This study optimizes a naturally occurring laboratory to study EBP adoption and implementation (EBP A&I) within the Total Community Approach (TCA) initiative-- a state-funded project (approximately 3 million dollars per year since FY08) implemented in six rural areas of New Mexico with high rates of substance abuse. TCA is a community-based, collaborative approach emphasizing the involvement of a full range of stakeholders at all levels of substance abuse program planning, implementation, evaluation, and sustainability. A significant finding from the evaluation of the TCA initiative has been that there is great variation in EBP A&I across sites. This purpose of this study is to examine the factors that may account for the variability in EBP A&I, explore the collaborative process by which state, local providers and consumers develop plans to support EBP A&I in TCA and statewide, and examine the impact of this process on improving EBP A&I capacity. This public health impact of this study is the ability to improve EBP implementation in the existing TCA initiative, support the successful expansion statewide of the TCA model, and provide a model for improving EBP A&I that can be implemented in other states facing similar significant challenges to EBP A&I. The proposed research will explore the following questions: (1) What factors impact EBP A&I in the TCA initiative? (2) Do the collaboratively developed EBP A&I Improvement Plans (AIIPs) enhance the capacity to adopt and implement EBPs in the TCA initiative and statewide? The Specific Aims to answer these questions are (1) Refine EBP Capacities Survey (EBPICS) and prepare for system change planning. This comparative design study will be conducted through use of Concept Mapping with state, local providers and consumers to develop and prioritize EBP A&I supports to be used to develop EBP A&I improvement plans (AIIPs) statewide and locally;followed by expert review to finalized the EBPIC survey (2) Examine what state agency, individual provider and consumer level factors are perceived to most impact substance abuse-related EBP A&I and the current level of EBP A&I capacity in local TCA programs through EBPIC survey with state, local provider and consumers, and in-depth interviews;(3). Document and examine the process of collaboratively developed statewide and local TCA EBP Adoption and Implementation Improvement Plans (AIIIPs) through a qualitative study of the impact of the collaborative process on plans developed;and (4) Examine success in the implementation of the TCA EBP AIIPs and improvements in EBP A&I capacity through T2 EBPIC survey, interviews, and reviews of annual TCA site proposals.
The state of New Mexico has committed extensive funding (approximately 3 million dollars per year since FY08) to the TCA initiative precisely because of its potential public health benefit of reducing the impact of high rates of substance abuse for all New Mexicans. This study strives to extend this benefit by not only improving EBP implementation within the existing TCA initiative, but also to support successful expansion of the TCA model statewide. Additionally, this proposal extends the possible public health benefit beyond New Mexico by providing a model for improving EBP A&I that can be replicated in other states facing similar challenges to EBP A&I.