A Large-scale Dissemination and Implementation Model for Evidence-based Treatment and Continuing Care

Area of Science:

• Addiction Medicine
• Implementation Science
• Adolescent Psychiatry

Background:

• Evidence-based treatments for adolescent substance use disorders (SUDs) exist but have limited real-world application.
• A gap persists between research findings and clinical practice for adolescent SUD interventions.

Purpose of the Study:

• To describe a dissemination and implementation model for evidence-based SUD treatments for adolescents.
• To detail the key components and processes for widespread adoption of specific SUD interventions.

Main Methods:

• A multi-site implementation model was used across 33 sites with over 200 clinical staff.
• Key elements included sustained funding, comprehensive training (workshops, coaching, feedback), clinician/supervisor certification, and fidelity reviews.
• Process data were collected from 167 clinicians and 64 supervisors.

Main Results:

• The model facilitated the diffusion of the Adolescent Community Reinforcement Approach and Assertive Continuing Care.
• Sustained funding, robust training, and certification processes were crucial for implementation.
• Ongoing performance feedback and fidelity monitoring supported consistent application of treatments.

Conclusions:

• A structured dissemination and implementation model can significantly improve the uptake of evidence-based SUD treatments for adolescents.
• The described model, incorporating training, certification, and ongoing support, offers a viable strategy for widespread clinical practice change.
• Long-term sustainability is enhanced through supervisor training and fidelity monitoring.