Training Drug Treatment Providers to Adopt Evidence-Based Practices

描述（由申请人提供）：本项目将评估由新英格兰成瘾技术转移中心（ATTCNE）开发的传播模型，以促进药物滥用循证治疗的采用和利用。ATTCNE模式是为数不多的几个国家培训模式之一，以解决个人和组织因素，已知显着影响采用和利用循证实践。该项目的主要目的是检验这一假设，即ATTCNE模型促进了12个综合卫星美沙酮治疗诊所的治疗提供者更多地采用和利用应急管理（CM）作为阿片类药物成瘾的治疗。应急管理与现有的阿片类药物成瘾治疗方法特别兼容，并提供了一个理想的测试案例，以模拟和评估不同的传播策略。48个治疗提供者嵌套和跨12个诊所将接受标准（教学）的CM培训。通过使用添加剂设计，一半的站点将根据ATTCNE模型接受额外的培训和支持。将以两种方式衡量变革管理的采用情况。首先，治疗提供者将根据CM激励措施（例如抽奖、代币、代金券等）的临床使用情况被分类为采用者或非采用者。其次，采用者对CM的利用率将根据他们包括临床使用CM激励措施的客户数量进行量化。我们将进一步研究ATTCNE模型对以下方面的影响：1）治疗提供者在个人和组织因素中采用CM的准备程度，2）治疗提供者对CM的态度，以及3）治疗提供者对所采用的培训方法的态度。将在基线（初始CM培训）、3个月和12个月时对两组中的参与治疗提供者进行评估，以评价ATTCNE模型对关注结局的影响。将确定针对所有目标的可能效应量，为更大规模的随访研究做准备。药物滥用的许多有效治疗方法已经存在，但没有被当前的治疗系统广泛使用。需要更好的方法来增加有效治疗的使用，并将在改善治疗结果，经济节约和整体生活质量方面使公众受益。

DESCRIPTION (provided by applicant): This project will evaluate a dissemination model developed by the Addiction Technology Transfer Center of New England (ATTCNE) to promote the adoption and utilization of evidence-based treatments for substance abuse. The ATTCNE model is one of only a few national training models to address both individual and organizational factors known to significantly influence the adoption and utilization of evidence-based practices. The principal aim of this project is to test the hypothesis that the ATTCNE model promotes increased adoption and utilization of Contingency Management (CM) as a treatment for opiate addiction among treatment providers across 12 integrated satellite methadone treatment clinics. Contingency Management is particularly compatible with existing treatment methods for opiate addiction, and provides an ideal test case to model and evaluate different dissemination strategies. Forty-eight treatment providers nested within and across the 12 clinics will receive standard (didactic) training in CM. Using an additive design, half of the sites will receive additional training and support in accordance with the ATTCNE model. Adoption of CM will be measured in two ways. First, treatment providers will be classified as adopters or non-adopters based on any clinical use of CM incentives (e.g. prize drawings, tokens, vouchers, etc.). Second, utilization of CM by adopters will be quantified based on the number of clients with whom they include the clinical use of CM incentives. We will further examine the impact of the ATTCNE model on: 1) readiness to adopt CM among treatment providers across personal and organizational factors, 2) treatment provider attitudes toward CM, and 3) treatment provider attitudes toward the training methods employed. Participating treatment providers in both groups will be assessed at baseline (initial CM training), 3, and 12 months to evaluate the impact of the ATTCNE model on outcomes of interest. Likely effect sizes specific to all aims will be established to prepare for a larger follow-up study. Lay Description: Many effective treatments for substance abuse already exist, but are not widely used by the current treatment system. Better methods to increase the use of effective treatments are needed, and would benefit the public in terms of improved treatment outcomes, economic savings, and overall quality of life.