Peer-based Retention of People Who Use Drugs in Rural Research (PROUD-R2)

The epidemics of opioid prescribing, injection drug use, overdose, and infectious disease transmission intersect in rural America. The National Rural Opioids Initiative recently funded by NIDA, CDC, and the Appalachia Regional Commission, is a multi-state consortium designed to study interventions that increase access to care and reduce opioid overdose deaths and infectious consequences of opioid use in rural America. Sites have just initiated recruiting an initial cohort of people who use opioids in rural areas using harmonized respondent-driven sampling (RDS). Participants complete rapid HIV, hepatitis C, and syphilis testing along with a single drug use and behavioral risk assessment using a survey instrument harmonized across states. Clinical and Translational Science Award (CTSA) sites and the NIDA Clinical Trials Network (CTN) are well-positioned to partner with the National Rural Opioids Initiative to determine optimal practices for recruiting and retaining study participants with opioid use disorder in rural America. We propose to test the use of peers recruited through RDS to improve clinical research participant retention among people who use drugs in rural America. This study leverages the Rural Opioids Initiative sites in Kentucky, Ohio, and Oregon, where an initial round of recruitment is already funded, but long-term follow-up plans are variable. CTSA support would increase capacity for follow-up at 6, 12, 18, and 24 months and testing retention strategies. The proposed study would compare the impact of an innovative peer-driven study retention strategy to a standard retention strategy (e.g., staff follow-up and appointment reminders via text, phone, and/or mail) on study retention at 6, 12, 18, and 24 months. Participant willingness to participate in future clinical trials for treatment of opioid use disorder is a secondary outcome. In depth qualitative interviews will assess participant’s views of study participation, retention, and priorities for participating in future clinical trials. The primary goal of the study is determine the optimal strategies for recruiting and retaining people who use opioids in rural America.