Technology Platform (Peer PLUS) Supporting the Work of Peer Recovery Coaches and the Communication Needs of Individuals in Recovery From Substance Use Disorder: Protocol for an R21 Development and Usability Trial.

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) can improve outcomes. The PRC-client relationship requires bidirectional mediated communication that is often informal but should be trackable, efficient, and aligned with health care privacy and security regulations. Current workflows and available apps do not meet these needs, illustrating the opportunity for client-centered technology tools. We have developed Peer PLUS (People Leveraging Urgent Support; Parkview Health System, Inc), a HIPAA (Health Insurance Portability and Accountability Act)-compliant mobile app and client management system, to address this need; however, the platform has not yet been tested in a clinical setting. Objective: We describe the protocol for the evaluation of our digital health platform to identify its perceived usability, potential sustained use, and potential impact on treatment-related outcomes, as well as to assess its feasibility for a future randomized controlled trial and develop an implementation tool kit to facilitate use by other organizations. Methods: Our evaluation leveraged user-centered design (UCD) and implementation science frameworks (Reach, Effectiveness, Adoption, Implementation, and Maintenance [RE-AIM]). We conducted prelaunch ethnographic observations of 3 PRCs' workflows for an understanding of user needs. During subsequent in-the-wild testing, PRC-client dyads will use the platform for asynchronous communication within their standard support relationship. We will deploy periodic electronic surveys, including the System Usability Scale (SUS) to assess perceived usability during beta testing, and additional validated measures assessing specific treatment-related outcomes (ie, recovery, quality of care, and therapeutic alliance) during pilot testing. App use log data will be leveraged to assess the likelihood of sustained use. After each test, UCD-focused stakeholder engagements will further elucidate opportunities for platform refinement and implementation tool kit development. Feasibility targets include SUS scores of 68 or more, 25% client eligibility and enrollment rate, and 20% increased contacts between PRCs and enrolled vs nonenrolled clients. Results: This project was funded in March 2023. Beta test recruitment began in January 2024, with 3 tests completed by November 2024 (3 PRCs and 7 clients). Pilot recruitment began in August 2025. Pilot testing and analyses will continue in 2026. If feasibility metrics are met, the platform will 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: Our evaluation assesses whether Peer PLUS is an efficient and usable tool that meets identified communication and documentation needs of clients and PRCs while fostering increased connection, which could suggest the likelihood of sustained use and improved treatment outcomes. This project contributes to the UCD and implementation science fields by demonstrating the importance of merging these frameworks during the design and evaluation of novel digital health solutions.