Pre-Implementation Review of Contracts, Prompts, and Reinforcement in SUD Continuing Care

The Contracts, Prompts, and Reinforcement (CPR) intervention has demonstrated an ability to increase the duration of continuing care participation following substance use disorder (SUD) treatment, resulting in improved treatment outcome. The current project was a qualitative pre-implementation study aimed at identifying barriers and facilitators to implementation of CPR using an evidence-based quality improvement (EBQI) approach. Formative evaluations were conducted with staff from residential SUD treatment programs across three VA sites, and key informant interviews were completed with opinion and program leaders. Data were analyzed using a grounded theory approach, which identified barriers and facilitators to implementation. Fidelity measures were developed for each of the core CPR components, and the research-focused treatment manual was rewritten to facilitate future implementation efforts with the design and content of the documents shaped by the findings of the qualitative analyses. Overall, data suggested that clinicians and administrators are receptive to the core components of CPR.