There is a recognized need to bridge the gap between research innovations and treatment. The NIDA Clinical Trials Network (CTN) is one attempt to narrow the gap by testing efficacious treatment in community treatment programs (CTPs). One goal of this network is to bring clinical knowledge to the research field. Another goal is bring new treatments to the programs. It is not clear, however, when or if the CTN-based treatments will diffuse and be retained. The innovative treatments also may have impact on the structure and processes of the organization. This proposal, using a validated diffusion of innovation model (Rogers, 1995), seeks to determine the processes by which innovations are diffused, retained, and have an impact on the CTPs of the Great Lakes Node.
The specific aims of this project are to: a) describe baseline structure and processes of social relations and clinical services of community treatment programs and their staff; b) describe organizational processes and strategies that are utilized by community treatment programs to adopt and adhere to CTN-approved research protocols; c) analyze diffusion and retention of treatment innovations at the practitioner level in both participating and non-participating community treatment programs; and d) examine whether organizational culture at baseline and/or changes in organizational culture are related to changes in organizational effectiveness over time, and whether CTN participation is related to movement toward more effective organizational cultures. The study will use a multi-method design of seven CTPs including sixteen different facilities. Annual quantitative and qualitative interviews of all staff will be conducted along with semi-annual interviews with key personnel. Organizational surveys of each facility will document the structure and culture of the organization. Supplemental data will be collected prior to specific clinical trial protocol implementation, at six months, and at conclusion of recruitment. The results of this in-depth research will enable more effective administration of CTN clinical trials and will yield organizational information that can be transferred to other substance abuse treatment settings to facilitate dissemination of research results and treatment innovations to non-participating agencies. Based upon this knowledge, relevant suggestions can be made to a wide range of treatment programs on how to introduce innovative treatments and management practices on an ongoing basis, and furthermore, how to retain these innovations over time.
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