

Conclusions:

For women with OUD, peer navigation can offer critical linkages to services at release from jail, in addition to hope, encouragement, and solidarity. Findings provide important insights for future peer-based interventions.