Empowering Support Persons to Enhance the Recovery Capital of Postpartum Women with Opioid Use Disorder

Opioid agonist treatment (OAT) is highly effective in preventing morbidity and mortality related to opioid use disorder (OUD), but long-term engagement is complicated by physical, social, and structural factors, especially for women. Postpartum women with OUD face the challenging transition from hospital care to the community, both for themselves and their newborns. Fear of judgment from healthcare providers may discourage women from asking for help or accessing necessary support services. The presence of supportive individuals—such as family or friends—can increase recovery capital; however, support people may require additional education and skills to effectively assist their loved ones, representing a critical gap in their ability to influence treatment outcomes. Theory-based, evidence-supported Patient Navigation (PN) interventions improve OAT engagement by addressing social, structural, and internal barriers (e.g. mistrust) using motivational techniques and providing tangible resources. This study aims to leverage the strengths of both PN and supportive family or friend involvement to enhance recovery capital and, secondarily, improve retention in community-based OAT. We hypothesize that training and engaging support persons will promote recovery capital by targeting social capital (by fostering stronger relationships), human capital (through increasing self-efficacy), and cultural capital (by promoting norms and values that support recovery). This project aligns with the objectives of RFA- DA-26-024, which emphasizes innovative strategies to improve care transitions and enhance recovery capital. The proposed study is a randomized controlled trial of a PN intervention called Supporting Treatment for Opioids and Recovery Capital (STORC) that blends PN with an added component designed to enhance recovery capital for postpartum women through additional training for chosen support persons. This intervention will provide patients with care coordination and resource referrals, and will provide support persons with comprehensive tools, including knowledge about OUD treatment, effective communication strategies, and emotional support. Patient navigation, combined with targeted training for support persons, equips family and friends with the skills and knowledge to offer more effective, impactful support for their loved ones in recovery. This project is significant to public health because it employs a recovery capital framework to explore how support persons can play a critical role in the recovery efforts of new mothers at high risk of overdose.