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

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.