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The relationship of counselor-level variables to intervention adoption

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### The relationship of counselor-level variables to intervention adoption

Joseph Guydish, Holly Fussell, Sarah Turcotte Manser,

Lynn E. Kunkel, Mable Chan, & Dennis McCarty

AHSR 2010

Lexington, Kentucky

This work was supported by NIDA R01DA025600 and the Western States Research Node of the NIDA Clinical Trials Network (U10 DA015815)

Adoption of Evidence-Based Practices (EBPs)

- One goal of the CTN is to translate EBPs shown to be effective into clinical practice
- EBPs are tested in multi-site clinical trials
- Clinicians and supervisors trained
- Opportunity to try a new intervention
- What happens to the EBP once the trial ends?

Spaceship RCT

Clinical Trial

Adherence

Resources

Intervention

Training

Setting

Motivations

Interests

Admin

Usual

Staff

Supervisor

Adoption of Matrix Following Clinical Trial

- Adoption of Matrix at 8 clinics
- Qualitative interviews at multiple levels
- Transcribed and coded

Matrix Clinical Trial Interviews (n=42)

Interviews were completed 2-12 months after treatment phase completion

Adoption of Matrix at Clinic Sites

Guydish, J.,Turcotte Manser, S., Jessup, M., Tajima, B., Sears, C., & Montini, T. (2005) Multi-level assessment protocol (MAP) for adoption in multi-site clinical trials, Journal of Drug Issues. 35, 529-546.

Adoption of MI/MET at Clinic Sites

Guydish, J., Jessup, M., Tajima, B., Turcotte Manser, S. (2010) Adoption of Motivational Interviewing and Motivational Enhancement Therapy following clinical trials. Journal of Psychoactive Drugs, 6, 215-226.

CTN 0031 STAGE-12:Stimulant Abuser Groups to Engage in 12-Step

- Twelve Step Facilitation
- 10 sites
- Stimulant Users
- 5 group sessions and 3 individual sessions

Relationships in Translational Research, Aligned with Stage -12 Clinical Trial

Pre-STAGE 12

During STAGE 12 Study

Post STAGE 12

Organizational

Variables

Counselor

Factors

Adoption

(Qualitative Measure)

Implementation

Fidelity

Client

Outcomes

Summary of Measures

Pre-STAGE 12 Staff Survey (119 Counselors)

- ATSG (General 12 step attitudes)
- SIGCS (Goal Commitment)

During STAGE 12 Implementation Fidelity (29 Counselors)

- Overall Skill and Fidelity
- Proscribed Behaviors
- Empathy

During STAGE 12 Client Outcomes: Days stimulant use in past 30

Post-STAGE 12 Adoption: Qualitative Interviews

- ATSG: Laudet, A.B.; White, W.L. (2005) An exploratory investigation of the association between clinicians\' attitudes toward twelve-step groups and referral rates. Alcohol Treatment Quarterly, 23 (1), 31-45.
- SIGCS: Hollenbeck, J.R., C.R. Williams, & H. Klein (1989). “An empirical examination of the antecedents of commitment to difficult goals.” Journal of Applied Psychology,74(1): 12-23.

Descriptive Statistics for STAGE-12 counselors as compared to non-STAGE-12 counselors in survey data (n=119)

Simple Regression Models (n=29): Baseline variables predicting fidelity outcomes

Regression Models (n=29): Baseline variables predicting fidelity outcomes

*significant at 0.05 level

54%

STAGE 12 counselors older, + 12 step attitudes, higher goal commitment

For 12 step counselors

Women had lower proscribed behaviors

and higher overall fidelity implementation

In regression predicting implementation:

Goal Commitment, gender predict proscribed beh.

Progress towards completion

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