Funded Pilot Studies
Our pilot studies aim to advance recovery housing research for people who use MOUD.
Pilot Studies Funded by I-STARR
Round 1
Pilot Study 1: Developing MOUD Stigma and Capacity Measures for Recovery Housing
Study Director: Rachel Winograd. PhD is an associate professor and licensed clinical psychologist at the University of Missouri, St. Louis, with dual appointments in the Department of Psychological Sciences and the Missouri Institute of Mental Health where she leads UMSL’s Addiction Science team.
I-STARR Mentor: mPI Amy Mericle, PhD
Study Overview: Rachel developed and validated comprehensive measures of MOUD stigma and capacities within recovery homes. The study aimed to establish key domains through focus groups and expert consultation, then create validated measures tailored for recovery housing operators and residents using multidimensional graded response modeling.
Approach: The multi-stage methodology includes literature review, virtual focus groups with 12 operators and 12 residents each, measure development with subject matter experts, quantitative validation surveying 145 operators and 250 recovery house residents, and psychometric analysis using exploratory and confirmatory factor analysis.
Innovations: This project created the first comprehensive, validated measures of intervention stigma and MOUD capacity specifically for recovery housing settings, capturing stigma across three FDA-approved MOUD forms and two administration routes. The validated measures will enable researchers and operators alike to assess MOUD-related barriers, advancing evidence-based policy development and future recovery housing research.
Watch an interview with Rachel to learn more.
Presentations and Publications:
Winograd, R. P. (2024). We could, couldn’t we? Measuring attitudinal and capacity barriers to supporting residents on MOUD in recovery housing. Presentation at the National Conference on Addiction Recovery Science (NCARS).
Winograd, R. P. (2024). Developing a Measure of MOUD Barriers in Recovery Housing: Findings from the MO-ISTARR project. I-STARR Webinar.
Winograd, R. P. (2024). We could, couldn’t we? Measuring attitudinal and capacity barriers to supporting residents on MOUD in recovery housing. Presentation at the annual AMERSA Conference.
Park, B., Winograd, R. P., Ghonasgi, R., Nellis, M., Smith, D., & Mericle, A. A. (2025). MOUD Stigma Distinguished by Medication-Specific Lived Experience Among Recovery Housing Residents. Poster at the annual Collaborative Perspectives on Addiction (CPA) conference.
Park, B., Winograd, R. P., Ghonasgi, R., Nellis, M., Smith, D., & Mericle, A. A. (2025). Evaluating Attitudes Toward Medications for Opioid Use Disorder (MOUD) Among Recovery Housing Residents by Lived Experience With MOUD, Racial-Ethnic Identity, and Gender. Poster at the annual College on Problems of Drug Dependence (CPDD) conference.
Pilot Study 2: Identifying Critical Elements for Recovery Housing Model for Criminal Legal System-Involved Individuals Receiving MOUD
Study Director: Jodie Dewey, PhD completed her pilot study while she was a research scientist at Chestnut Health Systems’ Lighthouse Institute in Chicago.
I-STARR Mentor: Co-I Lenny Jason, PhD.
Pilot Study: Jodie conducted a qualitative comparative case study to identify effective policies and practices for recovery homes serving criminal legal system-involved clients receiving MOUD. The study examined what critical elements are necessary for recovery home models to meet this population’s needs and how formerly incarcerated MOUD clients experience staff treatment and recovery processes.
Approach: The study used a qualitative comparative case study approach with four purposefully selected recovery homes in Chicago and Cook County. Data collection included document analysis of program policies, focus groups with staff at each site, and individual semi-structured interviews with five client participants per home.
Innovations: This is the first focused examination of recovery housing barriers and facilitators specifically for individuals involved in the criminal legal system who are receiving MOUD. The research will lead to development of the first research-informed recovery housing model designed for this vulnerable population, who are 129 times more likely to die from overdose following release and nearly 10 times more likely to experience homelessness.
Watch an interview with Jodie to learn more.
Presentations and Publications:
Dewey, J. M. (2024) Meeting the Recovery Housing Needs of Criminal Legal System-Involved Individuals. I-STARR Webinar
Dewey, J. M., & Watson, D. P. (2024). You Have to Show up as an Opportunity: Recovery Home Staff’s Key Ingredients Support Criminal Legal System-Involved Residents. Poster at the annual Addiction Health Services Research Conference.
Dewey, J. M. (2025). Meeting the Recovery Housing Needs of Criminal Legal System-Involved individuals. Presentation at the National Conference on Addiction Recovery Science.
Dewey, J. M., Tompkins, J., Mericle, A., & Watson, D. P. (2025). “Wing leaders” in recovery residences: staff key approaches supporting criminal legal system-involved residents receiving medication for opioid use disorder. Frontiers in public health, 13, 1519469.
Dewey, J. M., Bell, J. S., LaVergne, D., Jason, L. A., & Watson, D. P. (2025). “Trust the process:” NARR Level 3 recovery home approaches to working with criminal legal system-involved residents. Justice, Opportunities, and Rehabilitation, 64(3), 179–196.
Round 2
Pilot Study 3: Medication for Opioid Use Disorder Utilization among Philadelphia Recovery Home Residents with Opioid Use Disorder: A Feasibility Study of Resident and House-Level Factors
Study Director: Jennifer Miles, PhD, is an instructor at Rutgers University’s Institute for Health, Health Care Policy and Aging Research and the Robert Wood Johnson Medical School’s Department of Family Medicine and Community Health.
I-STARR Mentor: mPI Carmen Masson, PhD.
Study Overview: Jennifer is conducting a feasibility study examining medication for opioid use disorder (MOUD) utilization among Philadelphia Recovery Home residents. The study aims to describe inner contextual factors related to resident MOUD use, characterize residents’ MOUD utilization patterns during their first 90 days, and examine associations between resident MOUD use and recovery home organizational factors.
Approach: This multilevel longitudinal retrospective cohort study combines primary survey data from 26 recovery home operators with secondary Medicaid claims data from approximately 200 residents. The study uses the exploration, preparation, implementation and sustainment (EPIS) framework and employs group-based trajectory modeling to identify distinct MOUD utilization patterns.
Innovations: The study provides a novel contribution by incorporating Medicaid claims into a study of MOUD utilization among recovery home residents. Key innovations include studying Philadelphia’s unique recovery home system that requires MOUD acceptance, linking secondary administrative data with primary survey data for multilevel assessment, and applying group-based trajectory modeling to identify longitudinal utilization patterns rather than traditional binary measures.
Watch an interview with Jennifer to learn more.
Presentations and Presentations:
Forthcoming.
Pilot Study 4: A Formative Assessment of Mobile Pharmacy Services for Recovery Housing and Medication for Opioid Use Disorder (MOUD) Integration
Study Director: Adati Tarfa, PhD, is a postdoctoral associate at Yale University School of Medicine studying with Sandra Springer, MD. In addition to holding a doctoral degree in Health Services Research from the University of Wisconsin-Madison, she holds a PharmD from Drake University.
I-STARR Mentor: mPI Amy Mericle, PhD.
Pilot Study: To our knowledge, Adati is conducting the first study to examine mobile pharmacy services for recovery housing and MOUD integration. The study aims to examine recovery housing perspectives, preferences and knowledge of individuals receiving MOUD, and explore pharmacists’ knowledge and perspectives on recovery housing for patients receiving MOUD. The research addresses critical gaps by establishing mobile pharmacies as integral systems of recovery housing referrals and MOUD providers.
Approach: The study employs an exploratory sequential mixed methods design. Phase 1 recruits 50 MOUD recipients through the InMOTION mobile pharmacy for structured surveys assessing awareness and willingness to engage with recovery housing. Phase 2 collects qualitative data from 15 community pharmacists to understand their knowledge and readiness to support patients in accessing recovery housing services.
Innovations: This study is among the first exploration of pharmacy services within recovery housing research and introduces an innovative healthcare delivery system leveraging the first legal retail mobile pharmacy in the United States. The study is supported by Dr. Sandra Springer’s NIDA Avant-Garde Award for Project InMOTION, which deploys mobile pharmacies to communities identified by Connecticut’s Department of Public Health based on state overdose data.
Watch an interview with Adati to learn more.
Presentations and Publications:
Tarfa, A., Mericle, A., Schulthies, A. M., Di Paola, A., Frank, C.A., Brooks, R., Shenoi, S., & Springer, S. A. (2025). Mixed Methods Study of Mobile Pharmacy Services for Recovery Housing and Medication for Opioid Use Disorder (MOUD) Integration. Poster presentation at the annual American Pharmacists Association Conference, Nashville, TN
Tarfa, A., Mericle, A., Schulthies, A. M., Di Paola, A., Frank, C.A., Brooks, R., Shenoi, S., & Springer, S. A. (2025). Expanding the Impact of Pharmacy Services by Integrating them with Recovery Housing: A Mixed Methods Study. Virtual poster presentation at the annual National Conference on Addiction Recovery Science (NCARS).
Round 3
Pilot Study 5: Enhancing MOUD Access and Outcomes Through Low-Barrier Recovery Housing Models
Study Director: Justin S. Bell, PhD, is a postdoctoral fellow at Chestnut Health Systems’ Lighthouse Institute in Chicago.
I-STARR Mentors: Co-Is Lenny Jason, PhD and Sarah Zemore, PhD.
Pilot Study: Justin’s study examines low-barrier recovery housing (LBRH) and its role in supporting residents receiving MOUD. The study aims to assess the potential impact of LBRH residence on outcomes for residents with OUD through secondary analysis of a Chicago-based program evaluation and identify key LBRH service components that facilitate MOUD-related engagement, retention and recovery through cross-case analysis of programs in Chicago and Los Angeles.
Approach: The study uses a parallel mixed-methods approach with secondary analysis of quantitative and qualitative data from Chicago’s Sanctuary LBRH program (21 residents, 7 staff) and additional qualitative interviews with residents and staff from Los Angeles’ SHARE! Collaborative Housing program. Analysis applies the OUD Cascade of Care framework and EPIS implementation science framework to identify facilitators and barriers across MOUD engagement stages.
Innovations: To our knowledge, this is the first rigorous study of LBRH programs, which eliminate abstinence-only requirements and explicitly integrate MOUD as a supported recovery pathway. The study applies the OUD Cascade of Care framework to systematically assess how LBRH influences each stage of MOUD engagement, examining two sites at different developmental stages to identify essential program components for successful MOUD integration.
Presentations and Publications:
Forthcoming.
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