Statewide System and Organizational Strategy for Evidence-Based Practice Implementation and Sustainment in Substance Use Disorder Treatment

项目摘要 NIH呼吁测试有希望的实施策略（PAR-19-274），并且迫切需要 实施和维持有效的循证做法，以解决健康问题 包括物质使用障碍（SUD）。该项目符合NIDA的优先重点领域 “改进循证预防和治疗的有效和可持续实施的战略 实施科学（Implementation Science）。大多数实施战略不解决复杂的多层次 公共服务部门的执行背景。这一拟议项目将扩大领导和 组织变革促进实施（LOCI）干预，一项创新的组织变革战略， EBP的实施和维持，包括与全州精神卫生部的伙伴关系， 成瘾（DMHA）和社区心理健康中心（CMHC），以调整国家一级的领导 政策和指令与组织执行改进战略。SUD是最受欢迎的 公共卫生问题复杂，印第安纳州在提供SUD服务方面排名第四， 8.5%的人口符合SUD标准，其中只有13.6%寻求治疗。印第安纳州DMHA 我联系了UCSD LOCI团队，以帮助实施联合动机增强 治疗/认知行为疗法（MET/CBT）本项目的主要创新在于，与 探索，准备，实施，维持（EPIS）框架和系统和组织理论， 我们将在LOCI中增加一个系统级组件，其目标是连接外部和内部环境， 调整积极的执行气候，以支持执行和维持MET/CBT， SUD。该项目将测试一个实施策略，旨在调整，系统，组织和诊所 领导和战略，以实施和维持物质使用障碍的EBP。的领导和 实施组织变革-系统级（LOCI-SL）旨在改善实施 领导力、气候、供应商态度和行为，以及EBP忠诚度和客户参与服务。LOCI- SL将在全州范围的心理健康和成瘾服务系统及其社区心理健康中进行测试 中心.

PROJECT SUMMARY ABSTRACT The NIH has called for testing promising implementation strategies (PAR-19-274) and there is a critical need for implementation and sustainment of effective and evidence-based practices (EBPs) to address health conditions including substance use disorders (SUDs). This proposed project is consistent with NIDA’s Priority Focus Area “Strategies to improve the effective and sustainable implementation of evidence-based prevention and treatment interventions (implementation science).” Most implementation strategies do not address the complex multilevel context for implementation in public service sectors. This proposed project will expand the Leadership and Organizational Change for Implementation (LOCI) intervention, an innovative organizational change strategy for EBP implementation and sustainment, to include partnership with a statewide Department of Mental Health and Addiction (DMHA) and Community Mental Health Centers (CMHCs) in order to align state-level leadership policies and directives with organizational implementation improvement strategies. SUDs are among the most complex of public health issues and Indiana ranks as the fourth worst state in providing SUD services with about 8.5% of the population meeting criteria for a SUD, of whom only 13.6% seek treatment. Indiana DMHA approached the UCSD LOCI team to aid in the implementation of combined Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT) The main innovation in this project is that, consistent with the Exploration, Preparation, Implementation, Sustainment (EPIS) framework and system and organizational theory, we will add a system level component to LOCI with the goal of bridging outer and inner context and developing and aligning a positive implementation climate to support implementation and sustainment of MET/CBT for SUDs. This project will test an implementation strategy that seeks to align, system, organization, and clinic leadership and strategies to implement and sustain an EBP for substance use disorders. The Leadership and Organizational Change for Implementation - System Level (LOCI-SL) seeks to improve implementation leadership, climate, provider attitudes and behaviors, and EBP fidelity and client engagement in services. LOCI- SL will be tested in a statewide mental health and addiction service system and its community mental health centers.