Integrating Multi-Assessment Protocols into Practice

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DESCRIPTION: (provided by applicant) National leadership in field of drug abuse treatment has recognized the need to establish effective treatments, and to extend those treatments to more persons seeking treatment. This is reflected in establishment of the NIDA Clinical Trial Networks (CTNs) to study effectiveness through large-scale clinical trials, and in the establishment of CSAT Practice Research Collaboratives (PRCs) to bridge between research and practice. The full promise of these efforts, however, cannot be realized unless interventions with demonstrated effectiveness are adopted into clinical practice. Although available literature comments on factors influencing organizational change, factors influencing adoption of treatment innovation, and the gap between research and practice, there are no systematic efforts to integrate this literature, develop measurement strategies and, using these measures, study intervention adoption in multi-site clinical trials. This is a proposal to develop and apply a Multi-level Assessment Protocol (MAP) to investigate the extent to which behaviorally oriented drug abuse treatment interventions are adopted by community based providers participating in multi-site clinical trials. The proposed project will establish procedures for investigating how well research-based treatment interventions are adopted in the treatment field, identify barriers to intervention adoption, and identify factors that increase or decrease likelihood of adoption. We will develop and field test a MAP strategy in the context of the Matrix methamphetamine multi-site clinical trial, which is not a part of the NIDA CTN. We will then apply the MAP to the CTN Motivational Enhancement Therapy/Motivational Interviewing clinical trial currently in nascent stages. The long-term project goal is to establish strategies, for use in the national CTN, which will increase the likelihood of adoption of clinical trial interventions. This represents the earliest possible application of adoption assessment methods directly to the activities of CTN nodes, and identifies factors that facilitate or retard adoption of CTN interventions. Use of a refined MAP strategy within the CTN context sets the stage for expansion of the MAP across CTN nodes, and for future randomized designs in which specific intervention adoption technologies can be empirically tested.