A Digitally-Enhanced Model of Peer Doula Support for Substance Use Disorder and Peripartum Care

NIDA Clinical Trials Network, 3UG1DA040309-11S3 (CTN-0157)

3/1/25-2/28/26

Daisy J. Goodman, DNP, MPH, CARN-AP, APRN, CNM (Northeast Node, Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center); Lisa A. Marsch, PhD (Northeast Node, Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth)

Co-Investigators: Ximena Levander, MD, MCR, FACP (Western States Node, Oregon Health & Sciences University); Constance Guille, MD (Southern Consortium Node, MUSC); Jerry Cochran, MSW, PhD (Greater Intermountain Node, University of Utah)

Scientific Officer: Landhing Moran, PhD, NIDA CCTN.

Research Team: Elizabeth Saunders, PhD (Northeast Node, Co-Project Director); Kathleen Bell, MS (Northeast Node, Co-Project Director); Reina Bower, PSS, CRM, PWS (Western States Node, The Peer Company); Bradley Buchheit, MD, MS (Western States Node, Associate Professor); Kristi Carlston, MBA, CCRC (Greater Intermountain Node); Jasmin Charles, MS, PA-C (Greater Intermountain Node, Utah Perinatal Addiction Clinical Medical Director); Carol Defrancesco, MALS, RDN, LD (Western States Node, Senior Research Associate); Courtney King, PhD (Southern Consortium Node, Assistant Professor); Lynn Kunkel (Western States Node, Senior Research Project Manager); Lisa Lamadriz (Northeast Node, DHMC Project Manager); Terry Leckron-Myers (Western States Node, Senior Director of Programs); Sara McCrimmon, MPH, CCRP (Western States Node, Regulatory Specialist); Bethany McLeman, BA (Northeast Node; Node Coordinator); Alisa Patten, MA (Western States Node, Clinical Research Associate); Mary Shaw, BSc (Southern Consortium Node, Regulatory Specialist & Quality Assurance Monitor); Wendy Smith, MD, MPH, MS (Western States Node, OHSU Clinical Lead); Katherine Wallace, LISW-CP, MPH (Southern Consortium Node, Program Manager)

Engagement in perinatal care and substance use disorder (SUD) treatment is associated with improved outcomes for patients with perinatal substance use disorders (PSUD), who experience increased rates of morbidity and mortality. Although engagement in care is essential, stigma and concerns about child protective service involvement often prevent PSUD from receiving these critical services. To help tackle this urgent need, a novel digitally enhanced peer doula model of care has been implemented in New Hampshire (NH), based at Dartmouth-Hitchcock Medical Center (DHMC). In this recovery-centered model, every PSUD is given a free smartphone and data plan. Additionally, PSUD are partnered with a peer doula who provides synchronous and asynchronous support, including in-person, telehealth, telephone, and text-based services. A similar digitally enhanced peer doula care model is being implemented in the state of Oregon (OR) at the Oregon Health & Sciences University (OHSU) Meadowlark Program. As of September 2026, the model will also be evaluated at two additional sites (Medical University of South Carolina and University of Utah). The Medical University of South Carolina (MUSC) and University of Utah have likewise implemented similar peer doula care models for PSUD.

This Phase I project seeks to conduct a one-year mixed methods pilot study to systematically evaluate the feasibility and acceptability of this model. Additionally, this study will collect data to assess the impact of the digitally enhanced peer doula model on engagement and retention in perinatal and SUD care. This study will use a convergent approach to collect and analyze quantitative and qualitative data from patients, site staff and leadership engaged with the digitally enhanced peer doula model.

This pilot study will inform a larger multi-site experimental design to evaluate the impact of this model on perinatal and SUD treatment engagement, patient satisfaction, and peripartum outcomes for one-year postpartum. This larger study will be fully powered to assess the effectiveness of the model, in addition to more fully exploring the implementation of this model into standard clinical settings. The combination of using accessible digital technology to facilitate peer doula care offers great promise in engaging PSUD and reducing morbidity and mortality for this population.