Implementation barriers and fidelity in implementing evidence-based addiction treatment: A national study
Methods: This mixed methods study used open-ended qualitative data to identify the type of barriers staff experienced and level of modifications made to EBPs. A 10-point ordinal variable measured levels of modification. For each EBP, the mean modification score (MMS) and the most commonly identified barriers are presented.
Results: Data analyses identified that staff reported different levels of modifying EBPs, by type of EBP. Specifically, the EBPs reported to have been the most modified were the Peer to Peer Recovery Model and Motivational Enhancement Therapy (MMS score > 4). The two EBPs rated as having been changed the least were MI and Case Management (MMS <3). The EBP modification scores for staff implementing MI (n = 72) were higher when staff experienced barriers related to clients and to the logistics of implementation, compared to their counterparts.
Discussion: Barriers to EBP implementation are clearly associated with fidelity. As this and prior papers by the authors suggest, staff who experience different types and levels of barriers make changes to the EBP responding to these barriers. Funders of EBP implementation need to provide ongoing technical assistance to reduce barriers to EBP implementation.
Learning Areas:Implementation of health education strategies, interventions and programs
Identify a relationship between staff modification scores and barriers to adherence in implementing EBPs. Identify the types of barriers most commonly associated with EBPs, noting the level of modification for each EBP. Compare specific barriers related to adherence in the implementation of a commonly used EBP in addiction treatment, Motivational Interviewing.
Keyword(s): Evidence Based Practice, Substance Abuse Treatment
Qualified on the content I am responsible for because: I am a research assistant at the Center for Addictions Research and Services at Boston University School of Social Work and a macro MSW candidate. I have analyzed and compared staff-reported barriers to maintaining fidelity in evidence-based practices in substance abuse treatment programs from data funded by a Robert Wood Johnson Foundation grant, 2008â2011. The Center has published multiple articles on modifications to evidence-based practices in community substance abuse treatment programs.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.