Increasing the uptake of medication-assisted treatment for opioid use disorder

项目总结 K23指导患者导向研究事业发展奖的目标是支持 申请人在发展必要的关键技能，以成为实施循证医学的专家 社区环境中药物滥用障碍的治疗。这个K23应用程序建议研究 解决NIDA战略计划的目标3.4：制定和测试有效和可持续的战略 实施循证治疗，特别是确定影响有效和 可持续地传播和实施治疗药物使用的循证做法 并改善获得有效成瘾干预措施的机会。指导团队由一名 学术-公共合作伙伴关系结合了凯尔·坎普曼的临床、学术和公共系统专业知识， 医学博士、医学博士杰夫·内马克和一个顾问团队。具体的培训目标是：1)深入了解 组织、资助和提供阿片类药物使用社区药物滥用治疗的知识 障碍，特别是与药物辅助治疗有关的障碍，2)使用基于理论的方法来识别 具体的组织、从业人员和政策层面的因素，可以用来增加执行力度 社区环境中的MAT；以及3)发展设计和方法方面的专业知识，以进行随机化 试行组织战略，以在社区环境中更多地使用地垫，其中将包括：a) 基于理论的混合多层次有效性--实施研究设计和b)分析 用于衡量相关结果的行政(基于索赔的)数据。本K23中提出的研究将 重点关注以前没有采用MAT的机构。先前的研究和我们的试点数据表明有两个 未采用MAT的人的类别：障碍主要是意识形态/态度的人，以及 障碍在很大程度上是实际的/后勤的。拟议研究的目标是调查这两类 社区提供者之间的障碍，并开发一个资源包来支持未来的倡议 提高垫片能力。具体地说，申请人建议：1)确定哪些组织因素和 执行董事的特征与物质使用障碍治疗组织的(N)相关 =117)为响应鼓励采用MAT的政策而作出的决定，2)评估执行情况 为响应倡议而采用MAT的机构子集的成功，确定了可延展性 导致成功实施的组织和心理因素以及3)开发资源 一揽子MAT采用和实施战略，使用已建立的工具，并确定新的领域 未来的研究和探索。在这个项目的过程中，申请者将发展批判性知识。 社区成瘾治疗、实施科学和公共政策方面的技能，以及 经验丰富且成熟的导师团队。

PROJECT SUMMARY The goal of this K23 Mentored Patient-Oriented Research Career Development Award is to support the applicant in developing the critical skills necessary to become an expert in implementing evidence-based treatments for substance abuse disorders in community settings. This K23 application proposes research to address Objective 3.4 of the NIDA Strategic Plan: Develop and test strategies for effectively and sustainably implementing evidence-based treatments, specifically identifying factors that influence effective and sustainable dissemination and implementation of evidence-based practices for treatment of substance use disorders and improving access to effective addiction interventions. The mentorship team comprises an academic-public partnership that combines clinical, academic, and public system expertise in Kyle Kampman, MD, Geoff Neimark, MD, and a team of advisors. The specific trainings goals are to 1) Gain an in-depth knowledge of the organization, financing, and delivery of community substance abuse treatment for opioid use disorder, specifically as it relates to medication-assisted treatment, 2) Use theory-based approaches to identify specific organizational, practitioner and policy-level factors that could be leveraged to increase implementation of MAT in community settings; and 3) Develop expertise in designs and methods for conducting randomized trials of organizational strategies to increase the use of MAT in community settings, which will include: a) theory-based hybrid multi-level effectiveness-implementation research designs and b) analysis of administrative (claims-based) data to measure relevant outcomes. The research proposed in this K23 will focus on agencies that have not previously adopted MAT. Prior research and our pilot data suggest two categories of MAT non-adopters: those whose barriers are primarily ideological/attitudinal and those whose barriers are largely practical/logistical. The goal of the proposed study is to investigate both categories of barriers among community providers, and to develop a resource package to support future initiatives to enhance MAT capacity. Specifically, the applicant proposes to: 1) Determine what organizational factors and characteristics of executive directors are associated with a substance use disorder treatment organization’s (n = 117) decision to adopt in response to a policy incentivizing MAT adoption, 2) Evaluate the implementation success of the subset of agencies who adopt MAT in response to the initiative, identifying malleable organizational and psychological factors that lead to successful implementation and 3) Develop a resource package of MAT adoption and implementation strategies using established tools and identifying new areas for future research and exploration. Over the course of this project the applicant will develop critical knowledge and skills in community addiction treatment, implementation science, and public policy, with the expertise of an experienced and established team of mentors.