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Training community-based treatment providers to implement contingency management for opioid addiction: time to and frequency of adoption
- Publication Year :
- 2018
-
Abstract
- Contingency management (CM) is a well-established treatment for opioid use, yet its adoption remains low in community clinics. This manuscript presents a secondary analysis of a study comparing a comprehensive implementation strategy (Science to Service Laboratory; SSL) to didactic training-as-usual (TAU) as a means of implementing CM across a multi-site opioid use disorder program. Hypotheses predicted that providers who received the SSL implementation strategy would 1) adopt CM faster and 2) deliver CM more frequently than TAU providers. In addition, we examined whether the effect of implementation strategy varied as a function of a set of theory-driven moderators, guided by the Consolidated Framework for Implementation Research: perceived intervention characteristics, perceived organizational climate, and provider characteristics (i.e., race/ethnicity, gender). Sixty providers (39 SSL, 21 TAU) across 15 clinics (7 SSL, 8 TAU) completed a comprehensive set of measures at baseline and reported biweekly on CM use for 52 weeks. All participants received didactic CM training; SSL clinics received 9 months of enhanced training, including access to an external coach, an in-house innovation champion, and a collaborative learning community. Discrete-time survival analysis found that SSL providers more quickly adopted CM; provider characteristics (i.e., race/ethnicity) emerged as the sole moderator of time to adoption. Negative binomial regression revealed that SSL providers also delivered CM more frequently than TAU providers. Frequency of CM adoption was moderated by provider (i.e., gender and race/ethnicity) and intervention characteristics (i.e., compatibility). Implications for implementation strategies for community-based training are discussed.
- Subjects :
- Male
Time Factors
Health Personnel
Applied psychology
Ethnic group
030508 substance abuse
Medicine (miscellaneous)
Contingency management
Article
03 medical and health sciences
0302 clinical medicine
Sex Factors
Behavior Therapy
medicine
Humans
030212 general & internal medicine
Community Health Services
Racial Groups
Champion
Opioid use disorder
Collaborative learning
medicine.disease
Organisation climate
Moderation
Opioid-Related Disorders
Psychiatry and Mental health
Clinical Psychology
Female
Implementation research
Substance Abuse Treatment Centers
Pshychiatric Mental Health
Diffusion of Innovation
0305 other medical science
Psychology
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....e651992d82c0ac88f7bbceb61b24ec4a