Peer Support Workers Feasibility Study
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Peer support service.
- Who it may be relevant to
- Registry conditions: Substance Use Disorder (SUD). Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Canada
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Promoting Safety and Equity in Chaos: A Feasibility Study of Peer Support Workers to Support People Who Use Drugs in Emergency Departments
Overview
Many people with high-risk opioid use visit emergency departments (EDs), facing a high risk of death if they leave before completing care. Peer support workers (Peer) - people with lived experience of substance use - may improve patient comfort, reduce early departures, and potentially lower mortality rates. This study aims to evaluate how a hospital-implemented ED Peer program can enhance patient support, reduce barriers to care, and provide harm-reduction resources in a person-centred and trauma-informed manner. The study will also validate the outcome and obtain preliminary estimates of the benefits of decreasing patients who leave the ED before completing care.
Detailed description
The main objectives of the study are to 1) to describe, and evaluate the feasibility and acceptability of a novel ED Peer program implemented by the Vancouver Coastal Health at the Vancouver General Hospital (VGH) ED, 2) to evaluate the feasibility of creating a randomized shift schedule in support of a future definitive randomized controlled trial, 3) to validate outcomes related to patients leaving before completing care using administrative data from the National Ambulatory Care Reporting System (NACRS), and 4) to obtain preliminary estimates of incidence of patients who leave the ED before completing care, to inform sample size calculations for a definitive randomized controlled trial.
The study will take place at Vancouver General Hospital (VGH), a large ED with approximately 97,000 visits per year, serving a diverse urban population. Investigators will evaluate our randomized shift schedule generation, and will describe our intervention and patient population through data within our Peer interaction logs and linkages to regional data. To understand our intervention and patient and provider experiences, investigators will use a mixed methods design to comprehensively collect, analyze, and interpret both qualitative and quantitative data. This approach will provide insights from multiple perspectives, offering a robust understanding of the relationships and potential contradictions within the evidence, thereby enriching the data and deepening our understanding of the findings.
Investigators will evaluate feasibility and acceptability of the Peer program at engaging patients with specific demographic, health history, and risk profiles. Investigators will assess the degree to which patients of different backgrounds access and engage with Peer services, and what characteristics affect patient acceptance of Peer services offered. Investigators will then work with the ED leadership team to target and tailor the program to best meet the needs of patients at highest risk.
This feasibility study will set the foundation for a definitive randomized controlled trial, which will be the first to compare patients with substance use who leave EDs before completing care during shifts with Peer availability versus without, addressing a critical knowledge gap. The definitive trial will engage multiple sites across Canada to rigorously evaluate ED Peer effectiveness, with the potential to scale up an intervention that could improve patient outcomes on a national scale.
Interventions
- Behavioral Peer support service
Peers approach identified patients who could potentially benefit from peer support services. Peers offer a range of supports tailored to individual patients' needs, which include referrals to clinical and social support services (e.g., social work, addictions specialist, Indigenous patient navigator, community-based addictions resources), resources (e.g., blankets, food, naloxone kit, sterile drug use supplies, information brochures), providing emotional support, and liaising between patients an
Primary outcome measures
- Distribution of randomized Peer shifts by day of week [Time frame: Over the 48-week randomized schedule period approved to meet hospital staffing policy]
- Proportion of Peer interactions with complete standardized documentation [Time frame: Up to 15 months post-study initiation]
- Identification of substance use-related ED visits for Peer and No Peer shift comparison [Time frame: Up to 15 months post-study initiation]
- Characterization of Patients Receiving the Peer Intervention [Time frame: Baseline. Up to 15 months post-study initiation.]
- Patients leaving the ED prior to completing care [Time frame: Baseline. Data will be linked and assessed at the conclusion of the feasibility study, up to 15 months post-study initiation.]
- "Treatment effect in the treated" analysis [Time frame: Up to 15 months post-study initiation]
Secondary outcome measures (3)
- Thematic summary of Indigenous patients' experiences with the Peer program based on storytelling and sharing circles [Time frame: Within 6 months after the patient's ED visit involving Peer interaction]
- Thematic summary of healthcare providers' perceptions of the Peer program assessed through focus groups [Time frame: From 3 to 15 months after program implementation]
- Patient-reported acceptability of the Peer program using the Peer patient survey [Time frame: Up to 15 months post-study initiation]
Eligibility criteria
Inclusion criteria
- Emergency Department (ED) patient at Vancouver General Hospital (VGH)
- Age 18 years or older
- Identified as using substances
- Able to receive or decline peer support services during the ED visit
Exclusion criteria
- Under 18 years of age
- Does not report substance use
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Supportive care
Study locations
Canada · 1 center
- Vancouver General Hospital — Vancouver
Identifiers
NCT: NCT07030192 · H24-03008