CTN Membership and Innovation Adoption: Preliminary Data from the UGA

1
CTN Membership and Innovation AdoptionPreliminar
y Data from the UGA Platform Study

• NIDA Research Grant R01DA14482
• Paul M. Roman, Principal Investigator
• Co-Investigators JA Johnson, HK Knudsen,
• LJ Ducharme

2
Setting the Context The UGA Platform Study

• There is growing concern that the pace of
  adoption of evidence-based practices (EBPs) is
  slow
• The research to practice gap
• Given NIDAs vision of the CTN as an opportunity
  to blend research and practice, it is critical
  to understand if and how the CTN bridges that
  gap
• NIDAs Health Services Branch issued an RFA for
  studies of CTN as a platform
• UGAs study considers the innovation adoption
  process inside and outside the CTN
• Draws on data collected as part of the National
  Treatment Center Study

3
Research Objectives

• Does CTN participation enhance the likelihood of
  adopting evidence-based practices (EBPs)?
• This presentation provides preliminary data on
  CTP familiarity with and adoption of several
  EBPs.
• Comparative data from treatment centers outside
  the CTN are also presented.

4
Research Design

• The unit of analysis is a center
• Has own budget
• Has own administrator
• This unit allows for comparison with data
  collected from non-CTN centers
• Data collected via face-to-face interviews with
  administrators clinical directors
• Additional data collection via counselor
  administrator questionnaires and telephone
  follow-ups at 6-month intervals

5
NTCS Samples

• CTN centers N 239
• 92 response rate
• 57 Methadone OTPs
• 121 Publicly Funded CTPs
• 61 Privately Funded CTPs
• Non-CTN public centers N 365
• 80 response rate
• Non-CTN private centers N 401
• 87 response rate
• Public and private are defined by funding,
  not ownership
• Private as less than 50 funding from
  government block grants/contracts

6
Measures of Familiarity and Adoption

• Center administrators were asked, How familiar
  do you believe the staff at this center are with
  each EBP
• 0 no extent
• 5 very great extent
• Adoption of EBPs defined as current use
• 1 yes, 0 no
• EBPs in this presentation include
• Buprenorphine
• Selective Serotonin Re-uptake Inhibitors (SSRIs)
• Manual-Based Motivational Enhancement Therapy
• Motivational Incentives/Vouchers
• Comparisons within the CTN as well as between CTN
  non-CTN programs are presented

7
Data on Buprenorphine
8
Staff Familiarity with BuprenorphineCTPs

• Average extent of staff familiarity with
  buprenorphine by center type
• 0 no extent
• 5 very great extent
• No significant differences within the CTN

9
Familiarity with BuprenorphinePublic Centers

• Familiarity with buprenorphine also asked among
  publicly funded centers outside the CTN
• CTN public centers were significantly more
  familiar with buprenorphine than their non-CTN
  counterparts (plt.001)

10
Familiarity with BuprenorphinePrivate Centers

• Familiarity with buprenorphine also asked among
  privately funded centers outside the CTN
• There was a trend that CTN private centers were
  more familiar with buprenorphine (plt.10)

11
Adoption of Buprenorphine CTPs

• Adoption defined as center currently uses
  buprenorphine
• No significant differences in adoption between 3
  types of CTPs

12
Adoption of Buprenorphine Public Centers

• Publicly funded CTPs were significantly more
  likely to currently use buprenorphine than
  publicly funded programs outside the CTN

13
Adoption of Buprenorphine Private Centers

• The difference in adoption did not achieve
  statistical significance

14
Data on Selective Serotonin Re-uptake Inhibitors
(SSRIs)
15
Staff Familiarity with SSRIsCTPs

• Average staff familiarity with SSRIs by center
  type
• 0 no familiarity
• 5 very great familiarity
• No significant differences between 3 types of CTPs

16
Familiarity with SSRIsPublic Centers

• Familiarity with SSRIs also asked among publicly
  funded centers outside the CTN
• CTN public centers were significantly more
  familiar with SSRIs (plt.01)

17
Familiarity with SSRIsPrivate Centers

• Familiarity with SSRIs also asked among privately
  funded centers outside the CTN
• Private centers outside the CTN reported
  significantly greater familiarity with SSRIs
  (plt.01)
• May be due the higher percentage of
  hospital-based programs in the non-CTN private
  sample

18
Adoption of SSRIs CTPs

• Adoption defined as center currently uses SSRIs
• No significant differences between the three
  types of CTPs

19
Adoption of SSRIs Public Centers

• Publicly funded CTPs were significantly more
  likely to currently use SSRIs than publicly
  funded programs outside the CTN (plt.001)

20
Adoption of SSRIs Private Centers

• The difference in adoption did not achieve
  statistical significance

21
Data on Motivational Enhancement Therapy
22
Staff Familiarity with Motivational Enhancement
Therapy

• Average extent of staff familiarity with MET
• 0 no extent
• 5 very great extent
• No significant differences between 3 types of CTPs

23
Familiarity with METPublic Centers

• Familiarity with MET also asked among publicly
  funded centers outside the CTN
• CTN public centers were significantly more
  familiar with MET (plt.001)

24
Familiarity with METPrivate Centers

• Familiarity with MET also asked among privately
  funded centers outside the CTN
• The difference did not achieve statistical
  significance

25
Adoption of Manual-Based METCTPs

• CTN-public gt OTPs (plt.01)
• CTN-public gt CTN private (plt.05)

26
Adoption of Manual-Based MET Public Centers

• Publicly funded CTPs were significantly more
  likely to currently use manual-based MET than
  publicly funded programs outside the CTN (plt.001)

27
Adoption of Manual-Based MET Private Centers

• The difference in adoption was not statistically
  significant

28
Data on Motivational Incentives(Vouchers)
29
Staff Familiarity with Motivational Incentives

• Average extent of staff familiarity with
  motivational incentives by center type
• 0 no extent
• 5 very great extent
• No significant differences between 3 types of CTPs

30
Familiarity with Motivational IncentivesPublic
Centers

• Familiarity with incentives also asked among
  publicly funded centers outside the CTN
• The difference in familiarity was not significant

31
Familiarity with Motivational IncentivesPrivate
Centers

• Familiarity with incentives also asked among
  privately funded centers outside the CTN
• The difference did not achieve statistical
  significance

32
Adoption of Motivational Incentives

• No significant differences between 3 types of CTPs

33
Adoption of Motivational Incentives Public
Centers

• The difference was not statistically significant

34
Adoption of Motivational Incentives Private
Centers

• Privately funded CTPs were significantly more
  likely to have adopted motivational incentives
  than private centers outside the CTN (plt.05).

35
Summary

• Although these data are preliminary, these
  analyses suggest
• Overall pattern of similarity within the CTN
• Few differences in familiarity or adoption
• Considerable differences between publicly funded
  CTPs and public centers outside the CTN
• Fewer differences between privately funded CTPs
  and private centers outside the CTN

36
Next Steps

• Future data analyses will consider
• Multivariate models of EBP adoption
• Counselors attitudes toward EBPs
• Change in adoption and attitudes over time
• The UGA team is preparing the summary reports of
  our main findings
• Then well prepare the individualized reports
• We are preparing to re-enter the field for our
  second round of face-to-face interviews

37
The UGA team is grateful for the high level of
support shown by the CTPs. Thank you!