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Disseminating contingency management: Impacts of staff training and implementation at an opiate treatment program

机译:传播应急管理:阿片剂治疗计划中员工培训和实施的影响

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摘要

Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (intervention cost, feasibility, and sustainability) were assessed at study conclusion in a qualitative interview with OTP management. Intervention effectiveness was also assessed via independent chart review of trial CM implementation vs. a historical control period. Results included: 1) robust, durable increases in delivery skill, knowledge, and adoption readiness among trained staff; 2) positive managerial perspectives of intervention cost, feasibility, and sustainability; and 3) significant clinical impacts on targeted patient indices. Collective results offer support for the study’s collaborative intervention design and the applied, skills-based focus of staff training processes. Implications for CM dissemination are discussed.
机译:在综合实施模型的指导下,本研究针对临床试验网络附属阿片类药物治疗计划(OTP)制定的量身定制的应急管理(CM)干预措施,研究了培训/实施过程。在进行了16个小时的培训之前和之后以及在90天的试验实施期之后,再次评估了员工水平的培训成果(干预交付技能,知识和采用准备情况)。在研究结束时,与OTP管理层进行了定性访谈,评估了管理层的实施成果(干预成本,可行性和可持续性)。干预效果还通过对试验性CM实施与历史控制期的独立图表审查进行评估。结果包括:1)训练有素的员工在交付技能,知识和采用准备方面的能力得到持久,持久的提高; 2)对干预成本,可行性和可持续性的积极管理观点; 3)对目标患者指标的重大临床影响。集体结果为研究的协作干预设计以及员工培训过程中基于技能的应用重点提供了支持。讨论了CM传播的含义。

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