Tailoring dissemination strategies to increase evidence-informed policymaking for opioid use disorder treatment: study protocol.
Tailoring dissemination strategies to increase evidence-informed policymaking for opioid use disorder treatment: study protocol.
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DOI：
10.1186/s43058-023-00396-5
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发表时间：
2023-02-16
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政策是系统地改变医疗服务可及性和质量的有力工具，但对政策差距的研究阻碍了将循证实践转化为公共政策，并限制了服务和人口健康结果的广泛改善。美国阿片类药物的流行对医疗补助计划的成员产生了不成比例的影响，这些成员依赖公共资助的福利来获得循证治疗，包括阿片类药物使用障碍（MOUD）的药物。联邦机构、州医疗补助机构和管理式医疗组织的政策制定者制定了无数不一致的政策和证据使用行为，限制了医疗补助成员对MOUD的覆盖和使用。改善决策者对现有证据的使用的传播战略对于改善MOUD效益和减少健康差距至关重要。然而，没有研究描述医疗补助政策制定者的证据使用行为或偏好的关键决定因素，很少有研究探讨数据驱动的方法来制定传播策略，以加强循证决策。本研究旨在确定影响决策者证据使用行为的决定因素和中介因素，然后开发和测试数据驱动的定制传播策略，以促进MOUD在福利阵列中的覆盖率。在探索，准备，实施和维持（EPIS）框架的指导下，我们将对州医疗补助机构和管理式医疗组织的政策制定者进行全国调查，以确定影响他们如何寻求，接收和使用研究的决定因素和中介机构在他们的决策过程中。我们将使用潜在的类的方法，以经验确定具有不同的证据使用行为的机构的子组。一个10步的传播策略的发展和规范过程将被用来调整战略，以确定每个潜在类的重要预测。量身定制的传播战略将部署到每一类决策者，并评估其可接受性，适当性和可行性，以提供有关MOUD效益设计的证据。这项研究将阐明关键的决定因素和中介机构，影响决策者的证据使用行为时，设计的好处MOUD。这项研究将产生一套迫切需要的数据驱动的、量身定制的政策传播战略。研究结果将为随后的多地点试验提供信息，以衡量定制的传播策略对MOUD福利设计和实施的有效性。传播战略制定的经验教训将为今后关于决策者证据使用偏好的研究提供信息，并为定制传播战略提供一个可复制的过程。在线版本包含补充材料，可通过10.1186/s43058-023-00396-5获得。
Policy is a powerful tool for systematically altering healthcare access and quality, but the research to policy gap impedes translating evidence-based practices into public policy and limits widespread improvements in service and population health outcomes. The US opioid epidemic disproportionately impacts Medicaid members who rely on publicly funded benefits to access evidence-based treatment including medications for opioid use disorder (MOUD). A myriad of misaligned policies and evidence-use behaviors by policymakers across federal agencies, state Medicaid agencies, and managed care organizations limit coverage of and access to MOUD for Medicaid members. Dissemination strategies that improve policymakers’ use of current evidence are critical to improving MOUD benefits and reducing health disparities. However, no research describes key determinants of Medicaid policymakers’ evidence use behaviors or preferences, and few studies have examined data-driven approaches to developing dissemination strategies to enhance evidence-informed policymaking. This study aims to identify determinants and intermediaries that influence policymakers’ evidence use behaviors, then develop and test data-driven tailored dissemination strategies that promote MOUD coverage in benefit arrays. Guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, we will conduct a national survey of state Medicaid agency and managed care organization policymakers to identify determinants and intermediaries that influence how they seek, receive, and use research in their decision-making processes. We will use latent class methods to empirically identify subgroups of agencies with distinct evidence use behaviors. A 10-step dissemination strategy development and specification process will be used to tailor strategies to significant predictors identified for each latent class. Tailored dissemination strategies will be deployed to each class of policymakers and assessed for their acceptability, appropriateness, and feasibility for delivering evidence about MOUD benefit design. This study will illuminate key determinants and intermediaries that influence policymakers’ evidence use behaviors when designing benefits for MOUD. This study will produce a critically needed set of data-driven, tailored policy dissemination strategies. Study results will inform a subsequent multi-site trial measuring the effectiveness of tailored dissemination strategies on MOUD benefit design and implementation. Lessons from dissemination strategy development will inform future research about policymakers’ evidence use preferences and offer a replicable process for tailoring dissemination strategies. The online version contains supplementary material available at 10.1186/s43058-023-00396-5.