Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)

Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)

The purpose of this study is to expand access to medications for opioid use disorder (MOUD) in specialty addiction programs in Washington State. Sixty-four addiction treatment programs will participate in an adaptive implementation strategy trial that uses a stagewise implementation-to-target (stepped "care" type) approach whereby organizations engage in increasingly intensive implementation strategies as needed. Organizations are moved to a follow-up/sustainment arm once they have met the implementation targets described below. The design also includes an external comparator arm, which consists of 510 addiction treatment programs that are not participating in the study and will mimic as study controls.

The sequence of implementation strategies are:

1. Enhanced Monitoring and Feedback
2. NIATx/MAT Academy
3. Randomization to either NIATx Internal Facilitation or NIATx External Facilitation
4. Assignment to NIATx External Facilitation if outcome targets are not achieved in the NIATx Internal Facilitation arm

Implementation targets are:

1. Reach - At least 75% of patients with opioid use disorder (OUD) receiving MOUD for three consecutive months
2. Adoption - At least 1 integrated MOUD prescriber actively prescribing MOUD
3. Implementation - a total score ≥ 4 on the Integrating Medications for Addiction Treatment (IMAT) Index.

Contextual moderators and mediators of performance on target outcomes as a function of the implementation strategy step will be examined, as will the costs associated with participation in the sequence of implementation strategies.

Principal Investigator: Mark McGovern, PhD, Stanford University; Principal Investigator: James H Ford II, PhD, University of Wisconsin, Madison; Site Principal Investigator: Tony Walton, MS, Washington State Health Care Authority

Inclusion Criteria:

• Addiction treatment programs in Washington State
• Residential (detoxification or rehabilitation) or outpatient (intensive outpatient or outpatient) levels of care
• Primary care clinics, including Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs)

Exclusion Criteria:

• Opioid treatment programs