205410 Implementation of evidence-based substance abuse treatment by community-based organizations: Preliminary results from a national study

Tuesday, November 10, 2009

Lena Lundgren, PhD , School of Social Work, Boston University, Boston, MA
Maryann Amodeo, PhD , Center for Addictions Research and Services, Boston University, Boston, MA
Amanda Horowitz, MSW , BU School of Social Work, Center for Addictions Research and Services, Boston, MA
Deborah Chassler, MSW , School of Social Work, Boston University, Boston, MA
Lisa De Saxe Zerden, MSW, PhD , School of Social Work, Boston University, Boston, MA
Rebekah Gowler, MSW, MPH , Center for Health Equity and Social Justice, Boston Public Health Commission, Boston, MA
Alexander Cohen, BA , Center for Addictions Research and Services, Boston University, Boston, MA
Sara Keller, BS , Center for Addictions Research and Services, Boston University, Boston, MA
Objective: Federal grants for substance-abuse treatment require that community-based organizations (CBOs) implement evidence-based treatments (EBTs). Results from a national Robert Wood Johnson Foundation- funded study describe CBO variations in organizational responses to federal EBT requirements.

Methods: Data from semi-structured phone-interviews with 120 directors and staff from CBOs funded by Substance Abuse Mental Health Services Administration (SAMHSA) were analyzed using qualitative methods. Researchers explored: the degree to which CBOs implemented proposed EBTs; fidelity to the EBTs; and barriers/ facilitating factors to EBT implementation.

Findings: Three themes emerged: 1.The language in the request for applications (RFA) influenced CBO's decisions to implement EBTs. RFAs prior to 2006 strongly recommended but did not mandate EBTs; later RFAs mandated EBTs. Earlier grantees perceived greater leeway in implementing services, using statements such as, “do not remember what we proposed,” “were not required to implement EBTs” and “no EBT training was conducted.” 2.Earlier-funded project directors and staff were less congruent in their EBT descriptions; more often staff were unaware of the title or specific components of the EBT. 3.A larger number of later grantees seemed to be research institutions.

Implications: An unintended consequence of new mandates for EBTs may be that fewer CBOs apply for federal funding. Instead, a greater number of research institutions receive this funding. If federal funders want to fund CBOs, further specifications about CBO and research institution collaborations are needed.

Learning Objectives:
1) Understand the extent to which CBOs with the mandate to implement EBTs for substance-abuse treatment are doing so. 2) Identify results that can be used to strengthen government substance abuse policies promoting the use of EBTs among CBO treatment providers.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Director of Research at the BU School of Social Work and Co-Principle Investigator on this RWJ-funded project, I am fully qualified to present these preliminary results. I have served as PI on numerous national grants from the Robert Wood Johnson (RWJ) Foundation as well as the Substance Abuse and Mental Health Services Administration (SAMHSA) to conduct research and evaluation of substance abuse interventions and HIV prevention initiatives.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.