The Peer Recovery Coaching Linkage (RC-link) intervention study: Protocol for a randomized controlled trial for alcohol use disorder recovery in the inpatient hospital setting.

BACKGROUND: Alcohol Use Disorder (AUD) can cause significant physical health complications, including withdrawal, pancreatitis, and cirrhosis, that require inpatient hospitalization. However, few evidence-based recovery support interventions have been implemented in inpatient settings, and sustained recovery rates remain low. One potential intervention to bridge this gap in post-discharge continuity of care is linkage to peer recovery coaching (PRC) services, a psychosocial model of care in which trained, certified professionals in recovery guide others through their recovery journey. OBJECTIVES: This study seeks to test the Peer Recovery Coaching Linkage (RC-Link) intervention's impact on recovery outcomes, hospital utilization, and cost-effectiveness, as well as examine potential psychosocial mechanisms of change. METHODS: The RC-Link Study is a multi-site, prospective, two-arm randomized controlled trial that compares recovery outcomes in urban and rural settings over six months with a twelve-month follow-up. Participants with AUD will be recruited and randomized to either the RC-Link intervention or a control group receiving a brief, one-time intervention during hospitalization. The RC-Link intervention entails hospital-initiated linkage to a PRC plus six months of personalized support. The primary outcomes are changes in heavy drinking days and hospital costs. Secondary outcomes include AUD remission, biopsychosocial functioning, mortality, hospital utilization, and breath alcohol content. The predicted mechanisms of change are social support and self-efficacy. Measures will be assessed through longitudinal panel surveys and ecological momentary assessment. CONCLUSION: The RC-Link Study will inform whether implementing of a long-term inpatient PRC linkage improves AUD recovery outcomes and reduces hospital utilization in a cost-effective manner.