Evidence map›Paper›PMID 38852821›Full record

ArticleJournal of substance use and addiction treatment2024

Utility of the Leadership and Organizational Change for Implementation-Systems Level (LOCI-SL) strategy for a statewide substance use treatment implementation effort.

Erika L Crable, Marisa Sklar, Alexandra Kandah, Hannah C Samuels, Mark G Ehrhart, Matthew C Aalsma, Leslie Hulvershorn, Cathleen E Willging, Gregory A Aarons

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of substance use and addiction treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Erika L CrableDepartment of Psychiatry, University of California San Diego, La Jolla, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA; ACTRI Dissemination and Implementation Science Center, University of California San Diego, La Jolla, USA; Child and Adolescent Services Research Center, San Diego, CA, USA. Electronic address: ecrable@health.ucsd.edu.
Marisa SklarDepartment of Psychiatry, University of California San Diego, La Jolla, CA, USA; ACTRI Dissemination and Implementation Science Center, University of California San Diego, La Jolla, USA; Child and Adolescent Services Research Center, San Diego, CA, USA.
Alexandra KandahDepartment of Psychology, University of Central Florida, Orlando, FL, USA.
Hannah C SamuelsCommunity Psychology, DePaul University, Chicago, IL, USA.
Mark G EhrhartDepartment of Psychology, University of Central Florida, Orlando, FL, USA.
Matthew C AalsmaAdolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Clinical and Translational Sciences Institute, Indianapolis, IN, USA.
Leslie HulvershornAdolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Clinical and Translational Sciences Institute, Indianapolis, IN, USA.
Cathleen E WillgingSouthwest Center, Pacific Institute for Research and Evaluation, Albuquerque, NM, USA.
Gregory A AaronsDepartment of Psychiatry, University of California San Diego, La Jolla, CA, USA; ACTRI Dissemination and Implementation Science Center, University of California San Diego, La Jolla, USA; Child and Adolescent Services Research Center, San Diego, CA, USA.

Funding

Statewide System and Organizational Strategy for Evidence-Based Practice Implementation and Sustainment in Substance Use Disorder TreatmentR01DA049891 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI AARONS, GREGORY · 2020 to 2024
$3.6M
Policy Dissemination Strategies to Improve the Use of Research Evidence in Medicaid Benefits for Opioid Use Disorder TreatmentK01DA056838 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Erika Lynn Crable · 2022 to 2026
$914k
NIDA NIH HHS K01 DA056838NIDA NIH HHS L60 DA056946NIDA NIH HHS R01 DA049891
6 · The paper itself

Abstract

introductionMulti-level and cross-context implementation strategies are needed to support health systems, healthcare delivery organizations, and providers to adopt evidence-based practice (EBP) for substance use disorder (SUD) treatment. However, misalignment between state oversight agencies and healthcare organizations about which services to prioritize and which outcomes are reasonable to expect can hinder implementation success and widespread access to high-quality care. This study investigated the utility of the Leadership and Organizational Change for Implementation-System Level (LOCI-SL) strategy for supporting statewide EBP implementation for SUD treatment.

methodsNine community mental health centers (CMHCs) contracted by a state agency participated in a combined motivational-enhancement therapy and cognitive behavioral therapy (MET/CBT) implementation effort. Five of the CMHCs also received the LOCI-SL strategy to obtain ongoing implementation support. We conducted 21 individual interviews and three small group interviews with 30 participants across CMHCs and state health agencies to investigate the utility of LOCI-SL in supporting their EBP implementation efforts. Deductive thematic analysis was guided by the Exploration, Preparation, Implementation, Sustainment Framework.

resultsFive themes described CMHCs' LOCI-SL and broader contextual experiences implementing EBPs: (1) LOCI-SL supported executives in Preparation phase activities that holistically considered organizational needs and capacity to implement and sustain EBPs; (2) LOCI-SL facilitated trust and communication processes across Preparation, Implementation, and Sustainment phases to improve EBP uptake; (3) LOCI-SL increased CMHCs' use of implementation climate strengthening activities throughout the Implementation phase; (4) state contracts did not emphasize quality and thus were not sufficient bridging factors to enforce EBP fidelity during Implementation; and, (5) limited funding and low Medicaid reimbursement rates hindered EBP use throughout the Implementation and Sustainment phases.

conclusionsLOCI-SL was viewed as a favorable and useful implementation strategy for supporting statewide adoption of EBPs. However, outer context barriers, including limited financial investments in the treatment system, impeded implementation and sustainment efforts. While previous research suggests that contracts are viable alignment-promoting bridging factors, this study demonstrates the importance of articulating implementation outcome expectations to aid state-contracted organizations in achieving EBP implementation success. This study also highlights the need for multi-level implementation strategies to effectively align implementation expectations between outer- and inner-context entities.

Indexed as

Evidence-Based PracticeLeadershipOrganizational InnovationSubstance-Related DisordersCognitive Behavioral TherapyCommunity Mental Health ServicesHumansBridging factorsContractingImplementation scienceImplementation strategiesMedicaidPublic sectorSubstance use treatment

Identifiers

PMID38852821
PMCPMC12014198

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.