Effectiveness of Technology Assisted Diffusion For Evidence Based Treatment

描述（由申请人提供）：自医学研究所的里程碑式报告（IOM，1998）发布以来，已经过去了十多年，该报告描述了在研究和实践之间“弥合差距”的必要性。从那时起，努力传播循证治疗（EBT），以通常的护理提供设置已启动，但很少有人知道这些努力的长期有效性。例如，自2006年以来，药物滥用治疗中心（CSAT）资助全国81个药物滥用治疗中心提供EBT，作为其治疗方案的一部分。一旦这一计划结束，EBT的交付在很大程度上就留给了本地站点来支持。如果不注意确保可持续性，这些支持实施EBT的努力可能无法充分发挥其潜力。目前的建议是审查在这些情况下维持电子贸易工具的问题。我们提出以下目标：1）通过以下方式纵向表征接受CSAT资助以实施A-CRA的计划的EBT实施水平：确定EBT的持续方面、EBT实施中的创新以及实施的候选促进者和障碍; B.描述81个项目随时间推移的执行质量轨迹。我们假设，政府资助结束后将发生重大变化。具体来说，我们假设，该计划将证明随着时间的推移，将有不同的程序随着时间的推移而变化的可持续性下降;和2）经验评估因素，预测EBT可持续性的程度。我们假设EBT持续的程度将与环境（即，偿还服务费用）和组织因素（即，在资助阶段结束时有经过培训的主管和临床医生在场），尺寸）因素。所提出的研究是非常有意义的。更好地了解影响EBT提供可持续性的因素可能会导致更有效的传播策略，并最终提高社区成瘾治疗环境中提供的护理质量。

DESCRIPTION (provided by applicant): It has been more than a decade since the release of the Institute of Medicine's landmark report (IOM, 1998) that described the need to "bridge the gap" between research and practice. Since then, efforts to disseminate evidence-based treatments (EBTs) to usual care delivery settings have been launched, however little is known about the long-term effectiveness of these efforts. For example, since 2006, the Center for Substance Abuse Treatment (CSAT) funded 81 substance use treatment sites across the country to deliver an EBT as part of their treatment regime. Once this initiative ends, the deliver of the EBT is largely left up to the local sites to support. Without attention to ensuring sustainability, these efforts to support EBT implementation may not meet their full potential. The current proposal is to examine the sustainment of an EBT in these settings. We propose the following aims: 1) Characterize levels of EBT implementation longitudinally for programs that received CSAT funding to implement A- CRA by: a. Identifying aspects of the EBT that are sustained, innovations in EBT implementation, and candidate facilitators and barriers to implementation; b. Characterizing the trajectory of implementation quality among the 81 programs over time. We hypothesize that substantial changes will occur after government funding ends. Specifically, we hypothesize that programs will demonstrate decreases in sustainment over time and that there will be differences among programs in change over time; and 2) empirically evaluate factors that predict the degree of EBT sustainment. We hypothesize that the extent to which the EBT is sustained will be associated with environmental (i.e., reimbursement for services) and organizational factors (i.e., presence of trained supervisors and clinicians at the end of the funding phase) after controlling for a number of program-specific (e.g., size) factors. The proposed research is highly significant. Gaining a better understanding of the factors that influence the sustainability of EBT delivery may lead to more effective dissemination strategies and ultimately improve the quality of care being delivered in community based addiction treatment settings.