Peer support service activity prevalence by setting: a nine-state survey of peer workers

IntroductionPeer recovery support services (PRSS) are flexible, evidence-informed interventions that can be provided in a variety of settings and are delivered by credentialed people with lived-experience of mental health and substance use disorders. PRSS are a promising intervention that may increa...

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Main Authors: Angela Hagaman, Hannah L. Warren, Ruth Miller, Craig Henderson
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1533051/full
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author Angela Hagaman
Hannah L. Warren
Ruth Miller
Craig Henderson
author_facet Angela Hagaman
Hannah L. Warren
Ruth Miller
Craig Henderson
author_sort Angela Hagaman
collection DOAJ
description IntroductionPeer recovery support services (PRSS) are flexible, evidence-informed interventions that can be provided in a variety of settings and are delivered by credentialed people with lived-experience of mental health and substance use disorders. PRSS are a promising intervention that may increase linkage to care, treatment retention, and long-term recovery; however, there remains a sizable gap in the literature to disseminate these services to scale. Misunderstanding of the peer worker role, and a lack of consistent nomenclature to describe PRSS activities are barriers to studying PRSS effectiveness.MethodsThis sequential exploratory mixed-methods study began with a qualitative and methodological review of a previous peer worker survey instrument by eight subject matter experts with lived experience of substance use disorder. The improved 38-item web-based survey was then disseminated to a non-probability sample of peer workers in nine U.S. states.ResultsA total of 659 peer workers responded to the survey indicating that they perform an average of 24 different service activities most of the time (M = 23.6; SD = 16.7). PRSS interventions were most commonly delivered in communities and neighborhoods, client homes, and recovery community organizations. Survey participants reported spending approximately half of their time (M = 43.1, SD = 26.1) providing Emotional support, and less than one quarter of their time providing Affiliational (M = 21.3%; SD = 18.5), Informational (M = 18.0%; SD = 15.5), and Instrumental (M = 15.0%; SD = 15.3) support.DiscussionThis study may be the first of its kind to explore the broad array of service activities peer workers perform in multiple settings across regional service networks, also known as recovery ecosystems. Notably, peer worker respondents selected an average of 24 activities that they perform most of the time, and Emotional support was the most commonly delivered support type. Study results provide preliminary evidence about where PRSS are performed within both macro and micro settings indicating that services are frequently delivered in non-clinical community-based settings and client homes which may confer added benefit. These results can be used to inform future studies that examine the effectiveness of PRSS across the continuum of care.
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spelling doaj-art-4d6b2e8f3ce84d748419f8b92b384e4c2025-08-20T03:15:23ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-03-011310.3389/fpubh.2025.15330511533051Peer support service activity prevalence by setting: a nine-state survey of peer workersAngela Hagaman0Hannah L. Warren1Ruth Miller2Craig Henderson3College of Public Health, East Tennessee State University, Johnson City, TN, United StatesCollege of Public Health, East Tennessee State University, Johnson City, TN, United StatesDepartment of Psychology and Philosophy, Sam Houston State University, Huntsville, TX, United StatesDepartment of Psychology and Philosophy, Sam Houston State University, Huntsville, TX, United StatesIntroductionPeer recovery support services (PRSS) are flexible, evidence-informed interventions that can be provided in a variety of settings and are delivered by credentialed people with lived-experience of mental health and substance use disorders. PRSS are a promising intervention that may increase linkage to care, treatment retention, and long-term recovery; however, there remains a sizable gap in the literature to disseminate these services to scale. Misunderstanding of the peer worker role, and a lack of consistent nomenclature to describe PRSS activities are barriers to studying PRSS effectiveness.MethodsThis sequential exploratory mixed-methods study began with a qualitative and methodological review of a previous peer worker survey instrument by eight subject matter experts with lived experience of substance use disorder. The improved 38-item web-based survey was then disseminated to a non-probability sample of peer workers in nine U.S. states.ResultsA total of 659 peer workers responded to the survey indicating that they perform an average of 24 different service activities most of the time (M = 23.6; SD = 16.7). PRSS interventions were most commonly delivered in communities and neighborhoods, client homes, and recovery community organizations. Survey participants reported spending approximately half of their time (M = 43.1, SD = 26.1) providing Emotional support, and less than one quarter of their time providing Affiliational (M = 21.3%; SD = 18.5), Informational (M = 18.0%; SD = 15.5), and Instrumental (M = 15.0%; SD = 15.3) support.DiscussionThis study may be the first of its kind to explore the broad array of service activities peer workers perform in multiple settings across regional service networks, also known as recovery ecosystems. Notably, peer worker respondents selected an average of 24 activities that they perform most of the time, and Emotional support was the most commonly delivered support type. Study results provide preliminary evidence about where PRSS are performed within both macro and micro settings indicating that services are frequently delivered in non-clinical community-based settings and client homes which may confer added benefit. These results can be used to inform future studies that examine the effectiveness of PRSS across the continuum of care.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1533051/fullpeer supportrecovery supportssubstance use disorderopioid use disorderdrug abuse and addictionSUD treatment
spellingShingle Angela Hagaman
Hannah L. Warren
Ruth Miller
Craig Henderson
Peer support service activity prevalence by setting: a nine-state survey of peer workers
Frontiers in Public Health
peer support
recovery supports
substance use disorder
opioid use disorder
drug abuse and addiction
SUD treatment
title Peer support service activity prevalence by setting: a nine-state survey of peer workers
title_full Peer support service activity prevalence by setting: a nine-state survey of peer workers
title_fullStr Peer support service activity prevalence by setting: a nine-state survey of peer workers
title_full_unstemmed Peer support service activity prevalence by setting: a nine-state survey of peer workers
title_short Peer support service activity prevalence by setting: a nine-state survey of peer workers
title_sort peer support service activity prevalence by setting a nine state survey of peer workers
topic peer support
recovery supports
substance use disorder
opioid use disorder
drug abuse and addiction
SUD treatment
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1533051/full
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