Diffusion, Adoption, and Implementation of Pharmacotherapies in Alcohol Tx

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DESCRIPTION (provided by applicant): Despite recent advances in the development of pharmacotherapies for the treatment of alcohol dependence, the treatment community has been slow to adopt and implement these evidence-based practices. The proposed research addresses this research-to-practice gap by examining the adoption, diffusion, and implementation of the three most recent FDA approved pharmacotherapies for the treatment of alcohol dependence-naltrexone, acamprosate, and Vivitrol. The specific aims of the proposed research are threefold: (1) Describe, compare, and contrast trends in the adoption, diffusion and implementation of naltrexone, acamprosate.and Vivitrol by addiction treatment programs. (2) Identify key structural and workforce characteristics that facilitate or impede diffusion, adoption and implementation of these three pharmacotherapies over time. (3) Specify, test, and compare the "fit" of multivariate models predicting the adoption and implementation of the three pharmacotherapies. Data for the proposed research will be taken from the National Treatment Center Study (NTCS), a nationally representative, longitudinal study of 403 privatesector addiction treatment programs. Present and future NTCS data collections provide researchers the opportunity to examine the "real time" diffusion of acamprosate and Vivitrol into everyday treatment practice and to compare overall diffusion trends with naltrexone which received FDA approval in 1994. The proposed research will make significant contributions to the field of substance abuse health services by testing models of adoption and implementation as a product of both organizational and workforce level characteristics, testing for interactions between key organizational and workforce predictors, and utilizing multi-level and longitudinal data analysis techniques. The results of this research will provide important information about the organizational and workforce characteristics that shape the movement of research based medical technologies into everyday practice and provide a greater understanding of the barriers to adoption and implementation of pharmacotherapies. This information will be relevant to treatment providers, health researchers, and health policymakers as they seek to bridge the "research to practice gap" and improve access to quality treatment for persons suffering from alcoholism.