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User-centered design of contingency management for implementation in opioid treatment programs: a qualitative study
Sara J Becker1, Kelli Scott2, Cara M Murphy2
1Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Brown University, Providence, RI, 02912, USA. Sara_becker@brown.edu.
BMC Health Services Research
|July 11, 2019
Summary
Contingency management (CM) shows promise for opioid use disorder treatment but faces low adoption. This study used user-centered design to identify barriers and preferences for implementing CM in community programs, suggesting flexible approaches and leadership involvement for better uptake.
Area of Science:
- Behavioral science
- Addiction medicine
- Implementation science
Background:
- Contingency management (CM) is an effective behavioral intervention for opioid use disorders (OUD).
- Despite evidence, CM adoption in community settings is notably low.
- User-centered design principles were applied to understand implementation barriers.
Purpose of the Study:
- To explore familiarity with CM among treatment providers.
- To assess current clinical practices related to CM.
- To identify preferences for CM implementation in community-based opioid treatment programs.
Main Methods:
- Qualitative study involving semi-structured interviews with leaders and counselors from 11 opioid treatment programs.
- Interviews were coded by independent raters and analyzed using a reflexive team approach.
- NVivo software was used to identify key themes and exemplar quotes.
Main Results:
- Low familiarity with CM was observed; less than half of respondents could define it correctly.
- Abstinence and attendance were common CM targets, with varied monitoring frequencies.
- Program leaders and counselors were preferred for administering incentives, with donations and non-financial rewards suggested for funding.
Conclusions:
- User-centered design identified key factors for successful CM implementation.
- Flexible definitions of CM attendance and non-financial incentives are valuable.
- Involving clinical leaders and exploring fundraising are crucial for sustainability and buy-in.
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