Accepted for/Published in: JMIR Human Factors
Date Submitted: Nov 22, 2021
Date Accepted: May 31, 2022
What helps implement smartphone systems designed to improve quality of life for people with substance use disorder: an interim report on a randomized controlled trial with SUD providers in Iowa
ABSTRACT
Background:
Researchers have conducted numerous studies seeking to understand how to improve implementation of changes in healthcare organizations, but less focus has been given to applying lessons already learned from implementation science to current projects. Finding innovative ways to apply these findings efficiently will improve current research on implementation strategies and will allow organizations utilizing these techniques to make changes more easily.
Objective:
This research seeks to compare a practical implementation approach that uses principles from prior implementation studies to more traditional ways of implementing change to further understand this issue.
Methods:
Forty-three addiction treatment sites in Iowa were randomly assigned to two different implementation strategies in a randomized comparative effectiveness trial studying implementation of an e-health substance use disorder (SUD) treatment technology. One strategy used an adaptation of the NIATx improvement approach developed for use in addiction treatment organizations, while the other utilized a traditional product training model. This paper discusses lessons learned from interviews with clinicians at these organizations and other informal feedback gathered throughout the study.
Results:
Use of the NIATx approach led to improved outcomes on several measures, including initial and sustained use of new technology by both counselors and patients. Additionally, feedback from clinicians and organizations indicates that utilizing strategies like ensuring that changes address current challenges and outlining how it does so, integrating organizational changes into workflows, and utilizing coaching to overcome hurdles and assess progress are important to improving implementation projects.
Conclusions:
At this interim point in the study, it seems clear that use of the NIATx improvement process leads to better outcomes in implementation of changes within healthcare organizations. However, some strategies utilized in this improvement process are more useful and should be drawn on more heavily in future implementation efforts. Clinical Trial: ClinicalTrials.gov, NCT03954184. Registered 17 May 2019.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.