Kentucky Access to Recovery Evaluation

Evaluation of the Kentucky Access to Recovery (KATR) Linkage Strategy

Evaluate the long-term effectiveness of implementing vouchers as a linkage strategy in a population requiring recovery support services (RSS) when no other funding sources are available. A within-subjects study design will be used to test the effectiveness of the Kentucky Access to Recovery (KATR) last resort voucher linkage approach to reduce the risk of nonfatal and fatal overdoses by (a) increasing an individual's recovery capital; (b) reducing resumption of illicit substance use; and (c) promoting relinking to RSSs if illicit substance use is resumed.

Study Overview

• Status: Completed
• Conditions: Substance Use Disorders; Treatment Adherence and Compliance
• Intervention / Treatment: Behavioral: KATR Linkage Strategy

• Study Type: Observational
• Enrollment (Actual): 458

Contacts and Locations

Study Locations

• United States
  • Kentucky
    • Berea, Kentucky, United States, 40403
      • FAHE
    • Lexington, Kentucky, United States, 40506
      • University of Kentucky

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

individuals in underserved areas with incomes at or below the 200% poverty level, individuals with prior criminal-justice involvement, veterans, and pregnant and parenting populations, with illicit SUD

Description

Inclusion Criteria:

• be in SUD treatment or have completed within the past year SUD treatment for opioid use disorder or stimulant use disorder or have a history of overdose from opioid use
• be a first-time participant in KATR
• be in early stages of recovery (less than one year in recovery)
• be a resident of a KATR service county
• be at or below the 200% federal poverty level
• not have financial resources available through other funding mechanisms for RSSs
• be 18 years of age and older
• be in need of recovery supports that will enhance their likelihood of staying in recovery

Exclusion Criteria:

• Under 18
• Participated in KATR previously

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

KATR Clients; participants in the early stages of recovery and in substance use disorder (SUD) treatment; or those that have completed within the past year SUD treatment for opioid use disorder or stimulant use disorder or have a history of overdose from opioid use.

Behavioral: KATR Linkage Strategy; The Kentucky ATR (KATR) strategy is a 25-county program that links county residents at or below the 200% national poverty level who have an illicit SUD and are in treatment or early recovery to evidence-based RSSs such as recovery housing, and to other RSSs. The KATR linkage approach uses vouchers as a linkage strategy for individuals in SUD treatment who have no other funding options to acquire critical RSSs. As such, KATR's linkage through vouchers is a "last resort" approach for linking to RSSs.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Recovery Capital per person	Recovery capital will be assessed using the Brief Assessment of Recovery Capital-10 (BARC-10); 10 item survey unidimensional measure of recovery capital, scores may range from 6-60 at any given time. Evaluation of the measure suggests that individuals who have a higher score are likely to reach or sustain a year or longer of recovery from substance use disorder.	Enrollment, Up to 6 months, 3 months post discharge, and 12 months post enrollment
Change in number of drug overdoses per person	Number of drug overdoses will be assessed with the following survey question: In the past 30 days, did you experience an overdose or take too much of a substance that resulted in needing supervision or medical attention?	Enrollment, Up to 6 months, 3 months post discharge, and 12 months post enrollment
Change in number of days of illicit substance use per person	Number of days illicit substance use will be assessed with the following survey question: During the past 30 days, how many days have you used any substance	Enrollment, Up to 6 months, 3 months post discharge, and 12 months post enrollment

Collaborators and Investigators

• Sponsor: Terry Bunn
• Investigators: Principal Investigator: Terry Bunn, PhD, University of Kentucky

Study record dates

Study Major Dates

• Study Start (Actual): July 3, 2023
• Primary Completion (Actual): February 24, 2025
• Study Completion (Actual): February 24, 2025

Study Registration Dates

• First Submitted: May 23, 2023
• First Submitted That Met QC Criteria: June 1, 2023
• First Posted (Actual): June 5, 2023

Study Record Updates

• Last Update Posted (Actual): April 16, 2025
• Last Update Submitted That Met QC Criteria: April 11, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: Recovery; Addiction; Social Services; Opioid Overdose; Appalachia; Support Services
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders
• Other Study ID Numbers: 81811; R01CE003513-01-00 (Other Grant/Funding Number: CDC); R01CE003513-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No