This article presents models of the diffusion of innovation and how they can assist behavioral health systems and providers in not just acquiring, but implementing technological advances within their organizations. Through the case study of a multimedia substance abuse screening program (the Addiction Severity Index Multimedia Version [ASI-MV]), the authors use various perspectives on the diffusion of this innovation to illustrate how the early adoption of this technology has taken place in many behavioral health care settings. The reasons for the relatively successful diffusion of the ASI-MV, as well as the problems that have impeded even wider use, are addressed.The use of an innovation is dependent on far more than simply building a better mousetrap. Although various computer mediated technological advances (e.g., e-mail; online chat; handheld computing devices, such as personal digital assistants [PDAs]; multimedia programs; the Internet; and telephone interactive voice recognition, or IVR) have been available to those offering health care services for quite some time, acceptance has been relatively slow.In this article, through the case example of a computerized multimedia substance abuse screening program that simulates a human interviewer, we describe the early stages of innovation adoption in behavioral health care, particularly substance abuse treatment; discuss how and why this innovation has begun to gain acceptance and problems that have yet to be overcome; and discuss theories of innovation diffusion that clarify effective ways to persuade behavioral health systems and practitioners to adopt technological advances that enhance treatment quality and are cost-effective.

Objectives People tend to disclose more personal information when communication is mediated through the use of a computer. This study was conducted to examine the impact of this phenomenon on the way respondents answer questions during computer-mediated, self-administration of the Addiction Severity Index (ASI) called the Addiction Severity Index–Multimedia Version® (ASI-MV®). Methods A sample of 142 clients in substance abuse treatment was administered the ASI via an interviewer and the computerized ASI-MV®, three to five days apart in a counterbalanced order. Seven composite scores were compared between the two test administrations using paired t-tests. Post hoc analyses examined interviewer effects. Results Comparisons of composite scores for each of the domains between the face-to-face administered and computer-mediated, self-administered ASI revealed that significantly greater problem severity was reported by clients in five of the seven domains during administration of the computer-mediated, self-administered version compared to the trained interviewer version. Item analyses identified certain items as responsible for significant differences, especially those asking clients to rate need for treatment. All items that were significantly different between the two modes of administration revealed greater problem severity reported on the ASI-MV® as compared to the interview administered assessment. Post hoc analyses yielded significant interviewer effects on four of the five domains where differences were observed. Conclusions These data support a growing literature documenting a tendency for respondents to be more self-disclosing in a computer-mediated format over a face-to-face interview. Differences in interviewer skill in establishing rapport may account for these observations.

These results provide strong preliminary support for the SOAPP-8 as a brief screening tool of aberrant opioid-related behavior in chronic pain patients.

The current study was conducted to construct and validate a computer-delivered, multimedia, substance use self-assessment for adolescents. Reliability and validity of six problem dimensions were evaluated in two studies, conducted from 2003 to 2008. Study 1 included 192 adolescents from five treatment settings throughout the United States (N = 142) and two high schools from Greater Boston, Massachusetts (N = 50). Study 2 included 356 adolescents (treatment: N = 260; school: N = 94). The final version of Comprehensive Health Assessment for Teens (CHAT) demonstrated relatively strong psychometric properties. The limitations and implications of this study are noted. This study was supported by an SBIR grant.