Participant Perspectives on Peer Health Navigation during the Transition from Prison to the Community

Background and Purpose: Individuals with opioid use disorder (OUD) released from prisons are at high risk of adverse outcomes due to multiple health and psychosocial risk factors. The current system of care is inadequate in addressing these needs, as demonstrated by high overdose rates among individuals recently released from incarceration. Peer interventions to address these outcomes have expanded greatly in recent years, including recovery-oriented peer programs that assist individuals in accessing medications for OUD (MOUD). However, much remains unknown about peer program effectiveness, participant experiences with services, or factors contributing to utilization and retention. Drawing on data collected from individuals receiving services form the Intensive Recovery Treatment Support (IRTS) program, a peer navigator program for released prisoners with OUD, this study examines participant experiences with peer services. The objectives of this study were to understand what participants view as the benefits and limitations of peer health navigation; how services helped released individuals engage in treatment and address health and psychosocial needs; and participant experiences with services delivered by peers with shared lived experience.

Methods: As part of a larger mixed-method evaluation study, compensated in-depth, semi-structured phone interviews were conducted with 39 IRTS participants at the time of prison release and again approximately three months later. Participants were recruited by IRTS peer navigators, who distributed study flyers with research team contact information. Interviews focused on reasons for enrolling in IRTS; recovery/reentry goals and challenges; experiences with the peer health navigator; helpful aspects of services; areas of improvement; and impact of COVID. Interviews were audio recorded, transcribed, and analyzed via cross-case analysis using Dedoose software. This poster presents an overview of themes from the qualitative data.

Results: Participants reported that IRTS peer health navigators offered tangible and material support that was critical to ease community transition in the immediate post-release period, including a cell phone, clothing, and transportation. Peers provided linkages to needed services, including MOUD, and helped participants remain engaged in services by assisting with appointments and transportation. Participants noted that simply having someone available for support or to reach out to as needs arise improved their ability to successfully reintegrate into the community. Participants valued the peer role, noting that peers’ lived experience with addiction and/or justice system involvement made them more relatable and facilitated a strong working relationship. Participants highlighted many available services. However, the program could not always meet certain needs, including housing and employment, for which options are limited for released persons. Program changes occurring during COVID-19 also led to complications, including a shortened pre-release engagement period.

Conclusions and Implications: Peer health navigation is a promising approach for assisting individuals with OUD as they transition from prison to the community. Individuals enrolled in IRTS found the program valuable, as it helped connect them to treatment, addressed psychosocial needs, and provided ongoing team-based recovery support. Although participants described services as beneficial, further research is needed to determine whether services improved outcomes for participants, such as reducing overdoses and engaging in treatment and health services.