# Supporting Treatment Access and Recovery through Linkage and Support (STAR-LS)

> **NIH ALLCDC R01** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2024 · $745,767

## Abstract

PROJECT SUMMARY / ABSTRACT
Addiction is a growing public health problem in the United States (U.S.), with nearly 21 million Americans meeting
criteria for substance use disorder (SUD), 1.6 million meeting criteria for opioid use disorder (OUD), and opioid-
related overdoses have increased by 50% over the past 5 years. Among people with SUD, 49% have comorbid
mental health disorders (COD). Individuals with COD are vulnerable to substance use relapses, mental illness
exacerbations, overdoses, homelessness, and criminal justice involvement. However, despite the high rates of
morbidity, mortality, and broad social determinant of health needs among people with COD, only 8% of
individuals in the U.S. received treatment for both mental illness and SUD. Among those with a COD receiving
treatment, 6-month engagement rates are as low as 16% for psychosocial treatments, and 90% of individuals
leaving treatment will relapse within 12 weeks. Massachusetts is also hard hit, with a 16% higher SUD prevalence
compared to the U.S., and Worcester, the second largest city in Massachusetts, is disproportionately affected
by SUD, having one of the highest overdose rates in the state and is ranked 2nd on the CDC social vulnerability
index. These findings highlight the need to improve treatment access and engagement to support recovery in
Worcester, Massachusetts. Both linkage and multicomponent wraparound models have gained popularity as a
solution to increase treatment access and engagement. Maintaining Independence and Sobriety through
Systems Integration, Outreach and Networking (MISSION) is a hybrid multicomponent linkage and treatment
approach, providing assertive outreach linkage support combined with psychosocial treatment, delivered by a
cross disciplinary team. MISSION is aligned with the Social Ecological Model (SEM) to address multilevel client
needs via 3 evidence-based practices. They include 1) Critical Time Intervention (CTI), a time-limited form of
assertive community treatment; 2) Dual Recovery Therapy (DRT), which is integrated group therapy for COD;
and 3) Peer Support (PS), offering support for people in recovery by people in recovery. In response to RFA-
CE-22-010, the proposed 3-year Hybrid Type I study, “Supporting Treatment Access and Recovery through
Linkage and Support (STAR-LS),” will recruit and randomize 208 patients with COD in Worcester, MA in the
Hub, a program run by the Worcester Health and Human Services to one of the following conditions: 1) MISSION;
or 2) Peer Support (linkage only). There are three specific aims: Aim 1: To evaluate the effectiveness of
MISSION or compared to Peer Support to improve engagement, substance use and mental health symptoms.
Aim 2: To examine mechanisms of action of the interventions. Aim 3: To conduct a sequential mixed methods
process evaluation to inform sustainability and future implementation. This proposal is aligned with CDC’s
Strategic Priority Areas and Health People 2030 Core Objectives as it in...

## Key facts

- **NIH application ID:** 10830357
- **Project number:** 5R01CE003514-03
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Ayorkor Gaba
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $745,767
- **Award type:** 5
- **Project period:** 2022-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10830357

## Citation

> US National Institutes of Health, RePORTER application 10830357, Supporting Treatment Access and Recovery through Linkage and Support (STAR-LS) (5R01CE003514-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10830357. Licensed CC0.

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