Statewide System and Organizational Strategy for Evidence-Based Practice Implementation and Sustainment in Substance Use Disorder Treatment

项目总结摘要 美国国家卫生研究院要求测试有希望的实施战略(PAR-19-274)，迫切需要 实施和维持有效的循证做法(EBP)，以应对健康状况 包括物质使用障碍(SUDS)。这一拟议项目与NIDA的优先重点领域一致 “改进有效和可持续地实施循证预防和治疗的战略 干预措施(执行科学)。“大多数实施策略都没有解决复杂的多层次 在公共服务部门实施的背景。这一拟议的项目将扩大领导层和 实施组织变革(LOCI)干预，这是一种创新的组织变革战略，适用于 EBP的实施和维持，包括与全州精神卫生部和 上瘾(DMHA)和社区精神卫生中心(CMHC)，以协调州一级的领导 具有组织实施改进战略的政策和指令。肥皂水是最多的 复杂的公共卫生问题，印第安纳州在提供SUD服务方面排名第四，约有 8.5%的人口符合SUD的标准，其中只有13.6%的人寻求治疗。印第安纳州DMHA 与加州大学圣迭戈分校的现场团队联系，帮助实施综合激励增强 治疗/认知行为疗法(MET/CBT)这个项目的主要创新是，与 探索、准备、实施、可持续发展(EPIS)框架、制度和组织理论； 我们将向Loci添加一个系统级组件，目标是连接外部和内部上下文并开发 以及协调积极的执行环境，以支持执行和维持#年的MET/CBT 肥皂水。该项目将测试寻求协调、系统、组织和诊所的实施战略 实施和维持针对药物使用障碍的EBP的领导和战略。领导层和 实施的组织变革--系统一级(LOCI-SL)寻求改进实施 领导力、气候、提供商的态度和行为，以及EBP在服务中的忠诚度和客户参与度。基因座- SL将在全州范围的心理健康和成瘾服务系统及其社区心理健康中进行测试 中锋。

PROJECT SUMMARY ABSTRACT The NIH has called for testing promising implementation strategies (PAR-19-274) and there is a critical need for implementation and sustainment of effective and evidence-based practices (EBPs) to address health conditions including substance use disorders (SUDs). This proposed project is consistent with NIDA’s Priority Focus Area “Strategies to improve the effective and sustainable implementation of evidence-based prevention and treatment interventions (implementation science).” Most implementation strategies do not address the complex multilevel context for implementation in public service sectors. This proposed project will expand the Leadership and Organizational Change for Implementation (LOCI) intervention, an innovative organizational change strategy for EBP implementation and sustainment, to include partnership with a statewide Department of Mental Health and Addiction (DMHA) and Community Mental Health Centers (CMHCs) in order to align state-level leadership policies and directives with organizational implementation improvement strategies. SUDs are among the most complex of public health issues and Indiana ranks as the fourth worst state in providing SUD services with about 8.5% of the population meeting criteria for a SUD, of whom only 13.6% seek treatment. Indiana DMHA approached the UCSD LOCI team to aid in the implementation of combined Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT) The main innovation in this project is that, consistent with the Exploration, Preparation, Implementation, Sustainment (EPIS) framework and system and organizational theory, we will add a system level component to LOCI with the goal of bridging outer and inner context and developing and aligning a positive implementation climate to support implementation and sustainment of MET/CBT for SUDs. This project will test an implementation strategy that seeks to align, system, organization, and clinic leadership and strategies to implement and sustain an EBP for substance use disorders. The Leadership and Organizational Change for Implementation - System Level (LOCI-SL) seeks to improve implementation leadership, climate, provider attitudes and behaviors, and EBP fidelity and client engagement in services. LOCI- SL will be tested in a statewide mental health and addiction service system and its community mental health centers.