Impact of Core Implementation Components on Adoption

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In recent years the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) has made significant gains in testing the effectiveness of promising addiction treatments, and disseminating findings about those treatments to the field. At the same time, drug abuse treatment systems nationwide face a trend toward the increasing use of evidence-based practices. In the context of these complimentary efforts and trends, the translation of research findings to meet practice needs has gained prominence. A number of theoretical perspectives and constructs have been advanced, yet establishing their usefulness offers singular challenge due to the range of factors thought to impact research translation, and the number of programs and long time horizon needed to assess research translation outcomes. As a laboratory for translational research, where studies are conducted in partnership with Ureal world" community clinics, the CTN allows observation of the process of effectiveness research over time, from protocol conceptualization through implementation and into the post-study period. In collaboration with CTN protocol 0031 (Stimulant Abuser Groups to Engage in 12Step: STAGE-12), this study will assess relationships relevant to the translation of research into practice: a) how the fidelity of STAGE-12 implementation impacts client outcomes, b) whether commonly hypothesized counselor and organizational variables affect treatment fidelity, and c) uptake of the STAGE 12 intervention in participating clinics after the trial ends. In exploratory analyses, the project will model these multiple relationships for their impact on intervention adoption after the clinical trial ends. Although prior research has examined individual relationships among these variables, this study will assessing multiple relationships in the context of a multi-site clinical trial, extending observation to encompass pre-implementation, during implementation, and post implementation measures and constructs. The short term goal of the project is to assess key relationships in a theoretically driven model of implementation, using the CTN STAGE-12 study as a research platform. The 16ng term goal is to speed the translation of CTN research findings to implementation, so that clinics can more readily adopt research based interventions, and more effectively treat the persons families, and communities they serve.