Barriers to implementation of evidence-based addiction treatment: A national study

Lundgren, Lena; Chassler, Deborah; Amodeo, Maryann; D'Ippolito, Melinda; Sullivan, Lisa M.

doi:10.1016/j.jsat.2011.08.003

Cited by 47 publications

(53 citation statements)

References 27 publications

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“…In turn, the relationship between clinicians' intentions and their behaviors is moderated by the organizational barriers. The dual effect of culture and climate on intentions and barriers parallels research on innovation implementation and explains the influence of culture and climate on the adoption, implementation, and sustainment of EBTs and other innovations that has been established in many studies (1,4,9,14,18,21,29,55,56,64,75,112). Evidence has also shown that organizational culture impacts other employee behaviors (e.g., turnover) directly and indirectly through its effects on organizational climate (3,51,111).…”

Section: Mechanisms That Link Organizational Interventions and Socialmentioning

confidence: 90%

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

Glisson

Williams

2015

Annu. Rev. Public Health

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Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness.

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Section: Mechanisms That Link Organizational Interventions and Socialmentioning

confidence: 90%

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

Glisson

Williams

2015

Annu. Rev. Public Health

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“…The emerging literature on innovation implementation initially had a heavy emphasis on observational studies that documented the natural diffusion of evidence-based practices under natural conditions (Friedmann et al 2007; Knudsen et al 2011; Lundgren et al 2012; Miller et al 2006). More recently, the field of implementation science has been moving towards studies that explicitly compare how implementation strategies may be leveraged to increase the attainment of specific objectives.…”

Section: Applying Implementation Science To Inter-organizational Relamentioning

confidence: 99%

Effects of an Organizational Linkage Intervention on Inter-Organizational Service Coordination Between Probation/Parole Agencies and Community Treatment Providers

Welsh

Knudsen

Knight

et al. 2015

Adm Policy Ment Health

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Weak coordination between community correctional agencies and community-based treatment providers is a major barrier to diffusion of medication-assisted treatment (MAT)—the inclusion of medications (e.g., methadone and buprenorphine) in combination with traditional counseling and behavioral therapies to treat substance use disorders. In a multisite cluster randomized trial, experimental sites (j = 10) received a 3-h MAT training plus a 12-month linkage intervention; control sites (j = 10) received the 3-h training alone. Hierarchical linear models showed that the intervention resulted in significant improvements in perceptions of interagency coordination among treatment providers, but not probation/parole agents. Implications for policy and practice are discussed.

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“…Organizational factors associated with greater EBT engagement include larger program size (Guerrero et al, 2013), organizations that are younger (Lundgren et al, 2012), having better internet technology (Lundgren et al, 2011b), lower levels of organizational stress (Lundgren et al, 2012), accepting private insurance (Guerrero et al, 2013), the use of total quality management techniques (Fields and Roman, 2010), and supervisor expectations regarding EBT use (Guerrero et al, 2013). …”

Section: Introductionmentioning

confidence: 99%

“…Similarly, workforce factors associated with greater EBT engagement include higher levels of clinician education (Lundgren et al, 2011b) and clinical experience (Bride et al, 2010; Ducharme et al, 2010), positive attitudes to science-based treatments (Bride et al, 2010) as well as training in (Bride et al, 2010) and experience with specific EBTs (Bride et al, 2010; Lundgren et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities

Novins

Croy

Moore

et al. 2016

Drug and Alcohol Dependence

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Background Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes towards, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Methods Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes towards, and use of 9 psychosocial and 3 medication EBTs. Results Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). Conclusions EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination.

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Barriers to implementation of evidence-based addiction treatment: A national study

Cited by 47 publications

References 27 publications

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

Effects of an Organizational Linkage Intervention on Inter-Organizational Service Coordination Between Probation/Parole Agencies and Community Treatment Providers

Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities

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