abstract: 'BackgroundDespite efficacy of medication for opioid use disorder,

  low-income, ethno-racial minoritized populations often experience poor

  opioid use disorder treatment outcomes. Peer recovery specialists,

  individuals with lived experience of substance use and recovery, are

  well-positioned to engage hard-to-reach patients in treatment for opioid

  use disorder. Traditionally, peer recovery specialists have focused on

  bridging to care rather than delivering interventions. This study builds

  on research in other low-resource contexts that has explored peer

  delivery of evidence-based interventions, such as behavioral activation,

  to expand access to care.MethodsWe sought feedback on the feasibility

  and acceptability of a peer recovery specialist-delivered behavioral

  activation intervention supporting retention in methadone treatment by

  increasing positive reinforcement. We recruited patients and staff at a

  community-based methadone treatment center and peer recovery specialist

  working across Baltimore City, Maryland, USA. Semi-structured interviews

  and focus groups inquired about the feasibility and acceptability of

  behavioral activation, recommendations for adaptation, and acceptability

  of working with a peer alongside methadone treatment.ResultsParticipants

  (N = 32) shared that peer recovery specialist-delivered behavioral

  activation could be feasible and acceptable with adaptations. They

  described common challenges associated with unstructured time, for which

  behavioral activation could be particularly relevant. Participants

  provided examples of how a peer-delivered intervention could fit well in

  the context of methadone treatment, emphasizing the importance of

  flexibility and specific peer qualities.ConclusionsImproving medication

  for opioid use disorder outcomes is a national priority that must be met

  with cost-effective, sustainable strategies to support individuals in

  treatment. Findings will guide adaptation of a peer recovery

  specialist-delivered behavioral activation intervention to improve

  methadone treatment retention for underserved, ethno-racial minoritized

  individuals living with opioid use disorder.'
affiliation: 'Kleinman, MB (Corresponding Author), Univ Maryland, Dept Psychol, College
  Pk, MD 20742 USA.

  Kleinman, Mary B.; Anvari, Morgan S.; Bradley, Valerie D.; Seitz-Brown, C. J.; Dean,
  Dwayne; Magidson, Jessica F., Univ Maryland, Dept Psychol, College Pk, MD 20742
  USA.

  Felton, Julia W., Henry Ford Hlth Syst, Ctr Hlth Policy, Hlth Serv Res, Detroit,
  MI USA.

  Belcher, Annabelle M.; Greenblatt, Aaron D.; Bennett, Melanie, Univ Maryland, Dept
  Psychiat, Sch Med, Baltimore, MD USA.'
article-number: '15'
author: Kleinman, Mary B. and Anvari, Morgan S. and Bradley, Valerie D. and Felton,
  Julia W. and Belcher, Annabelle M. and Seitz-Brown, C. J. and Greenblatt, Aaron
  D. and Dean, Dwayne and Bennett, Melanie and Magidson, Jessica F.
author-email: mkleinm@umd.edu
author_list:
- family: Kleinman
  given: Mary B.
- family: Anvari
  given: Morgan S.
- family: Bradley
  given: Valerie D.
- family: Felton
  given: Julia W.
- family: Belcher
  given: Annabelle M.
- family: Seitz-Brown
  given: C. J.
- family: Greenblatt
  given: Aaron D.
- family: Dean
  given: Dwayne
- family: Bennett
  given: Melanie
- family: Magidson
  given: Jessica F.
da: '2023-09-28'
doi: 10.1186/s13011-023-00524-3
eissn: 1747-597X
files: []
journal: SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY
keywords: 'Peer recovery specialist; Behavioral activation; Methadone; Opioid use

  disorder; Health disparities'
keywords-plus: 'SUBSTANCE USE; BUPRENORPHINE TREATMENT; USE DISORDERS; SUPPORT;

  INDIVIDUALS; HEALTH; CARE'
language: English
month: MAR 6
number: '1'
number-of-cited-references: '43'
orcid-numbers: Anvari, Morgan/0000-0003-0732-2574
papis_id: 1939aebbc9132c23ea8702237f780dec
ref: Kleinman2023sometimesyou
times-cited: '1'
title: '``Sometimes you have to take the person and show them how″: adapting behavioral
  activation for peer recovery specialist-delivery to improve methadone treatment
  retention'
type: article
unique-id: WOS:000943647800001
usage-count-last-180-days: '2'
usage-count-since-2013: '2'
volume: '18'
web-of-science-categories: Substance Abuse
year: '2023'