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）开发的传播模式，以促进对药物滥用的循证治疗的采用和利用。ATTCNE模式是为数不多的国家培训模式之一，旨在解决已知对采用和利用循证实践有重大影响的个人和组织因素。本项目的主要目的是检验ATTCNE模型促进了12个卫星美沙酮综合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治疗的假设。应急管理与现有的阿片成瘾治疗方法特别兼容，并提供了一个理想的试验案例，以模拟和评估不同的传播策略。在12家诊所内和诊所内的48名治疗提供者将接受CM的标准（教学）培训。使用附加设计，一半的站点将根据ATTCNE模型获得额外的培训和支持。CM的采用将以两种方式进行度量。首先，治疗提供者将根据CM激励措施的临床使用情况（如抽奖、代币、代金券等）被分类为采用者或非采用者。其次，采纳者对CM的利用将根据客户的数量进行量化，这些客户包括CM激励的临床使用。我们将进一步研究ATTCNE模型对以下因素的影响：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。两组的参与治疗提供者将在基线（初始CM培训）、3个月和12个月进行评估，以评估ATTCNE模型对相关结果的影响。将建立针对所有目标的可能效应量，为更大规模的后续研究做准备。许多药物滥用的有效治疗方法已经存在，但目前的治疗系统没有广泛使用。需要更好的方法来增加有效治疗的使用，并在改善治疗结果、节省经济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.