Dr. Angela Hagaman, Operations Director of East Tennessee State University College of Public Health’s Addiction Science Center, is lead author of an article in Frontiers in Public Health. The article, "Peer support service activity prevalence by setting: a nine-state survey of peer workers" presents findings from a study examining the activities and settings of peer recovery support services across nine U.S. states.
Hannah Warren, current student in the college’s doctoral program is a co-author. Additional co-authors include members of Sam Houston State University.
The team conducted a sequential exploratory mixed-methods study, starting with a qualitative review of a previous peer worker survey instrument by eight subject matter experts with lived experience of substance use disorder. They then disseminated an improved 38-item web-based survey to a sample of peer workers across nine states. Peer recovery support services (PRSS) are flexible, evidence-informed interventions that can be provided in a variety of settings over varying lengths of time and are delivered by credentialed people in long-term recovery from substance use and mental health disorders.
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines PRSS support across four distinct categories: emotional (demonstrating empathy, caring, or concern to bolster self-esteem and confidence), informational (sharing knowledge and information and/or providing life or vocational skills training), instrumental (providing concrete assistance to help other accomplish tasks), and affiliational (facilitating contacts with others to promote learning of social and recreational skills to acquire a sense of belonging).
A total of 659 peer workers responded, reporting that they performed an average of 24 different service activities most of the time. PRSS interventions were most commonly delivered in communities and neighborhoods, client homes, and recovery community organizations. Participants indicated they spent approximately half of their time providing emotional support, with less time dedicated to affiliational and instrumental support.
This study may be the first to explore the broad array of service activities peer workers perform across multiple settings within regional recovery ecosystems. The findings provide preliminary evidence about where PRSS are performed, indicating that services are frequently delivered in non-clinical community-based settings and client homes, which may confer added benefits. These results can inform future studies examining the effectiveness of PRSS across the continuum of care.