Exploring recovery: Findings from a six-year evaluation of an American Indian peer recovery support program.

Objectives: We aimed to identify correlates of short-term recovery among American Indians who participated in the Transitional Recovery and Culture (TRAC) Program, a Peer Recovery Support (PRS) program. Research aims (As) were A1. How do recovery capital resources and indicators of recovery differ between TRAC participants who completed a six-month follow-up and those who did not? A2. How much did recovery capital resource measures change between intake and six-month follow-up? A3. Which recovery capital resources are associated with balanced recovery?

Methods: We used the medicine wheel evaluation framework. Each concept within the framework - spiritual, emotional, mental, and physical health - was incorporated into a composite recovery outcome variable. TRAC enrolled 422 American Indians from 2014 to 2019 living in Montana and Wyoming. Six-month change was examined among 214 program participants that completed the six-month program.

Results: We observed significant change for the following recovery capital resources: stable housing, being occupied, attending recovery groups, interacting with family and friends, past substance use activity, and self-reported health status. Logistic regression results for balanced short-term recovery showed that improving or maintaining occupation (AOR = 6.73, p = 0.0026), interacting with family or friends (AOR = 4.66, p = 0.0050), and still receiving services at follow-up (AOR = 2.25, p = 0.0487) were associated with significant increased odds of higher balanced short-term recovery scores.

Conclusion: PRS helps American Indian people achieve short-term recovery. Future efforts should focus on how to retain peers in PRS programs, and the recovery capital needed to sustain long-term recovery.