Peer Engagement in Methamphetamine Harm-Reduction With Contingency Management (PEER-CM)

Study Overview
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Brief Summary
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The main goal of this study is to tests the effect of incentivizing achievement of self-identified, personal harm reduction goals (Contingency management or CM) compared with standard of care (peer harm reduction service with incentives for peer visits) to increase the reach and effectiveness of methamphetamine (MA) harm reduction services.

Detailed Description
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Using a hybrid type 1 effectiveness-implementation framework and stepped-wedge design, this study will randomize eighteen community-based peer harm reduction sites to provide contingency management incentives for achieving self-identified harm reduction goals set with peer specialists using a participant-driven harm reduction goal-setting process (e.g. completing overdose prevention and supply training, daily life goals, treatment and care goals, relationship and social support goals) versus standard of care contingency management (i.e. incentives for peer encounter attendance).

Official Title
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Peer Engagement in Methamphetamine Harm-Reduction With Contingency Management (PEER-CM)

Conditions
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Methamphetamine Abuse

Intervention / Treatment
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* Behavioral: Peer Contingency Management
* Behavioral: Standard of Care Contingency Management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: This intervention is at the site level. Community-based organization sites are eligible if they: Use peer support specialists to provide direct outreach and harm reduction services to people who use drugs Are willing to be trained in the two strategies for peer-facilitated contingency management De-identified administrative data is used to identify an analytic sample of clients who: • Reported past 30-day methamphetamine use at community-based organization intake. Exclusion Criteria: Community-based organization sites who: Do not use peer support specialists to provide direct outreach and harm reduction services to people who use drugs Are not willing to be trained in the two strategies for peer-facilitated contingency management

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 105 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Sequential Assignment
Interventional Model Description: This is a cluster-randomized pragmatic trial using a hybrid type 1 effectiveness-implementation framework and stepped-wedge design.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PEER-CM<br>Peer-facilitated contingency management (PEER-CM). | Behavioral: Peer Contingency Management<br>* Participants allocated to peer-facilitated contingency management will receive incentives for achieving self-identified harm reduction goals set with peer specialists using a participant-driven harm reduction goal-setting process (e.g. completing overdose prevention and supply training, daily life goals, treatment and care goals, relationship and social support goals)<br>* Other names: PEER-CM;|
| Active Comparator: Standard of Care<br>Standard of care contingency management. | Behavioral: Standard of Care Contingency Management<br>* Participants allocated to standard of care contingency management will receive incentives for peer encounters.<br>* Other names: Standard of Care;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants who overdose | Test the impact of incentives for achieving self-identified, personal harm reduction goals on the likelihood of overdose among people using methamphetamine at 6 months from enrollment identified through completed assessment. | 6 months from baseline | 
| Number of participants who achieve self-identified goals | Determine whether incentives for achieving self-identified, personal harm reduction goals increases engagement with harm reduction services at 6 months from enrollment identified through completed assessment. | 6 months from baseline | 
| Number of participants who engage in substance use disorder treatment | Determine whether incentives for achieving self-identified, personal harm reduction goals increases engagement with treatment services at 6 months from enrollment identified through completed assessment. | 6 months from baseline |