Developing Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT): protocol for a pilot randomized controlled trial

Dennis P Watson, Bradley Ray, Lisa Robison, Huiping Xu, Rhiannon Edwards, Michelle P Salyers, James Hill, Sarah Shue, Dennis P Watson, Bradley Ray, Lisa Robison, Huiping Xu, Rhiannon Edwards, Michelle P Salyers, James Hill, Sarah Shue

Abstract

Background: There is a lack of evidence-based substance use disorder treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana's Access to Recovery program, which was closed due to lack of federal support despite positive improvements in clients' recovery outcomes. SUPPORT builds on noted limitations of Indiana's Access to Recovery program. The ultimate goal of this project is to establish SUPPORT as an effective and scalable recovery-oriented system of care. A necessary step we must take before launching a large clinical trial is pilot testing the SUPPORT intervention.

Methods: The pilot will take place at Public Advocates in Community Re-Entry (PACE), nonprofit serving individuals with felony convictions who are located in Marion County, Indiana (Indianapolis). The pilot will follow a basic parallel randomized design to compare clients receiving SUPPORT with clients receiving standard services. A total of 80 clients within 3 months of prison release will be recruited to participate and randomly assigned to one of the two intervention arms. Quantitative measures will be collected at multiple time points to understand SUPPORT's impact on recovery capital and outcomes. We will also collect qualitative data from SUPPORT clients to better understand their program and post-discharge experiences.

Discussion: Successful completion of this pilot will prepare us to conduct a multi-site clinical trial. The ultimate goal of this future work is to develop an evidence-based and scalable approach to treating substance use disorder among persons returning to society after incarceration.

Trial registration: ClinicalTrials.gov (Clinical Trials ID: NCT03132753 and Protocol Number: 1511731907). Registered 28 April 2017.

Keywords: Criminal justice; Pilot randomized control trial; Re-entry; Recovery; Recovery-oriented system of care; Substance abuse; Substance use disorder.

Conflict of interest statement

Dr. Dennis P. Watson is an Associate Professor of Social and Behavioral Sciences in the Richard M. Fairbanks School of Public Health, and his research focuses on the development, dissemination, implementation, and evalution of behavioral health policies and programs. Dr. Bradley Ray is an Assistant Professor in the School of Public and Environmental Affairs at IUPUI, and his research focuses on mental health and substance use. Lisa Robison is a project manager with the Fairbanks School of Public Health. Rhiannon Edwards is the Executive Director of Public Advocates in Community Re-Entry. Huiping Xu is an Associate Professor of Biostatistics in the Richard M. Fairbanks School of Public Health. Dr. Michelle P. Salyers is a Professor of Psychology at IUPUI, and her research is on psychiatric rehabilitation, specifically focusing on adults with severe mental illnesses. Dr. James Hill is an Associate Professor of Computer Science at IUPUI, and his research focuses on the techniques for evaluating and validating quality-of-service. Sarah Shue is a graduate student in the School of Health and Rehabilitation Sciences.This trial was reviewed by the Indiana University IRB (Protocol 151,173,190).Not applicableRE is the Executive Director of PACE where the pilot trial will be carried out. RE is included as an author on this paper because she provided information regarding PACE operations that were necessary for the development of the study protocols though she will have no involvement in the analysis of data related to this study. The other authors have no competing interests to declare.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Model of expected client recovery process in the SUPPORT program. By increasing options available to clients through its expanded infrastructure and flexible services, the program improves client’s sense of agency (i.e., control) over their recovery. Increased agency improves motivation to participate in treatment and supportive services, as well as other aspects of recovery capital (e.g., social support and self-efficacy). Improved social capital reduces barriers to recovery and leads to improved recovery outcomes. The model also asserts that improved recovery capital and services support the individual through a relapse (should one happen) and reflects process-based definitions central to current recovery policy.
Fig. 2
Fig. 2
Flow of clients through the study. The process that clients will undergo to participate in the study, from eligibility to informed consent to randomization

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