Abstract
We evaluated organizational factors associated with the implementation of contingency management treatment (CMT) and medication-assisted treatment (MAT) in substance abuse treatment (SAT) programs serving racial and ethnic minority communities. Analysis of cross-sectional data collected in 2010–2011 from a random sample of 148 publicly funded SAT programs showed that accepting private insurance was positively associated with CMT and MAT implementation, whereas larger programs were associated with greater implementation of MAT. Supervisorial openness to and expectations about implementing evidence-based practices (EBPs) and attributes for change were strongly associated with CMT, whereas the interactions between openness to EBPs and programs that accept private insurance and that are governed by parent organizations were positively associated with MAT. These external expectations and managerial attitudes supported the implementation of psychosocial and pharmacotherapy treatments in SAT. Implications for improving standards of care in minority communities are discussed.
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Aarons, G. A. (2004). Mental health provider attitudes toward adoption of evidence-based practice: The evidence-based practice attitude scale (EBPAS). Mental Health Services Research, 6, 61–74. doi:10.1023/B:MHSR.0000024351.12294.65.
Aarons, G. A. (2005). Measuring provider attitudes toward evidence-based practice: Consideration of organizational context and individual differences. Child and Adolescent Psychiatric Clinics of North America, 14, 255–271. doi:10.1016/j.chc.2004.04.008.
Aarons, G. A. (2006). Transformational and transactional leadership: Association with attitudes toward evidence-based practice. Psychiatric Services, 57, 1162–1169. doi:10.1176/appi.ps.57.8.1162.
Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011a). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38, 4–23. doi:10.1007/s10488-010-0327-7.
Aarons, G. A., & Palinkas, L. A. (2007). Implementation of evidence-based practice in child welfare: Service provider perspectives. Administration and Policy in Mental Health and Mental Health Services Research, 34, 411–419. doi:10.1007/s10488-007-0121-3.
Aarons, G. A., Sommerfeld, D. H., & Willging, C. E. (2011b). The soft underbelly of system change: The role of leadership and organizational climate in turnover during statewide behavioral health reform. Psychological Services, 8, 269–281. doi:10.1037/a0026196.
Abraham, A. J., Knudsen, H. K., Rothrauff, T. C., & Roman, P. M. (2010). The adoption of alcohol pharmacotherapies in the Clinical Trials Network: The influence of research network participation. Journal of Substance Abuse Treatment, 38, 275–283. doi:10.1016/j.jsat.2010.01.003.
Adams, A. S., Soumerai, S. B., Lomas, J., & Ross-Degnan, D. (1999). Evidence of self-report bias in assessing adherence to guidelines. International Journal for Quality in Health Care, 11, 187–192. doi:10.1093/intqhc/11.3.187.
Alegría, M., Page, J. B., Hansen, H., Cauce, A. M., Robles, R., Blanco, C., et al. (2006). Improving drug treatment services for Hispanics: Research gaps and scientific opportunities. Drug and Alcohol Dependence, 84, S76–S84. doi:10.1016/j.drugalcdep.2006.05.009.
Allison, P. D. (2002). Missing data. Thousand Oaks: Sage.
Alvarez, J., Olson, B. D., Jason, L. A., Davis, M. I., & Ferrari, J. R. (2004). Heterogeneity among Latinas and Latinos entering substance abuse treatment: Findings from a national database. Journal of Substance Abuse Treatment, 26, 277–284. doi:10.1016/j.jsat.2004.02.003.
Amaro, H., Arévalo, S., Gonzalez, G., Szapocznik, J., & Iguchi, M. Y. (2006). Needs and scientific opportunities for research on substance abuse treatment among Hispanic adults. Drug and Alcohol Dependence, 84, S64–S75. doi:10.1016/j.drugalcdep.2006.05.008.
Amass, L., Ling, W., Freese, T. E., Reiber, C., Annon, J. J., Cohen, A. J., et al. (2004). Bringing buprenorphine-naloxone detoxification to community treatment providers: The NIDA Clinical Trials Network field experience. American Journal on Addictions, 13, S42–S66. doi:10.1080/10550490490440807.
Bergkvist, L., & Rossiter, J. R. (2007). The predictive validity of multiple-item versus single-item measures of the same constructs. Journal of Marketing Research, 44, 175–184. doi:10.1509/jmkr.44.2.175.
Bride, B. E., Abraham, A. J., & Roman, P. M. (2010). Diffusion of contingency management and attitudes regarding its effectiveness and acceptability. Substance Abuse, 31, 127–135. doi:10.1080/08897077.2010.495310.
Bride, B. E., Abraham, A. J., & Roman, P. M. (2011). Organizational factors associated with the use of contingency management in publicly funded substance abuse treatment centers. Journal of Substance Abuse Treatment, 40, 87–94. doi:10.1016/j.jsat.2010.08.001.
Broome, K. M., Flynn, P. M., Knight, D. K., & Simpson, D. D. (2007). Program structure, staff perceptions, and client engagement in treatment. Journal of Substance Abuse Treatment, 33, 149–158. doi:10.1016/j.jsat.2006.12.030.
US Census Bureau (2010). Census bureau releases state and county data depicting nation’s population ahead of 2010 census. Accessed on October 12, 2012. http://www.census.gov/newsroom/releases/archives/population/cb09-76.html.
Center for Substance Abuse Treatment. (2006). Addiction counseling competencies: The knowledge, skills, and attitudes of professional practice (TAP Series 21, DHHS Publication No. SMA 06-4171). Rockville: Substance Abuse and Mental Health Services Administration.
Center for Substance Abuse Treatment. (2009a). Clinical supervision and professional development of the substance abuse counselor (TIP Series 52, DHHS Publication No. SMA 09-4377). Rockville: Substance Abuse and Mental Health Services Administration.
Center for Substance Abuse Treatment. (2009b). Implementing change in substance abuse treatment programs (TIP Series 31, DHHS Publication No. SMA 09-4377). Rockville: Substance Abuse and Mental Health Services Administration.
Chaffin, M., & Friedrich, B. (2004). Evidence-based treatments in child abuse and neglect. Children and Youth Services Review, 26, 1097–1113. doi:10.1016/j.childyouth.2004.08.008.
Claus, R., Gotham, H., Harper-Chang, L., Selig, K., & Homer, A. L. (2007, 17 Oct). Leadership style and dual diagnosis capability: Does transformational leadership make a difference. Paper presented at Addiction Health Services Research Annual Conference, Athens, GA.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Mahwah: Lawrence Erlbaum.
Courtney, K. O., Joe, G. W., Rowan-Szal, G. A., & Simpson, D. D. (2007). Using organizational assessment as a tool for program change. Journal of Substance Abuse Treatment, 33, 131–137. doi:10.1016/j.jsat.2006.12.024.
Cunningham, C., Giovanniello, A., Sacajiu, G., Whitley, S., Mund, P., Beil, R., et al. (2008). Buprenorphine treatment in an urban community health center: What to expect. Family Medicine, 40, 500–506.
D’Aunno, T. A. (2006). The role of organization and management in substance abuse treatment: Review and roadmap. Journal of Substance Abuse Treatment, 31, 221–233. doi:10.1016/j.jsat.2006.06.016.
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4, 50. doi:10.1186/1748-5908-4-50.
Delva, J., Wallace, J. M, Jr, O’Malley, P. M., Bachman, J. G., Johnston, L. D., & Schulenberg, J. E. (2005). The epidemiology of alcohol, marijuana, and cocaine use among Mexican American, Puerto Rican, Cuban American, and other Latin American eighth-grade students in the United States: 1991–2002. American Journal of Public Health, 95, 696–702. doi:10.2105/AJPH.2003.037051.
Ducharme, L. J., Knudsen, H. K., Roman, P. M., & Johnson, J. A. (2007). Innovation adoption in substance abuse treatment: Exposure, trialability, and the Clinical Trials Network. Journal of Substance Abuse Treatment, 32, 321–329. doi:10.1016/j.jsat.2006.05.021.
Edwards, J. R., Knight, D. K., Broome, K. M., & Flynn, P. M. (2010). The development and validation of a transformational leadership survey for substance use treatment programs. Substance Use and Misuse, 45, 1279–1302. doi:10.3109/10826081003682834.
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, National Implementation Research Network.
Friedmann, P. D., Jiang, L., & Alexander, J. A. (2010). Top manager effects on buprenorphine adoption in outpatient substance abuse treatment programs. Journal of Behavioral Health Services & Research, 37, 322–337. doi:10.1007/s11414-009-9169-z.
Fuller, B. E., Rieckmann, T., Nunes, E. V., Miller, M., Arfken, C., Edmundson, E., et al. (2007). Organizational readiness for change and opinions toward treatment innovations. Journal of Substance Abuse Treatment, 33, 183–192. doi:10.1016/j.jsat.2006.12.026.
Gill, D. P., Jones, G. R., Zou, G., & Speechley, M. (2012). Using a single question to assess physical activity in order adults: A reliability and validity study. BMC Medical Research Methodology, 12, 20. doi:10.1186/1471-2288-12-20.
Greenhalgh, T., Robert, G., MacFarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quarterly, 82, 581–629. doi:10.1111/j.0887-378X.2004.00325.x.
Guerrero, E. G. (2010). Managerial capacity and adoption of culturally competent practices in outpatient substance abuse treatment organizations. Journal of Substance Abuse Treatment, 39, 329–339. doi:10.1016/j.jsat.2010.07.004.
Guerrero, E. G. (2012). Organizational characteristics that foster early adoption of cultural and linguistic competence in outpatient substance abuse treatment in the United States. Evaluation and Program Planning, 35, 9–15. doi:10.1016/j.evalprogplan.2011.06.001.
Guerrero, E. G. (2013a). Workforce diversity in outpatient substance abuse treatment: The role of leaders’ characteristics. Journal of Substance Abuse Treatment, 44, 208–215. doi:10.1016/j.jsat.2012.05.004.
Guerrero, G. E. (2013b). Managerial challenges and strategies to implementing organizational change in substance abuse treatment for Latinos. Administration in Social Work,. doi:10.1080/03643107.2012.686009.
Guerrero, E., & Andrews, C. M. (2011). Cultural competence in outpatient substance abuse treatment: Measurement and relationship to wait time and retention. Drug and Alcohol Dependence, 119, e13–e22. doi:10.1016/j.drugalcdep.2011.05.020.
Hartzler, B., Donovan, D. M., Tillotson, C. J., Mongoue-Tchokote, S., Doyle, S. R., & McCarty, D. (2012). A multilevel approach to predicting community addiction treatment attitudes about contingency management. Journal of Substance Abuse Treatment, 42, 213–221. doi:10.1016/j.jsat.2011.10.012.
Haug, N. A., Shopshire, M., Tajima, B., Gruber, V., & Guydish, J. (2008). Adoption of evidence-based practices among substance abuse treatment providers. Journal of Drug Education, 38, 181–192. doi:10.2190/DE.38.2.f.
Institute of Medicine. (2006). Improving the quality of health care for mental and substance-use conditions. Washington: National Academies Press.
Knudsen, H. K., Abraham, A. J., & Roman, P. M. (2011). Adoption and implementation of medications in addiction treatment programs. Journal of Addiction Medicine, 5, 21–27. doi:10.1097/ADM.0b013e3181d41ddb.
Knudsen, H. K., Ducharme, L. J., & Roman, P. M. (2006). Early adoption of buprenorphine in substance abuse treatment centers: Data from the private and public sectors. Journal of Substance Abuse Treatment, 30, 363–373. doi:10.1016/j.jsat.2006.03.013.
Knudsen, H. K., Ducharme, L. J., Roman, P. M., & Link, T. (2005). Buprenorphine diffusion: The attitudes of substance abuse treatment counselors. Journal of Substance Abuse Treatment, 29, 95–106. doi:10.1016/j.jsat.2005.05.002.
Korthuis, P. T., Tozzi, M. J., Nandi, V., Fiellin, D. A., Weiss, L., Egan, J. E., et al. (2011). Improved quality of life for opioid-dependent patients receiving buprenorphine treatment in HIV clinics. Journal of Acquired Immune Deficiency Syndromes, 56, S39–S45. doi:10.1097/QAI.0b013e318209754c.
Lee, N., & Cameron, J. (2009). Differences in self and independent ratings on an organisational dual diagnosis capacity measure. Drug and Alcohol Review, 28, 682–684. doi:10.1111/j.1465-3362.2009.00116.x.
Lehman, W. E. K., Greener, J. M., & Simpson, D. D. (2002). Assessing organizational readiness for change. Journal of Substance Abuse Treatment, 22, 197–209. doi:10.1016/S0740-5472(02)00233-7.
Ling, W., & Compton, P. (2005). Recent advances in the treatment of opiate addiction. Clinical Neuroscience Research, 5, 161–167. doi:10.1016/j.cnr.2005.08.012.
Marsh, J. C., Cao, D., Guerrero, E., & Shin, H.-C. (2009). Need-service matching in substance abuse treatment: Racial/ethnic differences. Evaluation and Program Planning, 32, 43–51. doi:10.1016/j.evalprogplan.2008.09.003.
McCarty, D., Argeriou, M., Denmead, G., & Dilonardo, J. (2001). Public sector managed care for substance abuse treatment: Opportunities for health services research. Journal of Behavioral Health Services & Research, 28, 143–154. doi:10.1007/BF02287457.
McCarty, D., Fuller, B. E., Arfken, C., Miller, M., Nunes, E. V., Edmundson, E., et al. (2007). Direct care workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, opinions, and beliefs. Psychiatric Services, 58, 181–190. doi:10.1176/appi.ps.58.2.181.
National Council for Community Behavioral Healthcare. (2012). Training & development: Addressing Health Disparities Leadership Program. Retrieved from http://www.thenationalcouncil.org/cs/addressing_health_disparities_leadership_program.
Office of Applied Studies. (2007). Substance abuse treatment facilities provide programs to fit clients. Rockville: Substance Abuse and Mental Health Services Administration.
Oser, C., Knudsen, H., Staton-Tindall, M., & Leukefeld, C. (2009). The adoption of wraparound services among substance abuse treatment organizations serving criminal offenders: The role of a women-specific program. Drug and Alcohol Dependence, 103, S82–S90. doi:10.1016/j.drugalcdep.2008.12.008.
Packard, T. (2009). Leadership and performance in human services organizations. In R. J. Patti (Ed.), Handbook of Human Services Management (2nd ed., pp. 143–164). Thousand Oaks: Sage.
Petry, N. M., & Simcic, F, Jr. (2002). Recent advances in the dissemination of contingency management techniques: Clinical and research perspectives. Journal of Substance Abuse Treatment, 23, 81–86. doi:10.1016/S0740-5472(02)00251-9.
Pfeffer, J., & Salancik, G. R. (1978). The external control of organizations: A resource dependence perspective. New York: Harper & Row.
Prendergast, M., Podus, D., Finney, J., Greenwell, L., & Roll, J. (2006). Contingency management for treatment of substance use disorders: A meta-analysis. Addiction, 101, 1546–1560. doi:10.1111/j.1360-0443.2006.01581.x.
Raudenbush, S. W., & Liu, X. (2000). Statistical power and optimal design for multisite randomized trials. Psychological Methods, 5, 199–213. doi:10.1037/1082-989X.5.2.199.
Roman, P. M., Abraham, A. J., & Knudsen, H. K. (2011). Using medication-assisted treatment for substance use disorders: Evidence of barriers and facilitators of implementation. Addictive Behaviors, 36, 584–589. doi:10.1016/j.addbeh.2011.01.032.
Roman, P. M., Ducharme, L. J., & Knudsen, H. K. (2006). Patterns of organization and management in private and public substance abuse treatment programs. Journal of Substance Abuse Treatment, 31, 235–243. doi:10.1016/j.jsat.2006.06.017.
Saldana, L., Chapman, J. E., Henggeler, S. W., & Rowland, M. D. (2007). The organizational readiness for change scale in adolescent programs: Criterion validity. Journal of Substance Abuse Treatment, 33, 159–169. doi:10.1016/j.jsat.2006.12.029.
Simpson, D. D., & Flynn, P. M. (2007). Moving innovations into treatment: A stage-based approach to program change. Journal of Substance Abuse Treatment, 33, 111–120. doi:10.1016/j.jsat.2006.12.023.
Swain, K., Whitley, R., McHugo, G. J., & Drake, R. E. (2010). The sustainability of evidence-based practices in routine mental health agencies. Community Mental Health Journal, 46, 119–129. doi:10.1007/s10597-009-9202-y.
Walsh, S. L., & Eissenberg, T. (2003). The clinical pharmacology of buprenorphine: Extrapolating from the laboratory to the clinic. Drug and Alcohol Dependence, 70, S13–S27. doi:10.1016/S0376-8716(03)00056-5.
Zaller, N. D., Bazazi, A. R., Velazquez, L., & Rich, J. D. (2009). Attitudes toward methadone among out-of-treatment minority injection drug users: Implications for health disparities. International Journal of Environmental Research and Public Health, 6, 787–797. doi:10.3390/ijerph6020787.
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Guerrero, E.G., He, A., Kim, A. et al. Organizational Implementation of Evidence-Based Substance Abuse Treatment in Racial and Ethnic Minority Communities. Adm Policy Ment Health 41, 737–749 (2014). https://doi.org/10.1007/s10488-013-0515-3
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DOI: https://doi.org/10.1007/s10488-013-0515-3