Clinical trial NCT03007940: Using NIATx Strategies to Implement Integrated Services in Routine Care
Official title: Using NIATx Strategies to Implement Integrated Services in Routine Care
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Addiction
Mental Health Disorder
Keywords: Implementation Strategies
Sustainability
Integrated Services
Lead sponsor: University of Wisconsin, Madison
Sponsor class: OTHER
Collaborators: name: Washington State Department of Social and Health Services
name: National Institute on Drug Abuse (NIDA)
name: Stanford University
First posted: 2017-01-02
Enrollment: 49
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This is an implementation research study designed to evaluate a defined strategy, NIATx, for its effectiveness in installing and sustaining evidence-based integrated services for persons with co-occurring substance use and mental health disorders. This study is a cluster randomized wait-list control group design, in which a cohort of 25 addiction treatment agencies receives the active NIATx approach during an index 12 month period. The second (wait-list) cohort of 25 addiction treatment agencies activates NIATx strategies during a second index 12 month period. The primary "subjects" of the research are the treatment agencies themselves. The study specific aims are:

1. Relative to wait-list, to determine if NIATx strategies improve implementation outcomes (integrated service fidelity and receipt of more integrated services)
2. Relative to wait-list, to determine if NIATx strategies improve patient care outcomes (psychiatric, alcohol and drug problem severity)
3. Across entire sample, to evaluate variation in the extent of and fidelity to NIATx strategies

NIATx implementation strategies consist of learning sessions, individualized coaching and peer to peer sharing.


Eligibility criteria: Inclusion Criteria:

* Organizations who are licensed addiction treatment providers in the state of Washington were identified and provided the opportunity to participate in the study.

Eligibility criteria include:

* outpatient and/or intensive outpatient services
* tax-exempt, government status or at least 50% publicly funded (e.g., block grants, Medicare, Medicaid)
* no prior participation in NIATx research studies (this last criterion excludes 39 agencies who were involved in the NIDA funded NIATx 200)

Exclusion Criteria:

* Public mental health and private addiction treatment agencies are also excluded because only addiction treatment providers in Washington are required to use the state clinical information system, and therefore cannot provide the necessary standardized data

Primary outcomes:
measure: Change in Dual Diagnosis Capability in Addiction Treatment (DDCAT index) scores
timeFrame: Collected at baseline, 12 months, 24 months and 36 months
measure: Change in Penetration Rates: Gain Short Screen
timeFrame: Collected at baseline, 12 months, 24 months and 36 months
measure: Change in Penetration Rates: Patients receiving integrated medication and psychosocial services
timeFrame: Collected at baseline, 12 months, 24 months and 36 months
measure: Change in the Addiction Severity Index (ASI)
timeFrame: Collected at baseline, 12 months, 24 months and 36 months
Secondary outcomes:
Other outcomes:
measure: Consolidated Framework for Implementation Research Index
timeFrame: Collected at baseline, 12 months, 24 months and 36 months
measure: NIATx Stages of Implementation Completion
timeFrame: Collected during 12 month intervention period
measure: NIATx Fidelity
timeFrame: Collected during 12 month intervention period
Locations:
Study officials:
References:
citation: Ford JH 2nd, Osborne EL, Assefa MT, McIlvaine AM, King AM, Campbell K, McGovern MP. Using NIATx strategies to implement integrated services in routine care: a study protocol. BMC Health Serv Res. 2018 Jun 8;18(1):431. doi: 10.1186/s12913-018-3241-4.
citation: Chokron Garneau H, Assefa MT, Jo B, Ford JH 2nd, Saldana L, McGovern MP. Sustainment of Integrated Care in Addiction Treatment Settings: Primary Outcomes From a Cluster-Randomized Controlled Trial. Psychiatr Serv. 2022 Mar 1;73(3):280-286. doi: 10.1176/appi.ps.202000293. Epub 2021 Aug 4.
citation: Assefa MT, Ford JH 2nd, Osborne E, McIlvaine A, King A, Campbell K, Jo B, McGovern MP. Implementing integrated services in routine behavioral health care: primary outcomes from a cluster randomized controlled trial. BMC Health Serv Res. 2019 Oct 24;19(1):749. doi: 10.1186/s12913-019-4624-x.
citation: Ford JH 2nd, Kaur A, Rao D, Gilson A, Bolt DM, Garneau HC, Saldana L, McGovern MP. Improving Medication Access within Integrated Treatment for Individuals with Co-Occurring Disorders in Substance Use Treatment Agencies. Implement Res Pract. 2021 Jan 1;2:26334895211033659. doi: 10.1177/26334895211033659. Epub 2021 Sep 17.