Development and Piloting of a Scalable Training for Peer Recovery Specialists in an Evidence-Based Substance Use Intervention: Preliminary Implementation Outcomes

Individuals from minoritized and under-resourced communities have significantly less access to specialized services from substance use disorder. Peer recovery specialists (PRSs) show promise for increasing access to services, especially in low-resource settings, but have not historically been trained to deliver evidence-based interventions (EBIs). While behavioral activation (BA) has shown promise as a PRS-delivered EBI, few studies have examined broader training efforts that may inform the scale-up of this model. This study describes the co-development (including PRSs and community-based treatment providers) and dissemination of a BA training for PRSs. The initial training was piloted with five PRSs, who provided qualitative feedback on training content and delivery. The revised training was then delivered to 168 PRSs. Post-training, participants completed implementation outcome measures assessing feasibility, acceptability, and appropriateness. A follow-up survey was sent within six months to assess continued use and perceptions of BA. Qualitative feedback identified BA as feasible for PRS delivery and appropriate for the PRS role, and identified ongoing supervision and experiential learning as key needs for PRS training. PRSs who received the revised training found it to be feasible, appropriate and acceptable. Follow-up surveys suggest PRSs continued to use BA skills and found it was a good fit to their role and feasible for their work situation. PRS-delivery of EBIs has the potential to increase access to treatment for individuals from low-resource communities. With appropriate modifications for the unique needs of this workforce, PRSs can be trained on a large-scale to deliver BA.