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Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)

分阶段实施成瘾治疗目标药物 (SITT-MAT)

基本信息

批准号：
10462739
负责人：
James H Ford
金额：
$ 65.07万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10462739
关键词：
Academy Accident and Emergency department Address Adherence Adoption Biometry Budgets Buprenorphine COVID-19 pandemic Caring Centers for Disease Control and Prevention (U.S.)Characteristics Communities Community Healthcare Decision Making Diagnosis Discipline Educational workshop Effectiveness Engineering Ensure Epidemic Evidence based intervention Evidence based practice Evidence based treatment FDA approved Feedback Funding Goals Growth Health Health Benefit Health Services Research Health system Healthcare Hospitals Hour Improve Access Intervention Investments Lead Maintenance Measurement Measures Mediator of activation protein Medical Medication Management Methods Modeling Modification Monitor Naltrexone National Institute of Drug Abuse Nature Neighborhood Health Center Normalcy Outcome Overdose reduction Patients Performance Persons Pharmaceutical Preparations Pharmacology Pharmacotherapy Policies Prevention Primary Health Care Procedures Process Protocols documentation Provider Public Health Quarantine Randomized Reach Effectiveness Adoption Implementation and Maintenance Recommendation Reporting Research Research Personnel Strategic Planning Substance Use Disorder System Translations United States National Institutes of Health United States Substance Abuse and Mental Health Services Administration Washington Work addiction arm authority base care systems combat contextual factors coping cost design dissemination research economic evaluation evidence base global health health care service organization implementation research implementation science implementation strategy implementation trial improved innovation medical specialties novel therapeutics opioid epidemic opioid use disorder overdose death pandemic disease patient engagement prescription opioid programs recruit research study response scale up standardize measure substance use treatment treatment organization treatment program treatment services trial design

项目摘要

PROJECT SUMMARY/ABSTRACT To combat the US opioid epidemic, massive efforts have been focused on expanding access to medications for opioid use disorder (MOUD). While there are indications of improved reach and adoption, an ironic gap persists—only about one-third of specialty addiction treatment organizations offer MOUD. This proposal, Stagewise Implementation-To-Target – Medications for Addiction Treatment (SITT-MAT), not only advances the science of implementation, but advances our empirical understanding of how to best respond to a substance-related epidemic. This is a revised application in response to PAR-19-274: Dissemination and Implementation Research in Health” and aligned with the National Institute on Drug Abuse Strategic Plan “ensuring the effective translation and implementation of scientific research findings to improve the prevention and treatment of substance use disorders.” Within an adaptive implementation strategy trial design, using an innovative stagewise implementation-to-target approach, 72 community addiction treatment programs will participate. The stagewise implementation-to-target, stepped “care” type approach, deploys increasingly intensive strategies only if needed. The sequence of implementation strategies are: 1) Enhanced Monitoring and Feedback; 2) “NIATx/MAT Academy,” a 2-day workshop on MOUD and NIATx (Network for Improvement of Addiction Treatment)—an evidence-based process improvement strategy; 3) Randomization to either NIATx Internal Facilitation or NIATx External Facilitation; and, 4) If outcome targets are not achieved in the NIATx Internal Facilitation arm, assignment to NIATx External Facilitation. We evaluate the relative impact of 5 possible paths of implementation strategies on RE-AIM target outcomes: reach, effectiveness, adoption, and implementation quality. Maintenance of outcomes is evaluated for sustainment. Measures of multi-level contextual determinants are rigorous and systematic. In opening the “black box” of implementation strategies, we detail procedures, fidelity, participation and costs using standardized measures. The collective expertise of the research team, the established partnership with a state system of care and addiction treatment organizations, forecasts successful project execution. As we submit this application, the US is still coping with the COVID19 pandemic. The global health situation may rebound to relative normalcy in the months from December 2020. Meanwhile, the CDC, SAMHSA, CMS, and the State of Washington Health Care Authority have all made accommodations to continue the initiation and management of MOUD for patients receiving addiction treatment services. Therefore, even if the current quarantine restrictions persist, we do not anticipate major modifications to the study protocol, except in-person implementation support activities would be transitioned to videoconference formats. During this pandemic, it is even more critical for patients with opioid use disorders to access pharmacological interventions that require minimal physical contact with providers. This study has the potential to shift the paradigm in public health and implementation research.

项目总结/文摘