R01DA051545

Comparing Two Federal Financing Strategies on Treatment Penetration and Sustainment - Project Summary/Abstract

Sustained, widespread availability of evidence-based practices (EBPs) is essential to addressing the public health and societal impacts of adolescent substance use disorders (SUD), as recognized by the NIDA priority (Strategic Objective 3.4) to investigate strategies for effective and sustainable implementation of EBPs. There remains a particularly significant need to identify effective financing strategies, which secure and direct financial resources to support essential activities for EBP implementation and sustainment, and overcome cost-related barriers to the availability of effective adolescent SUD treatments.

The proposed R01 project will compare the effects of two SAMHSA grant mechanisms (i.e., financing strategies), which supported the adoption of an EBP for adolescent SUD, the Adolescent Community Reinforcement Approach, through either organization-focused or state-focused granting of funds. The Exploration-Preparation-Implementation-Sustainment framework will guide our study aims, hypotheses, and selection of measures.

The interdisciplinary project team – consisting of experts in implementation science, adolescent SUD treatment, health economics, public policy, and statistics – will employ a longitudinal, mixed method (i.e., quantitative surveys and qualitative interviews, document review, and focus groups), quasi-experimental design to compare the grant types' outcomes and examine theoretically-informed mediators and moderators.

Aim 1 will examine penetration of the Adolescent Community Reinforcement Approach among eligible clinicians (i.e., proportion certified with adequate fidelity) and clients (i.e., proportion receiving the treatment) at the end of SAMHSA funding; and Aim 2 will examine sustainment of the treatment model, using a 10-element composite measure of treatment delivery and supervision activities, up to 5 years post-funding.

Our approach aligns with a previous grant (R01AA021217), enabling integration of the data we collect from state-focused grant recipients (85 organizations in 19 states) with previously collected data on implementation and sustainment outcomes among organization-focused grant recipients (84 organizations in 26 states). We will also evaluate non-equivalent dependent variables (i.e., outcomes that are not expected to change as a result of grant type) to control for key observable, time-varying cohort effects within our quasi-experimental study design.

Finally, Aim 3 will use comparative case study methods to identify policy implications for promoting EBP penetration and sustainability through integration of our diverse quantitative and qualitative measures. The proposed research will have immediate, practical implications for behavioral health administrators, policymakers, implementation experts, and the public with new knowledge that can directly inform financing strategies to support large-scale, sustained EBP delivery in behavioral health – while simultaneously advancing the emergent implementation science field through use of novel methods to study financing strategies and sustainment outcomes.

RAND Corporation

TO SUPPORT BASIC AND CLINICAL NEUROSCIENCE, BIOMEDICAL, BEHAVIORAL AND SOCIAL SCIENCE, EPIDEMIOLOGIC, HEALTH SERVICES AND HEALTH DISPARITY RESEARCH. TO DEVELOP NEW KNOWLEDGE AND APPROACHES RELATED TO THE PREVENTION, DIAGNOSIS, TREATMENT, ETIOLOGY, AND CONSEQUENCES OF DRUG ABUSE AND ADDICTION, INCLUDING HIV/AIDS. TO SUPPORT RESEARCH TRAINING AND RESEARCH SCIENTIST DEVELOPMENT. TO SUPPORT DISSEMINATION OF RESEARCH FINDINGS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) LEGISLATION IS INTENDED TO EXPAND AND IMPROVE THE SBIR PROGRAMS TO EMPHASIZE AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF TECHNOLOGY DEVELOPED THROUGH FEDERAL SBIR RESEARCH AND DEVELOPMENT, INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN THE SBIR PROGRAM. THE LEGISLATION INTENDS THAT THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Drug Abuse (NIDA) [HHS - NIH]

Santa Monica, California 904013208 United States

Single Zip Code

Dissemination and Implementation Research in Health (R01 Clinical Trial Optional) (PAR-19-274)

Amendment Since initial award the total obligations have increased 398% from $629,854 to $3,133,863.