1. The University of Georgia CTN Membership and Innovation Adoption: Preliminary Data from the UGA “Platform” Study NIDA Research Grant R01DA14482 Paul M. Roman, Principal Investigator Co-Investigators: JA Johnson, HK Knudsen, LJ Ducharme

2. The University of Georgia 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 NIDA’s 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 NIDA’s Health Services Branch issued an RFA for studies of CTN as a “platform” UGA’s study considers the innovation adoption process inside and outside the CTN –Draws on data collected as part of the National Treatment Center Study

3. The University of Georgia 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. The University of Georgia 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. The University of Georgia 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. The University of Georgia 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. The University of Georgia Data on Buprenorphine

8. The University of Georgia Staff Familiarity with Buprenorphine: CTPs Average extent of staff familiarity with buprenorphine by center type –0 = no extent –5 = very great extent No significant differences within the CTN

9. The University of Georgia Familiarity with Buprenorphine: Public 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 (p<.001)

10. The University of Georgia Familiarity with Buprenorphine: Private 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 (p<.10)

11. The University of Georgia Adoption of Buprenorphine: CTPs Adoption defined as center currently uses buprenorphine No significant differences in adoption between 3 types of CTPs

12. The University of Georgia Adoption of Buprenorphine: Public Centers Publicly funded CTPs were significantly more likely to currently use buprenorphine than publicly funded programs outside the CTN

13. The University of Georgia Adoption of Buprenorphine: Private Centers The difference in adoption did not achieve statistical significance

14. The University of Georgia Data on Selective Serotonin Re-uptake Inhibitors (SSRIs)

15. The University of Georgia Staff Familiarity with SSRIs: CTPs Average staff familiarity with SSRIs by center type –0 = no familiarity –5 = very great familiarity No significant differences between 3 types of CTPs

16. The University of Georgia Familiarity with SSRIs: Public Centers Familiarity with SSRIs also asked among publicly funded centers outside the CTN CTN public centers were significantly more familiar with SSRIs (p<.01)

17. The University of Georgia Familiarity with SSRIs: Private Centers Familiarity with SSRIs also asked among privately funded centers outside the CTN Private centers outside the CTN reported significantly greater familiarity with SSRIs (p<.01) –May be due the higher percentage of hospital- based programs in the non-CTN private sample

18. The University of Georgia Adoption of SSRIs: CTPs Adoption defined as center currently uses SSRIs No significant differences between the three types of CTPs

19. The University of Georgia Adoption of SSRIs: Public Centers Publicly funded CTPs were significantly more likely to currently use SSRIs than publicly funded programs outside the CTN (p<.001) `

20. The University of Georgia Adoption of SSRIs: Private Centers The difference in adoption did not achieve statistical significance

21. The University of Georgia Data on Motivational Enhancement Therapy

22. The University of Georgia 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. The University of Georgia Familiarity with MET: Public Centers Familiarity with MET also asked among publicly funded centers outside the CTN CTN public centers were significantly more familiar with MET (p<.001)

24. The University of Georgia Familiarity with MET: Private Centers Familiarity with MET also asked among privately funded centers outside the CTN The difference did not achieve statistical significance

25. The University of Georgia Adoption of Manual-Based MET: CTPs CTN-public > OTPs (p<.01) CTN-public > CTN private (p<.05)

26. The University of Georgia 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 (p<.001) `

27. The University of Georgia Adoption of Manual-Based MET: Private Centers The difference in adoption was not statistically significant

28. The University of Georgia Data on Motivational Incentives (Vouchers)

29. The University of Georgia 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. The University of Georgia Familiarity with Motivational Incentives: Public Centers Familiarity with incentives also asked among publicly funded centers outside the CTN The difference in familiarity was not significant

31. The University of Georgia Familiarity with Motivational Incentives: Private Centers Familiarity with incentives also asked among privately funded centers outside the CTN The difference did not achieve statistical significance

32. The University of Georgia Adoption of Motivational Incentives No significant differences between 3 types of CTPs

33. The University of Georgia Adoption of Motivational Incentives: Public Centers The difference was not statistically significant

34. The University of Georgia Adoption of Motivational Incentives: Private Centers Privately funded CTPs were significantly more likely to have adopted motivational incentives than private centers outside the CTN (p<.05).

35. The University of Georgia 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. The University of Georgia 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 we’ll prepare the individualized reports We are preparing to re-enter the field for our second round of face-to-face interviews

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