Baystate Medical Center
The goal of this clinical trial is to evaluate the effectiveness and implementation of Relational Health Enhanced Parenting Support (RHEP), an implementation strategy designed to improve delivery of evidence-based parenting support within family-focused peer recovery support services (PRSS), for parents with substance use disorders (SUDs) receiving services through the FIRST Steps Together (FST) home visiting program. The main questions it aims to answer are: 1. Does FST plus RHEP improve parenting-related outcomes, substance use disorder treatment retention, and reduction in substance use compared with FST alone? 2. How do implementation processes vary across sites, and what role do peer recovery support specialists play in implementation and effectiveness outcomes? Researchers will compare FST alone to FST plus RHEP to determine whether RHEP enhances parenting support delivery and improves parent and recovery outcomes. Participants will: 1. Receive family-focused peer recovery support services through the FIRST Steps Together (FST) program; 2. Complete surveys and assessments related to parenting, recovery, and substance use over time; 3. Participate in follow-up data collection to evaluate treatment retention and recovery outcomes. Peer recovery support specialists participating in the study will: 1. Receive training and consultation. 2. Use implementation tools and supports designed to improve delivery of evidence-based parenting support. 3. Participate in implementation-related assessments and activities.
This study evaluates Relational Health Enhanced Parenting Support (RHEP), an implementation strategy designed to strengthen delivery of evidence-based parenting support within family-focused peer recovery support services (PRSS) for families affected by substance use disorders (SUDs). Parents with SUDs often experience challenges in the parent-child relationship that can negatively affect both recovery and child well-being. Although family-focused PRSS models are increasingly used to support families affected by SUDs, peer recovery support specialists may face barriers to integrating parenting…
Inclusion criteria: * At least 18 years old or older * Newly enrolled in FIRST Steps Together (\<1 month) * Expecting a child or parenting a child age 0-5 years, with either custody of the child or regularly planned visitation * History of SUDs (opioids or stimulants on self-report screening). Exclusion criteria: -Parents who are actively suicidal or homicidal or not able to give informed consent because of severe cognitive impairments or psychosis
Relational Health Enhanced Parenting support (RHEP) is an implementation bundle to promote more effective delivery of evidence-based parenting services within the PRSS model. It encompasses three primary implementation strategies: 1) Mirror training, 2) reflective consultation, 3) implementation blueprint. RHEP is delivered at the agency level for all FST staff with the intent to shift practice towards a more strengths-based, process-oriented, relational approach to enhance reflection within organizations and between peers and parents.
FIRST (Families in Recovery SupporT) Steps Together (FST) is centered on the Peer Recovery Support Service (PRSS) model and involves service delivery by people with lived SUD experience combined with specialized training. PRSS can employ case management, patient navigation, mentoring, or public health education strategies to assist with the unique needs of parents with SUDs in connecting to care, navigating child welfare systems, and preventing future substance misuse and overdose. By virtue of their lived experience, peers may serve as critical liaisons or ambassadors between systems of care and clients. FST further combines evidence-based parent home visiting with peer-led recovery supports to provide flexible, trauma-informed, community-based outreach and care. Mental health clinicians are affiliated with each site.