# Teaching harm reduction in vulnerable environments (THRIVE): a peer-led intervention bridging acute care settings and the discharge to the community

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2022 · $49,600

## Abstract

ABSTRACT
People who use drugs (PWUD) with acute medical problems have high rates of subsequent mortality and
morbidity related to substance use, with notable racial disparities. While harm reduction services to reduce
overdose and injection-related complications have historically functioned outside of health care settings,
integrating harm reduction into acute care clinical settings could improve these outcomes. There is a critical
gap in how best to implement harm reduction services in the health system that will lead to effective behavioral
change and address equity gaps. Our study proposes to develop an acceptable, feasible, and effective peer-led
bundle of harm reduction services. Our overall objectives are to tailor the THRIVE (Teaching Harm Reduction
In Vulnerable Environments) intervention and determine its efficacy in changing behaviors and reducing
health risks among PWUD. The THRIVE intervention was conceptualized by our team along with people with
lived experience and informed by the COM-B model for Behavior Change and the Theoretical Domains
Framework. THRIVE bundles evidence-based harm reduction strategies (e.g. safer injection education, take
home naloxone, and fentanyl test strips). It includes a face-to-face session boosted by weekly text messages and
electronic content. Content is delivered over 12 weeks. Our research team has the extensive expertise in
community-partnered research, qualitative methodology, behavioral health intervention design, and clinical
trial management needed to successfully complete the proposed aims. We will use a human-centered design
approach to tailor the THRIVE model and address the patient, provider, and systems-level barriers to
implementation in hospital and emergency-department settings. This includes a “Design Sprint” in which
PWUD will map the problem (guided by qualitative interviews with patients and healthcare providers), sketch
implementation elements, choose the key aspects to develop, and build model components. These
implementation methods for the THRIVE model will then be user-tested with 20 patients over an 8-week
period. We will then examine the efficacy of the THRIVE intervention in reducing the cumulative incidence of
self-reported non-fatal overdose or skin and soft tissue infection between baseline and 6-months among
PWUD in a hybrid type 1 randomized controlled trial. We will conduct a randomized controlled trial recruiting
patients (n=390) admitted to the hospital or Emergency Department with opioid use disorder in one of three
hospitals. We will also analyze implementation barriers and facilitators of the THRIVE model using the health
equity implementation framework to identify any needed implementation supports for widescale
implementation.

## Key facts

- **NIH application ID:** 10589388
- **Project number:** 1R01DA057633-01
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Jacqueline Deanna Wilson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $49,600
- **Award type:** 1
- **Project period:** 2022-09-30 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10589388

## Citation

> US National Institutes of Health, RePORTER application 10589388, Teaching harm reduction in vulnerable environments (THRIVE): a peer-led intervention bridging acute care settings and the discharge to the community (1R01DA057633-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10589388. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*