JMIR Publications

ABSTRACT

Technology Needs Assessment: Delivery of Digital Recovery Support Services Tara E. Karns-Wright, Ph.D., M.S.1,2, Erin Finley, Ph.D., M.P.H.1,3, Robert Ashford, Ph.D., MSW4, Ducel Jean-Berluche, Ph.D., M.S. 1, Daniela I. Olmos, M.P.H.1, & Jennifer S. Potter, Ph.D., M.P.H.1,2 1Be Well Institute on Substance Use and Related Disorders, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 2Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 3Center for the Study of Healthcare Innovation, Impact, and Policy, VA Greater Los Angeles Healthcare System 4Unity Recovery, Philadelphia, PA 19127 Corresponding Author: Tara E. Karns-Wright, Ph.D., M.S., The University of Texas Health Science Center at San Antonio, Be Well Institute on Substance Use and Related Disorders 5109 Medical Drive, 4th floor, San Antonio, TX 7822. Phone: (210) 450-3903; Email: wrightt3@uthscsa.edu Acknowledgment This work is funded through contracts HHS001042300003 and HHS00104230000 with the Texas Health and Human Services Commission. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the Texas Health and Human Services Commission. ABSTRACT

Background:

Recovery support services (RSS) are an evidenced-based approach to support recovery from substance use disorders, most often comprised of peer-to-peer support, referrals to housing, job training, and other forms of pro-social engagement and activities. During the COVID-19 pandemic, RSS providers quickly converted in-person services to avoid disruption from primarily in-person to digital delivery. It is unclear if this rapid conversion impacted the delivery of services and if this delivery model could enhance RSS reach and uptake more generally by extending the reach of RSS providers and offering an alternative delivery method and access point. The goal of the current study was to identify how RSS providers in Texas adapted their services for digital delivery and to what extent, if at all, technology limitations (e.g., lack of digital infrastructure) were present.

Methods:

We conducted an electronic survey of 85 RSS providers, assessing their current capacity and methods for digital RSS, followed by semi-structured online interviews with a subset of 20 respondents.

Results:

Most survey respondents (74, 87.1%) used digital RSS, though they used many dated technologies, devices, and platforms for service delivery. Many respondents indicated they use Zoom video conferencing to communicate with participants; however, providers also indicated that they must use several different technology platforms to accomplish their service delivery goals. Four main themes emerged from the interviews: 1) the impact of the COVID-19 pandemic on RSS delivery; 2) barriers and facilitators to technology-delivered digital RSS; 3) awareness and expectations regarding the use of digital RSS; and 4) training needs to deliver digital RSS.

Conclusions:

RSS organizations have access to technology for digital RSS; however, the technology is often outdated and lacks proper security measures. Because the pandemic required a rapid and unexpected shift to digital RSS to maintain and potentially expand access during a public health emergency, providers desire guidance for training staff and participants on how to best use technology, thereby increasing technology literacy. A subset of providers endorsed the potential of a unified platform for RSS delivery, especially for data capture. Digital platforms for RSS should allow multiple modes of HIPAA-compliant communication (e.g., texting, video, etc.) to sustain successful adoption of digital RSS. Most barriers to digital RSS identified by our respondents may be addressable through the streamlined deployment of technology resources, rigorous training and onboarding programs in best practices for providers and participants, and tailored implementation strategies for varying local contexts. We recommend the consideration of a digital platform that could facilitate large-scale implementation of RSS best practices and data collection infrastructure to better assess the impact of digital RSS on recovery.