Efficacy of Centervention-ATOD: An Implementation Tool for Dissemination of Evidence-based Programs for Substance Abuse
Condition: Substance Abuse
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The pilot test of Centervention-ATOD, a customizable suite of online tools specifically
      designed to support quality implementation and sustainability of any ATOD-EBP within
      real-world service settings, will evaluate whether the product awards additive benefits in
      provider implementation proficiency and efficacy, quality of implementation delivery, and EBP
      (i.e., Free Talk or CHOICE) outcomes compared to traditional implementation methods.
      Additionally, a cost-effectiveness study will be conducted to assess whether the
      implementation support strategy (i.e., Centervention-ATOD) is more cost-effective than
      traditional implementation methods.
    

Detailed description: 
      Alcohol, tobacco, and other drug (ATOD) use among adolescents is a major public health
      problem with devastating personal, familial, and societal costs. Substance use in youth is
      associated with increased accidental injuries (including overdoses), psychiatric
      comorbidities, suicidality, school problems, juvenile delinquency, social and family
      problems, sexual impulsivity, and health consequences.A burgeoning neuroscience literature
      demonstrates ATOD use in youth is associated with a host of negative and potentially
      long-term sequelae, including alterations in brain structure, function, and neurocognition.
      Moreover, drug use in adolescence is the best predictor of abuse in adulthood; data published
      by the National Center on Addiction and Substance Abuse reveal that 90% of adults who meet
      substance dependence criteria began using alcohol and drugs during adolescence. In the U.S.,
      the economic impact of substance abuse is staggering: in 2005, federal, state, and local
      governments spent a combined $467 billion on the direct and indirect costs associated with
      addiction, rendering substance dependence the largest, costliest, and most preventable public
      health problem in the U.S. today.

      Over the past few decades, significant progress has been made in the field of ATOD research
      in developing evidence-based practices (EBPs), with research demonstrating ATOD users who
      receive research-proven treatments are nearly 2.5 times more likely to achieve clinically
      significant post-treatment abstinence compared to those receiving non-evidence-based
      treatment. However, despite availability, EBPs are rarely adopted for use in everyday service
      settings. Further, even when adopted, considerable variation exists both in the quality with
      which EBPs are implemented and their long-term sustainability. Furthering our understanding
      of how efficacious treatment programs can be successfully introduced into real-world
      treatment settings is key to bridging this research-to-practice gap.

      The pilot test of Centervention-ATOD, a customizable suite of online tools specifically
      designed to support quality implementation and sustainability of any ATOD-EBP within
      real-world service settings, will evaluate whether the product awards additive benefits in
      provider implementation proficiency and efficacy, quality of implementation delivery, and EBP
      (i.e., Free Talk or CHOICE) outcomes compared to traditional implementation methods.
      Additionally, a cost-effectiveness study will be conducted to assess whether the
      implementation support strategy (i.e., Centervention-ATOD) is more cost-effective than
      traditional implementation methods.

      The pilot test will employ a Hybrid Type II study design[14] to simultaneously test the
      clinical evidence-based program as well as the implementation strategy. Regardless of the EBP
      implemented, 110 mental health (MH) providers will be randomly assigned to one of two
      conditions: (1) Enhanced implementation (EI) or (2) Implementation as Usual (IAU). Providers
      will either implement (a) Free Talk, a motivational interviewing group intervention with 5-8
      youth per group over a six-week period or (b) CHOICE, a motivational interviewing group
      prevention program with 5-8 youth per group over a five-week period. Participating youth
      between ages 14-17 who may have experimented with alcohol or other drugs (AOD) will
      participate in the Free Talk intervention while youth between ages 11-15 who may or may not
      have used any substances will participate in the CHOICE prevention program. At the conclusion
      of the pilot test, a study of cost-effectiveness of the implementation support strategy
      (i.e., Centervention-ATOD) will be conducted with agency administrators of participating
      providers.
    

Intervention name(s): Centervention-ATOD (CV-ATOD)
Intervention type(s): Other
Intervention description(s): A customizable suite of online tools specifically designed to support quality implementation and sustainability of any ATOD-EBP within real-world service settings.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The pilot test will employ a Hybrid Type II study design to simultaneously test the clinical evidence-based program as well as the implementation strategy.
Masking: None (Open Label)
Primary purpose: Other
Keywords: Substance Abuse; Implementation Science; Evidence-based Practices