A guiding framework and approach for implementation research in substance use disorders treatment

This paper introduces readers to the concepts of implementation science, implementation theory, and implementation frameworks and models. A wide range of models has been published in the literature related to implementation. The paper will present an overview of the Consolidated Framework for Implementation Research (CFIR), which is a comprehensive typology that unifies and consolidates the array of constructs that influence implementation from the perspective of these models. The CFIR is then used to evaluate implementation models used in studies of substance use disorder (SUD) treatments. Implementation research is scarce, with few prospective studies of theory-driven implementation. We assert that future research in SUD needs to meet three overarching objectives to promote wider implementation of evidence-based practices: (a) differentiation of core versus adaptable components of evidence-based interventions need; (b) development of methods to design implementation strategies, effectively adapted to the broad context; and (c) design and testing of predictive models to assess likelihood of effective implementation and prospects for sustainability while taking into account salient contextual factors. A recommended strategy for accomplishing these objectives is described.