223646 Barriers to effective implementation of evidence-based practices in community-based addiction treatment organizations: Findings on use of rigorous treatment models from a nationwide sample

Monday, November 8, 2010

Alexander Cohen, MSW , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Lena Lundgren, PhD , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Maryann Amodeo, PhD, MSW , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Deborah Chassler, MSW , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
Dylan Rose, BA , Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA
  
Objectives: This Robert Wood Johnson Foundation, Substance Abuse Policy Research Program funded study examined implementation of evidence-based practices (EBPs) by 250 community-based addiction treatment organizations (CBOs) nationwide. This preliminary research effort explores the range of social and behavioral EBPs selected for addiction treatment by the CBOs. It also explored the relationship between CBO project directors' (PDs) satisfaction with the EBPs selected and the models' levels of rigor and complexity.

Methods: Quantitative and qualitative data from online surveys and semi-structured phone interviews completed by 250 CBO project directors were analyzed using one-way ANOVA tests and qualitative methods. PD ratings of barriers to EBP implementation were compared to interviewers' ratings of these barriers' interference.

Findings: Project directors (PDs) described being highly satisfied with the EBPs selected, and the great majority perceived the EBPs used as being valuable to the addiction treatment field. However, PDs expressed significantly less positive attitudes both about implementing more rigorous EBPs and implementing EBPs specifically mandated by the grantor, SAMHSA. PDs reported significantly higher levels of barrier when implementing more rigorous or SAMHSA-mandated EBPs. Finally, PD and interviewers' ratings of barrier significance were more disparate for more rigorous EBPs and those that projects were mandated to implement.

Implications: Effectively implementing EBPs in addiction treatment CBOs requires awareness of anticipated barriers to program services. Addiction treatment researchers need to continue to investigate organizational conditions and EBP characteristics that may obstruct effective EBP implementation. Treatment outcomes could be improved by providing greater technical support to agencies implementing more rigorous EBPs.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
1. Explain the concept of ‘rigor’ as it pertains to EBPs for addiction treatment. 2. Describe effects of prescriptive practice on treatment implementation and provider attitudes. 3. Discuss considerations for government policy that would support CBOs in providing effective, feasible treatment services.

Keywords: Community-Based Public Health, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been integral in the design, data collection and data analysis of this study, and also have clinical experience as a clinician providing community-based substance abuse treatment
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.

Back to: 3194.0: Alcohol, Tobacco, and Drug Related Health Issues