JMIR Publications

ABSTRACT

Background:

Substance use disorder (SUD) represents a significant public health concern in the United States. SUD recovery is complex and individualized, and support provided by peer recovery coaches (PRCs), has been shown to improve outcomes. The PRC-client relationship requires bidirectional mediated communication that is often informal but should be trackable, efficient, and aligned with healthcare privacy and security regulations. Current PRC workflows and available digital recovery support apps do not meet these needs, illustrating the opportunity for development and utilization of client-centered specialized technology tools to facilitate improved outcomes. We have developed Peer PLUS, a HIPAA-compliant mobile app and client management system, to address this need; however, the platform has not yet been tested in a clinical setting.

Objective:

In this paper, we describe the protocol for the evaluation of our novel digital health platform to identify its perceived usability and potential for continued use, as well as its potential impact on treatment-related outcomes (i.e., recovery, quality of care, therapeutic alliance), and assess its feasibility for a future randomized controlled trial, as well as develop an implementation toolkit to facilitate future use by other organizations.

Methods:

We leveraged both user-centered design (UCD) and implementation science frameworks to conduct pre-launch ethnographic observations, followed by beta testing and a pilot study, to identify user needs and evaluate platform usability and related outcomes. During testing, participants (clients in recovery and their PRCs) will utilize the app as part of their standard support relationship. Additionally, they will be prompted to respond to periodic electronic surveys assessing perceived usability of the platform during the beta testing phases, and to surveys assessing treatment-related outcomes during pilot testing. After each test, stakeholder engagements focused around UCD activities will be completed to further elucidate opportunities for refinement of the app and implementation toolkit.

Results:

Recruitment for beta testing began in January 2024, with an initial beta test completed in March 2024. Beta testing was completed in November 2024, with recruitment for the pilot test beginning in August 2025. Pilot testing and analyses will continue in 2026. If feasibility metrics are met, the platform will then be tested in a later study phase that will include a randomized controlled trial and a second pilot trial to test implementation at a different organization.

Conclusions:

While this evaluation is ongoing, we hypothesize that our platform will increase efficiency of PRC workflows and foster therapeutic alliance for improved outcomes. This project contributes to the UCD and implementation science fields by demonstrating the importance of merging these frameworks during design and evaluation to increase uptake and sustained use of digital health technologies.