BurnoutPhase 2NCT07218562
PATH to Reducing Burnout Among Peers Who Deliver Overdose Prevention Services (R61 Phase Pilot)
A Phase 2 study testing PATH (Peer Advanced Training for total Health) in people with Burnout and Compassion Satisfaction, run by Chestnut Health Systems at 1 site in United States.
Trial summary
The investigators propose to develop and 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… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Burnout, Compassion Satisfaction, Secondary Trauma
- What is being tested?
- PATH (Peer Advanced Training for total Health)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 18 participants
- Where
- 1 siteUnited States
- Study dates
- 12 Jan 2026to 8 May 2026
- Phase
- Phase 2
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- current PRSS staff or administrator employed by a partnering Recovery Community Organization (RCO)
- is at least 18 years of age.
Who cannot join
- none
Trial locations and contacts
1 site in 1 country.
United States1 site
Chestnut Health Systems Lighthouse Institute
Chicago, Illinois, 60610
About this study
Official title: PATH to Reducing Burnout Among Peers Who Deliver Overdose Prevention Services: Improving Workforce and Service System Outcomes Through a Combined eLearning and Group Consultation Intervention (R61 Phase Pilot)
The investigators propose to develop and 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.
Read the detailed description
The investigators will pilot the PATH intervention with two Recovery Community Organizations (RCOs) to understand its acceptability, appropriateness, and feasibility.
PATH will include 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 full PATH intervention will take 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.
The investigators will administer the PATH components with the PRSS and administrators/supervisors from two RCOs, while assessing the duration and dose of an individual participant's engagement by tracking eLearning module completion and ECHO attendance. Voluntary survey and qualitative data collection will be used to assess the primary measures for this pilot. Data collection will also assess training satisfaction, burnout, compassion satisfaction, secondary trauma, job crafting, boundaries, OP knowledge, attitudes, and skills, and OP stigma.
Participants of the PATH pilot will be invited to complete surveys at three timepoints. The baseline survey will be distributed immediately prior to beginning the PATH training activities. Following the completion of the eLearning components of the training (approximately 1 month post-initiation), the second survey will be distributed to all participants. Finally, following completion of the final ECHO meeting (approximately 3 months post-initiation), the third survey will be distributed to all participants. All surveys will be collected in REDCap. Personalized survey links will be sent directly to each participant's email address. Each survey will take approximately 30 minutes to complete. Additionally, the investigators will track and obtain administrative training data for the eLearning modules and ECHO meetings, including engagement and attendance.
PATH participants will also be invited to complete a final qualitative focus group regarding their participation in the PATH training activities. Depending on the final number of participants per RCO, investigators will conduct 1-2 focus groups for each site. Each focus group will last approximately 60-90 minutes and be conducted via Zoom teleconference. Questions will focus on participants' experiences with the PATH training activities, particularly regarding the content, clarity, applicability, relevance, and usefulness of both the eLearning modules and ECHO meetings. Additionally, participants will be asked about barriers and facilitators to completing the PATH training activities and suggestions for improvement. Similarly, the administrator/supervisor will be invited to complete a final qualitative group interview regarding their organization's participation in the PATH training activities. The interview will last approximately 60-90 minutes and be conducted via Zoom teleconference. Questions will focus on the administrator's opinions of staff experiences with the PATH training activities, particularly regarding the applicability, relevance, and usefulness of both the eLearning modules and ECHO meetings, as well as the impact of the training on their team. Administrators/supervisors will be asked about barriers and facilitators to having their staff complete the PATH training activities and suggestions for improvement.
- Conditions
- Burnout, Compassion Satisfaction, Secondary Trauma
- Being tested
- PATH (Peer Advanced Training for total Health)
- Keywords
- peer recovery support specialist, opioid use disorder, substance use disorder, overdose prevention
- Medical subject headings
- Burnout, Psychological, Compassion Fatigue, Opioid-Related Disorders, Substance-Related Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PATH (Peer Advanced Training for total Health)Behavioural
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 will include 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 will take 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.
| Study group | Role | What they receive |
|---|---|---|
| PATH pilot participants | Experimental | Receive PATH pilot intervention Receives: Behavioral: PATH (Peer Advanced Training for total Health) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Acceptability, Appropriateness, and Feasibility
Measured using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM), 12 validated items measuring participants' level of agreement (1/Completely disagree - 5/Completely agree) with the intervention's relevance, practicality, and fit for their work.
Each of the three scales (AIM, IAM, and FIM) contains 4 questions and is scored by averaging responses. Each has a minimum score of 1 and a maximum score of 5. Higher scores indicate higher perceived levels of Acceptability, Appropriateness, or Feasibility of the intervention.
Measured: At the conclusion of PATH eLearning modules, approximately 1 month post-baseline
Acceptability, Appropriateness, and Feasibility
Measured using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM), 12 validated items measuring participants' level of agreement (1/Completely disagree - 5/Completely agree) with the intervention's relevance, practicality, and fit for their work.
Each of the three scales (AIM, IAM, and FIM) contains 4 questions and is scored by averaging responses. Each has a minimum score of 1 and a maximum score of 5. Higher scores indicate higher perceived levels of Acceptability, Appropriateness, or Feasibility of the intervention.
Measured: At the conclusion of PATH ECHO sessions, approximately 3 months post-baseline
Training Satisfaction
Measured using the Training Satisfaction Questionnaire, a custom 5-point Likert-scale (1/Totally disagree - 5/Totally agree) survey with 12-items assessing overall satisfaction with the learning experience, content relevance, and applicability to peer support practice.
The questionnaire includes 3 sub-scales: Objectives and Content (3 items), Methods and Training Context (6 items), and Usefulness and Overall Rating (3 items). Each sub-scale is scored by averaging responses and has a minimum score of 1 and a maximum score of 5. Higher scores indicate higher levels of satisfaction with the training.
Measured: At the conclusion of PATH eLearning modules, approximately 1 month post-baseline
Training Satisfaction
Measured using the Training Satisfaction Questionnaire, a custom 5-point Likert-scale (1/Totally disagree - 5/Totally agree) survey with 12-items assessing overall satisfaction with the learning experience, content relevance, and applicability to peer support practice.
The questionnaire includes 3 sub-scales: Objectives and Content (3 items), Methods and Training Context (6 items), and Usefulness and Overall Rating (3 items). Each sub-scale is scored by averaging responses and has a minimum score of 1 and a maximum score of 5. Higher scores indicate higher levels of satisfaction with the training.
Measured: At the conclusion of PATH ECHO sessions, approximately 3 months post-baseline
Secondary outcomes (18)
Job Crafting
Measured using 15 items from the Adaptive Adjustment Job Crafting Scale (AAJCS), a validated instrument using a 7-point Likert scale (1/Totally disagree -7/Totally agree) measuring participants' proactive cognitive strategies for adapting to work demands and resources.
Three sub-scales from the questionnaire were used in the survey: Approach Cognitive Resources Crafting (5 items), Approach Cognitive Demands Crafting (5 items), and Avoidance Cognitive Demands Crafting (5 items). Each sub-scale is scored by averaging responses and has a minimum score of 1 and a maximum score of 7. Higher scores reflect greater utilization of job crafting approaches.
Measured: Baseline
Job Crafting
Measured using 15 items from the Adaptive Adjustment Job Crafting Scale (AAJCS), a validated instrument using a 7-point Likert scale (1/Totally disagree -7/Totally agree) measuring participants' proactive cognitive strategies for adapting to work demands and resources.
Three sub-scales from the questionnaire were used in the survey: Approach Cognitive Resources Crafting (5 items), Approach Cognitive Demands Crafting (5 items), and Avoidance Cognitive Demands Crafting (5 items). Each sub-scale is scored by averaging responses and has a minimum score of 1 and a maximum score of 7. Higher scores reflect greater utilization of job crafting approaches.
Measured: At the conclusion of PATH eLearning modules, approximately 1 month post-baseline
Job Crafting
Measured using 15 items from the Adaptive Adjustment Job Crafting Scale (AAJCS), a validated instrument using a 7-point Likert scale (1/Totally disagree -7/Totally agree) measuring participants' proactive cognitive strategies for adapting to work demands and resources.
Three sub-scales from the questionnaire were used in the survey: Approach Cognitive Resources Crafting (5 items), Approach Cognitive Demands Crafting (5 items), and Avoidance Cognitive Demands Crafting (5 items). Each sub-scale is scored by averaging responses and has a minimum score of 1 and a maximum score of 7. Higher scores reflect greater utilization of job crafting approaches.
Measured: At the conclusion of PATH ECHO sessions, approximately 3 months post-baseline
Overdose Prevention Knowledge, Attitudes, and Skills
Measured using the Harm Reduction Knowledge, Attitudes, and Skills (HR-KAS), a 20-item scale assessing conceptual understanding and application of overdose prevention in peer recovery work. Participants are asked to rate each item on a 10-point Likert scale. Subscales of the HR-KAS include: Knowledge (5 items; 1/no knowledge-10/high level of knowledge), Attitudes (6 items; 1/strongly disagree-10/strongly agree), and Skills (9 items; 1/cannot do at all-10/highly certain).
Each sub-scale is scored by averaging responses and has a minimum score of 1 and a maximum score of 10. Higher scores indicate higher perceptions of overdose prevention knowledge, agreement with overdose prevention efforts, and confidence with delivering overdose prevention services.
Measured: Baseline
Overdose Prevention Knowledge, Attitudes, and Skills
Measured using the Harm Reduction Knowledge, Attitudes, and Skills (HR-KAS), a 20-item scale assessing conceptual understanding and application of overdose prevention in peer recovery work. Participants are asked to rate each item on a 10-point Likert scale. Subscales of the HR-KAS include: Knowledge (5 items; 1/no knowledge-10/high level of knowledge), Attitudes (6 items; 1/strongly disagree-10/strongly agree), and Skills (9 items; 1/cannot do at all-10/highly certain).
Each sub-scale is scored by averaging responses and has a minimum score of 1 and a maximum score of 10. Higher scores indicate higher perceptions of overdose prevention knowledge, agreement with overdose prevention efforts, and confidence with delivering overdose prevention services.
Measured: At the conclusion of PATH eLearning modules, approximately 1 month post-baseline
Overdose Prevention Knowledge, Attitudes, and Skills
Measured using the Harm Reduction Knowledge, Attitudes, and Skills (HR-KAS), a 20-item scale assessing conceptual understanding and application of overdose prevention in peer recovery work. Participants are asked to rate each item on a 10-point Likert scale. Subscales of the HR-KAS include: Knowledge (5 items; 1/no knowledge-10/high level of knowledge), Attitudes (6 items; 1/strongly disagree-10/strongly agree), and Skills (9 items; 1/cannot do at all-10/highly certain).
Each sub-scale is scored by averaging responses and has a minimum score of 1 and a maximum score of 10. Higher scores indicate higher perceptions of overdose prevention knowledge, agreement with overdose prevention efforts, and confidence with delivering overdose prevention services.
Measured: At the conclusion of PATH ECHO sessions, approximately 3 months post-baseline
Professional Quality of Life
Measured using the 30-item Professional Quality of Life instrument, which assesses positive and negative aspects of helping professionals' work experiences. Respondents are asked to rate how often they have experienced items over the past 30 days on a 5-point Likert scale (1/Never-5/Very often).
The measure includes 3 sub-scales: Compassion Satisfaction (10 items), Burnout (10 items), and Secondary Traumatic Stress (10 items). Each has a minimum score of 10 and a maximum of 50.
Higher scores of Compassion Satisfaction reflect greater satisfaction related to one's ability to be an effective caregiver. Higher scores of Burnout reflect greater risk of burnout associated with difficulties in dealing with work. Higher scores of Secondary Traumatic Stress reflect higher exposure to traumatically stressful events.
Measured: Baseline
Professional Quality of Life
Measured using the 30-item Professional Quality of Life instrument, which assesses positive and negative aspects of helping professionals' work experiences. Respondents are asked to rate how often they have experienced items over the past 30 days on a 5-point Likert scale (1/Never-5/Very often).
The measure includes 3 sub-scales: Compassion Satisfaction (10 items), Burnout (10 items), and Secondary Traumatic Stress (10 items). Each has a minimum score of 10 and a maximum of 50.
Higher scores of Compassion Satisfaction reflect greater satisfaction related to one's ability to be an effective caregiver. Higher scores of Burnout reflect greater risk of burnout associated with difficulties in dealing with work. Higher scores of Secondary Traumatic Stress reflect higher exposure to traumatically stressful events.
Measured: At the conclusion of PATH eLearning modules, approximately 1 month post-baseline
Professional Quality of Life
Measured using the 30-item Professional Quality of Life instrument, which assesses positive and negative aspects of helping professionals' work experiences. Respondents are asked to rate how often they have experienced items over the past 30 days on a 5-point Likert scale (1/Never-5/Very often).
The measure includes 3 sub-scales: Compassion Satisfaction (10 items), Burnout (10 items), and Secondary Traumatic Stress (10 items). Each has a minimum score of 10 and a maximum of 50.
Higher scores of Compassion Satisfaction reflect greater satisfaction related to one's ability to be an effective caregiver. Higher scores of Burnout reflect greater risk of burnout associated with difficulties in dealing with work. Higher scores of Secondary Traumatic Stress reflect higher exposure to traumatically stressful events.
Measured: At the conclusion of PATH ECHO sessions, approximately 3 months post-baseline
Boundaries
Measured using 7 original items with a 7-point Likert scale (1/Strongly disagree - 7/Strongly agree) assessing participants ability to maintain healthy work-related boundaries with clients.
The instrument is scored by averaging responses and has a minimum score of 1 and a maximum score of 7. A lower score reflects greater boundary management.
Measured: Baseline
Boundaries
Measured using 7 original items with a 7-point Likert scale (1/Strongly disagree - 7/Strongly agree) assessing participants ability to maintain healthy work-related boundaries with clients.
The instrument is scored by averaging responses and has a minimum score of 1 and a maximum score of 7. A lower score reflects greater boundary management.
Measured: At the conclusion of PATH eLearning modules, approximately 1 month post-baseline
Boundaries
Measured using 7 original items with a 7-point Likert scale (1/Strongly disagree - 7/Strongly agree) assessing participants ability to maintain healthy work-related boundaries with clients.
The instrument is scored by averaging responses and has a minimum score of 1 and a maximum score of 7. A lower score reflects greater boundary management.
Measured: At the conclusion of PATH ECHO sessions, approximately 3 months post-baseline
Moral Injury
Measured using 6 unmodified items and 1 modified item from the Moral Injury Symptoms Scale-Health Professional (MISS-HP) which assesses distress resulting from workplace situations that conflict with personal or professional values using a 10-point Likert scale (1/Strongly disagree - 10/Strongly agree).
The instrument has a minimum score of 7 and a maximum of 70. A higher score reflects greater internal moral conflict, guilt or shame, spiritual struggle, loss of meaning, difficulty forgiving oneself, or difficulty with strength of personal recovery.
Measured: Baseline
Moral Injury
Measured using 6 unmodified items and 1 modified item from the Moral Injury Symptoms Scale-Health Professional (MISS-HP) which assesses distress resulting from workplace situations that conflict with personal or professional values using a 10-point Likert scale (1/Strongly disagree - 10/Strongly agree).
The instrument has a minimum score of 7 and a maximum of 70. A higher score reflects greater internal moral conflict, guilt or shame, spiritual struggle, loss of meaning, difficulty forgiving oneself, or difficulty with strength of personal recovery.
Measured: At the conclusion of PATH eLearning modules, approximately 1 month post-baseline
Moral Injury
Measured using 6 unmodified items and 1 modified item from the Moral Injury Symptoms Scale-Health Professional (MISS-HP) which assesses distress resulting from workplace situations that conflict with personal or professional values using a 10-point Likert scale (1/Strongly disagree - 10/Strongly agree).
The instrument has a minimum score of 7 and a maximum of 70. A higher score reflects greater internal moral conflict, guilt or shame, spiritual struggle, loss of meaning, difficulty forgiving oneself, or difficulty with strength of personal recovery.
Measured: At the conclusion of PATH ECHO sessions, approximately 3 months post-baseline
Overdose Prevention Stigma
Measured using the Harm Reduction Stigma Scale, a 24-item instrument assessing stigmatizing attitudes toward overdose prevention and people who use drugs using a 3-point Likert scale (1/Agree - 3/Disagree).
The instrument is scored by averaging responses and has a minimum score of 1 and a maximum score of 3. A lower score reflects fewer stigmatizing attitudes.
Measured: Baseline
Overdose Prevention Stigma
Measured using the Harm Reduction Stigma Scale, a 24-item instrument assessing stigmatizing attitudes toward overdose prevention and people who use drugs using a 3-point Likert scale (1/Agree - 3/Disagree).
The instrument is scored by averaging responses and has a minimum score of 1 and a maximum score of 3. A lower score reflects fewer stigmatizing attitudes.
Measured: At the conclusion of PATH eLearning modules, approximately 1 month post-baseline
Overdose Prevention Stigma
Measured using the Harm Reduction Stigma Scale, a 24-item instrument assessing stigmatizing attitudes toward overdose prevention and people who use drugs using a 3-point Likert scale (1/Agree - 3/Disagree).
The instrument is scored by averaging responses and has a minimum score of 1 and a maximum score of 3. A lower score reflects fewer stigmatizing attitudes.
Measured: At the conclusion of PATH ECHO sessions, approximately 3 months post-baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Oct 2025
- Study start12 Jan 2026
- Primary completion8 May 2026
- Study completion8 May 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for BurnoutStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Health services research
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 18 participants (actual)
Sponsor and investigators
- Lead sponsor
- Chestnut Health Systems
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Drug Abuse (NIDA)
- Responsible party
- Principal investigator, Dennis Watson, Chestnut Health Systems
- Investigators
- Dennis P Watson, PhD, Principal investigator, Chestnut Health Systems
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07218562
- Sponsor's protocol ID
- R61DA061340
- Status last verified
- Sep 2026
- First submitted
- 30 Sep 2025
- Last updated
- 16 Oct 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: 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.