Safe and stable housing is critical to recovery from alcohol and other drug disorders. Among individuals in recovery from these disorders, those living in recovery housing are among the most vulnerable. Recovery housing is rooted in the social model of recovery, which emphasizes peer support in helping residents maintain their recovery. CDC guidance for the general public for managing COVID-19 as well as its guidance for shared or congregate housing providers may present significant challenges for residential recovery residence operators. Because the majority of recovery residences operate with almost no formal third-party payers to reimburse or offset costs of this service, furloughs and work stoppages for residents who are responsible for paying for this service may contribute financial hardship and closure of recovery residences. To better understand how recovery residence are responding to the COVID-19 pandemic and its impact on recovery housing, this applications aims to: (1) Examine the extent to which CDC guidance and other best practice guidelines are being implemented in recovery residences, identify residence and other contextual characteristics related to differential implementation, and describe changes in implementation over time; and (2) Examine how the pandemic has affected the availability and financial viability of recovery housing, identify whether this impact differs by residence and other contextual factors, and describe changes in availability and financial viability over time. To address these aims, the proposed study will add questions to the survey administered to residences (N=800) participating in the National Study of Treatment and Addiction Recovery Residence (NSTARR) project (R01AA027782). These questions will query the extent to which the COVID-19 pandemic has affected sources of revenue for the residence, policies and practices, and programming for residents. An additional 200 randomly sampled residences (stratified by US Census Division) will be asked to complete a COVID-19-specific survey that also collects information on implementation of COVID-19 guidance to ensure resident and staff safety. These residences will be geocoded and linked with US Census data, COVID-19 case rates, and geo-located data for federally qualified health centers (FQHCs) and publicly-funded hospitals. They will also be resurveyed 6 and 12 months later to track changes over time. Finally, operators of residences that are no longer open will be asked to participate in a semi-structured interview about the role that COVID-19 may have played in residence closure.
/PUBLIC HEALTH RELEVANCE The COVID-19 pandemic may be particularly harmful to the physical health and wellbeing of those in recovery from alcohol and other drug disorders. Among individuals in recovery from these disorders, those living in recovery housing are among the most vulnerable. By conducting a national longitudinal survey of recovery residences, this study will provide requisite data to better understand the impact of the COVID-19 pandemic on recovery housing and how recovery residences are responding to it.
