Co-occurring mental health and substance use disorders (COD) are common in the United States and providers have been challenged to provide effective treatments. As a consequence, their clients with COD may experience poor treatment engagement, symptom exacerbation and cycle in and out of emergency services. This is particularly true for underrepresented populations with a COD including individuals whom are homeless and involved in the criminally justice system. Research shows that integrated and coordinated community- based services for COD can improve client outcomes. However, healthcare workforce has a gap in training staff on such treatment techniques, which we aim to close via this Phase II STTR project. Maintaining Independence and Sobriety through Systems Integration, Outreach and Networking (MISSION) is a unique evidence-based, trans-disciplinary treatment designed to address the complex needs of individuals with CODs and includes manuals for high risk populations of civilian and veteran homeless individuals as well as those involved in the criminally justice system. Listed in the Substance Abuse and Mental Health Service Administration-Registry for Evidence Based Practices (NREPP), MISSION has had substantial impact. The Veterans Health Administration has deployed it in their national plan to end Veteran Homelessness. Massachusetts has used it in its Statewide Plan to End Homelessness and written it into Public Law for delivery alongside Veterans Treatment courts. While MISSION is a manualized treatment, a recent multisite implementation study identified the need for more comprehensive training tools. With NIAAA support, the University of Massachusetts Medical School (MISSION developers) partnered with Praxis on a Phase I STTR to (1) develop the MISSION University online training platform, (2) show proof of concept by implementing two training modules and an e-simulation case study, and (3) conduct a pilot randomized trial which demonstrated that training-as-usual Distance Learning (DL) + Technical Assistance (TA) outperformed TA alone. In Phase II, we will complete MISSION U by developing and testing five new MISSION modules and companion e-simulations tools that test knowledge acquisition and application. We will first do a formative evaluation with 20 learners who will provide feedback on MISSION U modules. This will be followed by a randomized controlled trial similar to Phase I in which 60 learners will be randomized to the DL or the DL+TA conditions. In preparation for future scalability, we will uniquely conduct a qualitative process evaluation using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework with 42 MISSION U participants to look at facilitators and barriers to implementation. Lastly, we will pilot test machine learning techniques with our 60 individuals who participated in the randomized trial in an effort to help personalize the MISSION U training experience for commercialization. !1
?MISSION U: A Multimedia Training Tool for Treatment of Individuals with Co-occurring Mental Health and Substance Use Disorders? is aimed at training providers of services for these individuals. MISSION U challenges prevailing provider training methodology that relies mainly on on-site provider training and/or online training using typical classroom-type materials. This project not only addresses the growing need for new provider training methodologies, but also offers the promise of improving clinical efficacy and reducing training costs and medical expenditures overall.! !
