Enhancing Delivery of Parenting Support Within a Peer Recovery Support Service Model
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: Relational Health Enhanced Parenting Support (RHEP) implementation bundle, First Steps Together.
- Who it may be relevant to
- Registry conditions: Substance Use Disorders (SUDs). 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
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Relational Health Enhanced Parenting Support (RHEP) Type 2 Hybrid Effectiveness-Implementation Study
Overview
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.
Detailed description
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 support into routine service delivery.
RHEP was developed to address these barriers through a multilevel implementation approach that includes workforce training, consultation, and site-level implementation planning. The study is conducted in partnership with the Massachusetts Department of Public Health through FIRST Steps Together (FST), a statewide home visiting program that uses a family-focused PRSS model.
Using a hybrid type 2 effectiveness-implementation design, the study will examine both the effectiveness of RHEP-enhanced services and the implementation processes required to support adoption across six FST sites. A stepped-wedge cluster randomized design will allow each site to transition from FST alone to FST plus RHEP during the study period. Data collected from participating parents and peer recovery support specialists will be used to evaluate intervention effectiveness, implementation outcomes, and factors that influence successful integration of parenting support within peer-led recovery services. Findings will inform future dissemination of parenting support strategies across peer-led, community-based models of care.
Interventions
- Other Relational Health Enhanced Parenting Support (RHEP) implementation bundle
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 org - Behavioral First Steps Together
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
Primary outcome measures
- Parenting Related Factors [Time frame: Baseline, 1, 3, and 6 months]
Secondary outcome measures (5)
- Child Protective Service Involvement [Time frame: Baseline, 1, 3 and 6 months]
- Substance Use Disorder (SUD) Treatment Retention [Time frame: Baseline, 1, 3 and 6 months]
- Substance Use [Time frame: Baseline, 1, 3 and 6 months]
- Depression [Time frame: Baseline, 1, 3 and 6 months]
- Anxiety [Time frame: Baseline, 1, 3 and 6 months]
Eligibility criteria
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.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Supportive care
Study locations
United States · 1 center
- Baystate Medical Center — Springfield
Publications
- Lowell AF, Peacock-Chambers E, Zayde A, DeCoste CL, McMahon TJ, Suchman NE. Mothering from the Inside Out: Addressing the Intersection of Addiction, Adversity, and Attachment with Evidence-Based Parenting Intervention. Curr Addict Rep. 2021;8(4):605-615. doi: 10.1007/s40429-021-00389-1. Epub 2021 Jul 15. PMID 34306964
- Lowell AF, DeCoste C, Dalton R, Dias H, Borelli JL, Martino S, McMahon TJ, Suchman NE. Mothering from the Inside Out: Results of a community-based randomized efficacy trial testing a mentalization-based parenting intervention for mothers with addictions. Infant Ment Health J. 2023 Mar;44(2):142-165. doi: 10.1002/imhj.22043. Epub 2023 Mar 2. PMID 36862381
Identifiers
NCT: NCT07743359 · 2422062