# Emergency department community health worker-peer recovery navigation for linkage to recovery: A mixed methods evaluation

> **NIH ALLCDC R01** · RHODE ISLAND HOSPITAL · 2022 · $749,995

## Abstract

Project Summary
The emergency department (ED) is on the front lines of the overdose epidemic, treating an increasing number
of people with substance use disorders (SUD). In the year after a substance use-related ED visit, risk of death
is six time higher than other patients, and for people treated after an opioid overdose, more than one in twenty
patients will die. Each substance use-related ED visit represents a crucial opportunity to link patients to
recovery services, however there are significant gaps in service provision with less than one in three receiving
behavioral counseling and only one in five linked to addiction treatment. To improve linkage to recovery and
addiction treatment services from the ED, we launched a multidisciplinary, ED community health worker-peer
recovery specialist program (PCHW), the Substance Misuse Assistance Response Team (SMART), at a large,
academic, urban medical center which cares for the majority of patients with SUDs in Rhode Island. Drawing
from models of existing peer recovery specialist, CHW, and health promotion advocate programs, SMART is a
novel ED-based program that provides people with a substance-use related ED visit individualized support,
short term case management, navigation to social services, harm reduction, recovery, and addiction treatment
services in and out of the ED. SMART distinguishes itself from other models of ED patient navigation and/or
peer recovery specialist programs by working in and out of the ED and focusing on social determinants of
recovery. In recent years there has been a proliferation of ED peer recovery programs, but little is known about
their effectiveness. We will conduct a pragmatic, mixed methods study of an established ED PCHW program to
evaluate program delivery, linkage to evidence-based recovery services, and short- and long-term patient
outcomes. Aims of this study are to 1) understand participant experiences working with a SMART PCHW and
identify possible mechanisms for successful recovery linkage; 2) Evaluate SMART effectiveness on patient-
centered outcomes, building recovery capital, and recovery linkage; 3) Evaluate SMART implementation and
effectiveness on patient outcomes over time. Participant interviews will examine participant experiences with
SMART, recovery services engagement, and identify potentially effective engagement strategies. A RE-AIM
framework will be used to evaluate program implementation (process outcomes) and effectiveness (patient
outcomes). Surveys and data linkage to hospital and state administrative databases will be used to measure
changes in recovery capital, social networks, receipt of social services, linkage to harm reduction, recovery,
and addiction treatment services, and changes in acute care utilization and mortality among people receiving
SMART. Results from this study will provide robust data about ED peer recovery specialist program process
and patient-level outcomes needed for a subsequent multilevel, comprehensive st...

## Key facts

- **NIH application ID:** 10591625
- **Project number:** 1R01CE003516-01
- **Recipient organization:** RHODE ISLAND HOSPITAL
- **Principal Investigator:** Elizabeth ANNE Samuels
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $749,995
- **Award type:** 1
- **Project period:** 2022-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10591625

## Citation

> US National Institutes of Health, RePORTER application 10591625, Emergency department community health worker-peer recovery navigation for linkage to recovery: A mixed methods evaluation (1R01CE003516-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10591625. Licensed CC0.

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