Peer Recovery Support Specialists: Role Clarification and Fit Within the Recovery Ecosystems of Central Appalachia

The Peer Recovery Support Specialist (PRSS), a certified professional who self-identifies as being in recovery from a substance use disorder (SUD), mental illness, or co-occurring disorders, plays a key role in the ongoing transformation of SUD treatment from one of acute clinical service provision with documented short-term outcomes including symptom reduction, to a more holistic and comprehensive approach to long-term recovery. Empirical evidence specific to outcomes of PRSS working in the addiction treatment realm is sparse and equivocal, indicating the need for additional research and improved methods designed to explore the nature of the PRSS role and fit within the expanding models of a recovery eco-system. This sequential exploratory mixed-methods study surveyed PRSS in five states of Central Appalachia in order to better understand the nature of their work, personal recovery characteristics and their interactions within existing recovery ecosystems. The final sample included 565 PRSS. Results indicate that PRSS frequently provide emotional support to persons they work with and are overwhelmingly satisfied with their work but have few professional advancement opportunities and generally feel that others misunderstand their role. They have a strong voice and wish to be heard as evidenced by their responses to open text questions and interest in future work. This baseline survey can serve as the beginning of a framework for improved methods if driven by PRSS

Prescription Drug Abuse Communication: A Qualitative Analysis of Prescriber and Pharmacist Perceptions and Behaviors

Background: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited. Objectives This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists. Methods: Five focus groups (N = 35) were conducted within the Appalachian Research Network (AppNET), a rural primary care practice-based research network (PBRN) in South Central Appalachia between February and October, 2014. Focus groups were structured around the administration of three previously validated trait-level communication survey instruments, and one instrument developed by the investigators to gauge HCP prescription drug abuse communication engagement and perceived communication importance. Using a grounded theory approach, focus group themes were inductively derived and coded independently by study investigators. Member-checking interviews were conducted to validate derived themes. Results: Respondents\u27 trait-level communication self-perceptions indicated low communication apprehension, high self-perceived communication competence, and average willingness to communicate as compared to instrument specific criteria and norms. Significant variation in HCP communication behavior engagement was noted specific to PDA. Two overarching themes were noted for HCP-patient communication: 1) influencers of HCP communication and prescribing/dispensing behaviors, and 2) communication behaviors. Multiple sub-themes were identified within each theme. Similarities were noted in perceptions and behaviors across both prescribers and pharmacists. Conclusions: Despite the perceived importance of engaging in PDA communication, HCPs reported that prescription drug abuse communication is uncomfortable, variable, multifactorial, and often avoided. The themes that emerged from this analysis support the utility of communication science and health behavior theories to better understand and improve PDA communication behaviors of both prescribers and pharmacists, and thereby improve engagement in PDA prevention and treatment

Interprofessional Working Group Addresses Prescription Drug Abuse

Northeast Tennessee has been disproportionately burdened by a high prevalence of opioid prescribing, prescription drug abuse, addiction, overdose, and Neonatal Abstinence Syndrome. The East Tennessee State University Prescription Drug Abuse and Misuse Working Group (PDAMWG) formed upon recognizing an urgent need for a collaborative, multi-faceted response to reduce prescription drug abuse. Composed of over 100 members from various agencies, organizations, and institutions, members of this highly interprofessional, university-sponsored working group include academic scholars, healthcare providers, pharmacists, elected officials, students, community members, and more. This collaboration has successfully generated multiple funded research projects and numerous evidence- and community-based initiatives targeting prescription drug abuse. This seminar will focus on substance abuse prevention, specifically the prevention of prescription drug abuse. In addition to providing a data supported summary of the epidemic in the region, this seminar will outline the historical development of the PDAMWG and describe past and present research and community-based initiatives. An emphasis will be on the continuous commitment of the PDAMWG to the development, dissemination, and implementation of evidence-based practices to reduce prescription drug abuse and improve population health in the region. This seminar will also document research as well as community-based outcomes of PDAMWG efforts. Consequently, participants will recognize the effectiveness of strong, cross-sector partnerships for population health improvement. Relatedly, participants will develop a concrete understanding of a collaborative approach that bridges academic research and community-based practice. Perhaps most importantly, participants will discover its potential for replication in other communities to support the achievement of maximum, evidence-based outcomes for various health concerns. Lastly, participants will be introduced to the underlying model of the PDAMWG, which visually depicts evidence-based strategies along the disease continuum. As a result, participants will appreciate the complexity of public health problems and the subsequent importance of a multi-pronged, evidence-based response to addressing the