The Implementation and Translational Research (I/Trans) Core of the Mason Coordination and Translation Center (MCTC) will study the effectiveness of Dissemination and Implementation (D/I) strategies to facilitate use and uptake of JCOIN scientific findings into widespread practice in criminal justice (CJ) and health settings. The CJ system, just as clinical settings, experiences a large gap between the development of research evidence and actual adoption into practice. With few rigorous, prospective studies examining mechanisms of implementation strategies in CJ settings, the time is now to examine mechanisms of D/I strategies to advance the adoption, implementation, and maintenance of behavioral health evidence-informed practice, treatments, and policy in CJ health. The I/Trans Core, led by Drs. Faye Taxman (George Mason University [Mason]) and Todd Molfenter (University of Wisconsin-Madison, NIATx), with health communications scholar Dr. Xiaoquan Zhao (Mason) will be theoretically grounded in the Exploration, Preparation, Implementation, Sustain (EPIS) and CJ Evidence-based Interagency Implementation Model (CJ-IIM), using Re-AIM and the HIV Cascade to measure impact. The goal is to test implementation mechanisms of action to better understand effective D/I strategies that affect the effectiveness of JCOIN scientific messages, and adoption and effective use of evidence-based treatments and practices. One large RCT trial is planned for Aim One to determine the optimal approach to low cost interventions of coaching and Extension for Community Healthcare Outcomes (ECHO) model in 44 settings that work with CJ-OUD clients.
Aim Two is devoted to advancing the materials used to communicate JCOIN findings by systematically assessing what sources, channels, and messages used by the Dissemination and Engagement Stakeholder (D/SE) Core in routine trainings, workshops, presentations, webinars, and other events are effective. This will entail exploring issues related to message appeal, credible sources, appropriate communication channels, and audience-specific framing production modalities. A longitudinal feedback questionnaire of participants at D/SE events will be used to assess how the material was received, knowledge gained, and likely action using the Perceived Argument Strength Scale and Behavioral Intention Scales.
Aim Three will conduct up to three low-cost trials each year, with Steering Committee and NIDA approval, to test key D/I strategies and actionable messages that stakeholders use to make practice changes. Examples of possible D/I strategies include message effectiveness for different audiences, tools to build champions, mediums to build constituent confidence in scientific evidence, tools to assess and use implementation drivers, and techniques to better use academic-practitioner partnerships. JCOIN provides opportunities for researching content and mediums for diffusion of scientific findings. I/Trans will use these studies to advance a core set of translational and diffusion principles. The implementation science field emphasizes the importance of identifying mechanisms of implementation (i.e., the experimental therapeutics of implementation science) which this Core will address.
Dissemination and implementation are often guided by trial and error. D/I studies can advance a core set of translational principles and identify mechanisms of effective D/I that can improve the uptake of evidence-based treatments and practices for a justice system that serves on average 6.7 million a day, many with OUD.
