Training opioid addiction treatment providers to adopt contingency management: A prospective pilot trial of a comprehensive implementation science approach.
Training opioid addiction treatment providers to adopt contingency management: A prospective pilot trial of a comprehensive implementation science approach.
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DOI：
10.1080/08897077.2015.1129524
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发表时间：
2016
期刊：
影响因子：
3.5
通讯作者：
Petry NM
中科院分区：
文献类型：
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作者：
Becker SJ;Squires DD;Strong DR;Barnett NP;Monti PM;Petry NM
很少有前瞻性研究评估了理论驱动的方法来实施循证阿片类药物治疗。本研究比较了实施模式（科学到服务实验室；SSL）与常规培训（TAU）在促进跨多站点阿片类药物成瘾治疗计划采用应急管理方面的有效性。我们还研究了SSL是否影响应急管理采用的假定中介（感知创新特征和组织变革准备）。来自15个地理位置不同的卫星诊所（7个SSL， 8个TAU）的60名治疗提供者（39个SSL， 21个TAU）参加了为期12个月的研究。两组都接受了说教性应急管理培训，预先确定实验区的受试者接受了9个月的ssl强化培训。每两周监测应急管理的采用情况，同时在基线、3个月和12个月测量假定的中介。相对于TAU地区的提供者，SSL地区的治疗提供者在研究的前20周采用应急管理的可能性相当，然后在研究的其余时间采用的可能性显着更高（优势比= 2.4-13.5）。尽管没有证据表明SSL随着时间的推移影响了这些假定的中介，但SSL提供者也报告了更高水平的可感知创新特征（可观察性）和组织准备变化的一个方面（培训资源的充分性）。本研究结果表明，SSL的全功率随机试验是有必要的。讨论了今后评价的注意事项。
Few prospective studies have evaluated theory-driven approaches to the implementation of evidence-based opioid treatment. This study compared the effectiveness of an implementation model (Science to Service Laboratory; SSL) to training as usual (TAU) in promoting the adoption of contingency management across a multi-site opiate addiction treatment program. We also examined whether the SSL affected putative mediators of contingency management adoption (perceived innovation characteristics and organizational readiness to change). Sixty treatment providers (39 SSL, 21 TAU) from 15 geographically diverse satellite clinics (7 SSL, 8 TAU) participated in the 12-month study. Both conditions received didactic contingency management training and those in the pre-determined experimental region received 9 months of SSL-enhanced training. Contingency management adoption was monitored biweekly, while putative mediators were measured at baseline, 3-, and 12-months. Relative to providers in the TAU region, treatment providers in the SSL region had comparable likelihood of contingency management adoption in the first 20 weeks of the study, and then significantly higher likelihood of adoption (odds ratios = 2.4-13.5) for the remainder of the study. SSL providers also reported higher levels of one perceived innovation characteristic (Observability) and one aspect of organizational readiness to change (Adequacy of Training Resources), although there was no evidence that the SSL affected these putative mediators over time. Results of this study indicate that a fully powered randomized trial of the SSL is warranted. Considerations for a future evaluation are discussed.