An interventional study of PATH (Peer Advanced Training for total Health) in Burnout, Secondary Trauma and Compassion Fatigue, sponsored by Chestnut Health Systems. Enrolling by invitation at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-21.
Sponsored by Chestnut Health Systems · Not applicable, Interventional, and Health services research
The investigators propose to test the effectiveness of PATH (Peer Advanced Training for total Health) as an educational workforce intervention for improving peer recovery support specialists' (PRSS) overdose prevention (OP) service delivery ability and quality and as a PRSS workforce and service system support. The PATH intervention combines (a) virtual education and (b) case-based consultation. The investigators hypothesize that PATH will improve organizational-level PRSS burnout, additional workforce outcomes, and OP service quality.
This trial will test the effectiveness of the PATH intervention with 10 Recovery Community Organizations (RCOs) to understand its impact on workforce outcomes. PATH will be administered to all peer recovery support specialist (PRSS) staff and administrators from each of the RCOs. Using a stepped-wedged design (SWD), the investigators will implement the PATH intervention with RCOs in dyads. A new dyad will begin PATH approximately every 4 months.
Participants of PATH will be invited to complete electronic surveys at 8 time points, beginning 3 months before the first dyad begins PATH and subsequently every 4 months. Each survey will be distributed to all PRSS staff and administrators from the 10 RCOs, regardless of when their dyad participates in PATH. Surveys measures include demographics, job crafting, burnout, compassion satisfaction/fatigue, secondary trauma, moral injury, boundaries assessment, health outcomes productivity, overdose prevention (OP) stigma, and OP knowledge, attitudes, and skills. Each survey will repeat these measures and take approximately 25-35 minutes to complete. An additional, separate 5-minute electronic survey will be distributed to PATH participants following their dyad's eLearning and ECHO completion to measure training satisfaction. All surveys will be collected in REDCap. Personalized survey links and survey reminders will be sent directly to each participant's email address. Additionally, the investigators will track and obtain administrative PATH training data for the eLearning modules and ECHO meetings, including engagement and attendance, to understand the dose and duration of PATH involvement.
A randomly selected subset of PATH participants from each dyad (2 PRSS and 1 administrator per RCO) will be invited to participate in qualitative semi-structured interviews at 2 time points: 30 days pre-PATH and 30-60 days post-PATH. Each interview will last approximately 45-60 minutes, be audio-recorded, and be conducted via Zoom. Interviews questions will focus on: (a) harm reduction job demands and resources; (b) how harm reduction work is conducted; (c) how stressors and motivators impact harm reduction work; (d) the quality of PRSS-client relationships; (e) how clients experience offered harm reduction services; (f) how harm reduction principles are integrated within services delivered/received; and (g) how PATH participation impacted services (post-PATH only).
A purposeful sample of 8 clients per dyad (4 per RCO) will also be invited to participate in qualitative semi-structured interview at 1 time point: 30-60 days post-PATH. The interview will last 45-50 minutes, be audio-recorded, and be conducted via Zoom. Interview questions will focus on: (a) addiction and treatment history, (b) recovery pathway, (c) recovery services history, (d) recovery plan and harm reduction, (e) relationships with peers.
To further assess the impact of PATH on a client-level service delivery, we will also obtain a complete sample of de-identified client-level records from each of the 10 RCOs. Data will contain client-level records, including demographic information, service delivery information, and recovery plan information. Data obtained will reflect the initial 28-month period of the study. Investigators will work with the State's data broker to merge these records with state-level criminal justice, health service, and recovery service records.
458 studies on the registry are indexed under Burnout, Psychological; 110 are open to participants now.
This study's planned enrollment of 200 is above the median of 80 across 331 interventional studies indexed under Burnout, Psychological.
Browse Burnout, Psychological studies →Chestnut Health Systems is the lead sponsor of 24 studies on the registry; 5 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Survey inclusion criteria are:
-Current peer recovery support specialist (PRSS) staff, including employee or volunteer, of a participating Recovery Community Organization (RCO)
PRSS semi-structured qualitative interview inclusion criteria are:
Administrator semi-structured qualitative interview inclusion criteria are:
-Current administrator at a participating RCO
Client semi-structured qualitative interview inclusion criteria are:
Receive PATH clinical trial intervention
Behavioral: PATH (Peer Advanced Training for total Health)
PATH is an educational workforce intervention for improving peer recovery support specialists' (PRSS) overdose prevention (OP) service delivery ability and quality and as a PRSS workforce and service system support. PATH includes 4 hours of eLearning modules completed within a 1-month period, as well as 8 weekly ECHO sessions lasting 1.5 hours each delivered over 2 months. Each ECHO session includes a 30-minute presentation followed by one hour of case-based discussion about a real client or problem. The entire PATH intervention takes 16 hours (4 hours of eLearning and 12 hours of ECHO participation) over 3 months. Participants are expected to complete all 16 hours, completing the 4 hours of eLearning before starting the 12 hours of ECHO activities
Job Approach Crafting
Measured using the Approach domains of the Approach-Avoidance Job Crafting Scale (AAJCS). The measure assesses behavioral and cognitive strategies staff use to increase positive work resources and challenges.
Time frame: Every 4 months from enrollment to 29 months post-enrollment.
Job Avoidance Crafting
Measured using the Avoidance domains of the Approach-Avoidance Job Crafting Scale (AAJCS). The measure assesses behavioral and cognitive strategies staff use to avoid or distance themselves from stressful or unhelpful work demands.
Time frame: Every 4 months from enrollment to 29 months post-enrollment.
Professional Quality of Life
Measured using the Professional Quality of Life Scale (ProQOL v.5), which assesses three dimensions of workforce well-being over the past 30 days: Compassion Satisfaction, Burnout, and Secondary Traumatic Stress.
Time frame: Every 4 months from enrollment to 29 months post-enrollment.
Overdose Prevention Knowledge, Attitudes, and Skills
Measured using the Harm Reduction Knowledge, Attitudes, and Skills scale, which is a 13-item measure that assesses overdose prevention learning outcomes.
Time frame: Every 4 months from enrollment to 29 months post-enrollment.
Overdose Prevention Recovery Plan Integration
This is the extent to which individual overdose prevention strategies are included in client recovery plans. This will be measured by reviewing client recovery plans and identifying the number of overdose prevention approaches incorporated in each plan, which requires peer understanding of clients' individualized needs as it relates to substance use and community supervision terms. This measure will be calculated by reviewing and qualitatively coding all instances of overdose prevention within recovery plan documents and then averaging across all documents at each time point by staff person and site.
Time frame: From enrollment to 29 months post-enrollment
Client Retention
Measured taking the total number of clients served by the program for a minimum of 30 days within the month and dividing it by the total number of clients served in that month. Measured using RCO-level administrative data.
Time frame: From enrollment to 29 months post-enrollment
Staff Boundaries with Clients
Measured using an original 10-item instrument aimed at measuring peers' ability to manage boundaries with clients.
Time frame: Every 4 months from enrollment to 29 months post-enrollment.
Moral Injury
Measured using a modified version of the Moral Injury Symptom Scale-Health Professional (MISS-HP), which assesses staff experiences of guilt, shame, betrayal, self-condemnation, and loss of meaning in work.
Time frame: Every 4 months from enrollment to 29 months post-enrollment.
Bias Against Overdose Prevention
Measured using the Harm Reduction Stigma Scale, which assess respondents' current views on different aspects of overdose prevention.
Time frame: Every 4 months from enrollment to 29 months post-enrollment.
Training Satisfaction
Measured using the Training Satisfaction Rating Scale, which includes 3 domains: objectives \& content, method \& training context, and training process usefulness.
Time frame: Immediately post-completion of PATH eLearning and PATH ECHO
Training Engagement
Measured using eLearning administrative data showing module completion and time-to-complete and ECHO engagement duration.
Time frame: From PATH initiation to PATH completion
Staff Turnover
Measured by calculating the percentage of staff who remained in the organization from the first to last day of the month.
Time frame: From enrollment to 29 months post-enrollment
Continuity of Care
Measured by assessing whether a client accessed at least one recovery or treatment service every 30 days since enrollment using RCO-level administrative data.
Time frame: From enrollment to 29 months post-enrollment
Service Utilization
Measured by totaling the number and types of services utilized from enrollment using RCO-level administrative data .
Time frame: From enrollment to 29 months post-enrollment
Client Overdose Fatal
Measured using data provided through death certificates submitted by county coroners to the Department of Health on all accidental drug overdose deaths.
Time frame: From enrollment to 29 months post-enrollment
Client Overdose Non-Fatal
Measured using data provided through the emergency medical services records and emergency department records to produce counts of nonfatal overdose events.
Time frame: From enrollment to 29 months post-enrollment
Client Recidivism
Measured using data on incarceration events provided through the State Police and Department of Corrections, with data from police provided through the Criminal History Repository Information System.
Time frame: From enrollment to 29 months post-enrollment
Client All-Cause Mortality
Measured using vital statistics data held by the Department of Public Health.
Time frame: From enrollment to 29 months post-enrollment
Plan to share: Yes
Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Analytic code
Access criteria: De-identified individual and aggregate PRSS survey data (raw and recoded) will be shared publicly after completing all data and analyses. Files will be shared in the format most relevant to the software used to develop them, as well as CSV files. De-identified qualitative transcripts will be maintained and shared only with an established data-sharing agreement. Files containing coding lists and summaries and transcript attributes will also be shared with appropriate agreements in place. Open sharing of qualitative data may risk identifying participants, particularly in small rural organizations where contextual details are difficult to mask. Standard protections, like de-identification and Certificates of Confidentiality, may be insufficient.
No publications or documents are linked to this record.
Started Oct 2026 (actual). Primary completion is estimated for Mar 2029, 29 months after the start.
Of 248 non-industry interventional studies with no phase under Burnout, Psychological, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 21. This study's planned 29 months is above that.
Counting every sponsor, half of 255 studies reached it within 11 months; a quarter within 5 and three quarters within 22.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.
No contact was published for this record. The registry link below has the sponsor’s details.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Chestnut Health Systems