Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2014

Open Access 01-12-2014 | Study Protocol

Continuous quality improvement (CQI) in addiction treatment settings: design and intervention protocol of a group randomized pilot study

Authors: Sarah B Hunter, Allison J Ober, Susan M Paddock, Priscillia E Hunt, Deborah Levan

Published in: Addiction Science & Clinical Practice | Issue 1/2014

Login to get access

Abstract

Background

Few studies have designed and tested the use of continuous quality improvement approaches in community based substance use treatment settings. Little is known about the feasibility, costs, efficacy, and sustainment of such approaches in these settings.

Methods/Design

A group-randomized trial using a modified stepped wedge design is being used. In the first phase of the study, eight programs, stratified by modality (residential, outpatient) are being randomly assigned to the intervention or control condition. In the second phase, the initially assigned control programs are receiving the intervention to gain additional information about feasibility while sustainment is being studied among the programs initially assigned to the intervention.

Discussion

By using this design in a pilot study, we help inform the field about the feasibility, costs, efficacy and sustainment of the intervention. Determining information at the pilot stage about costs and sustainment provides value for designing future studies and implementation strategies with the goal to reduce the time between intervention development and translation to real world practice settings.
Appendix
Available only for authorised users
Literature
1.
Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment: Implementing Change in Substance Abuse Treatment Programs. 2009, Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment
2.
Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K: Alcohol: No Ordinary Commodity–A Summary of the Second Edition. 2010, Oxford: Oxford University PressCrossRef
3.
Institute of Medicine: Improving the Quality of Health Care for Mental and Substance-Use Conditions. 2006, Washington, DC: National Academies Press
4.
McCarty D, Gustafson D, Capoccia VA, Cotter F: Improving care for the treatment of alcohol and drug disorders. J Behav Health Serv Res. 2009, 36: 52-60. 10.1007/s11414-008-9108-4.PubMedCentralCrossRefPubMed
5.
Hoffman KA, Ford JH, Choi D, Gustafson DH, McCarty D: Replication and sustainability of improved access and retention within the network for the improvement of addiction treatment. Drug Alcohol Depend. 2008, 98: 63-69. 10.1016/j.drugalcdep.2008.04.016.PubMedCentralCrossRefPubMed
6.
Forman R, Crits-Christoph P, Kaynak O, Worley M, Hantula DA, Kulaga A, Rotrosen J, Chu M, Gallop R, Potter J, Muchowski P, Brower K, Strobbe S, Magruder K, Chellis AH, Clodfelter T, Cawley M: A feasibility study of a web-based performance improvement system for substance abuse treatment providers. J Subst Abuse Treat. 2007, 33: 363-371. 10.1016/j.jsat.2007.01.007.PubMedCentralCrossRefPubMed
7.
Fields D, Roman PM: Total quality management and performance in substance abuse treatment centers. Health Serv Res. 2010, 45: 1630-1649. 10.1111/j.1475-6773.2010.01152.x.PubMedCentralCrossRefPubMed
8.
Chinman M, Hunter SB, Ebener P: Employing continuous quality improvement in community-based substance abuse programs. Int J Health Care Qual Assur. 2012, 25: 606-617.CrossRef
9.
Wisdom JP, Ford JH, Hayes RA, Edmundson E, Hoffman K, McCarty D: Addiction treatment agencies' use of data: a qualitative assessment. J Behav Health Serv Res. 2006, 33: 394-407. 10.1007/s11414-006-9039-x.CrossRefPubMed
10.
Gustafson DH, Quanbeck AR, Robinson JM, Ford JH, Pulvermacher A, French MT, McConnell KJ, Batalden PB, Hoffman KA, McCarty D: Which elements of improvement collaboratives are most effective? A cluster-randomized trial. Addiction. 2013, 108: 1145-1157. 10.1111/add.12117.PubMedCentralCrossRefPubMed
11.
Crits-Christoph P, Ring-Kurtz S, McClure B, Temes C, Kulaga A, Gallop R, Forman R, Rotrosen J: A randomized controlled study of a web-based performance improvement system for substance abuse treatment providers. J Subst Abuse Treat. 2010, 38: 251-262. 10.1016/j.jsat.2010.01.001.PubMedCentralCrossRefPubMed
12.
Colton D: Quality improvement in health care: conceptual and historical foundations. Eval Health Prof. 2000, 23: 7-42. 10.1177/01632780022034462.CrossRefPubMed
13.
Burda D: Providers look to industry for quality models. Mod Healthc. 1988, 18: 24-26. 28, 30-22
14.
McLaughlin CP, Simpson KN: Does TQM/CQI Work in Health Care?. Continuous Quality Improvement in Health Care: Theory, Implementation, and Applications. Edited by: McLaughlin CP, Kaluzny AD. 1994, Gaithersburg, MD: Aspen
15.
O'Connor PJ, Rush WA, Peterson J, Morben P, Cherney L, Keogh C, Lasch S: Continuous quality improvement can improve glycemic control for HMO patients with diabetes. Arch Fam Med. 1996, 5: 502-506. 10.1001/archfami.5.9.502.CrossRefPubMed
16.
Pearson ML, Wu S, Schaefer J, Bonomi AE, Shortell SM, Mendel PJ, Marsteller JA, Louis TA, Rosen M, Keeler EB: Assessing the implementation of the chronic care model in quality improvement collaboratives. Health Serv Res. 2005, 40: 978-996. 10.1111/j.1475-6773.2005.00397.x.PubMedCentralCrossRefPubMed
17.
Peterson KA, Radosevich DM, O'Connor PJ, Nyman JA, Prineas RJ, Smith SA, Arneson TJ, Corbett VA, Weinhandl JC, Lange CJ, Hannan PJ: Improving diabetes care in practice: findings from the TRANSLATE trial. Diabetes Care. 2008, 31: 2238-2243. 10.2337/dc08-2034.PubMedCentralCrossRefPubMed
18.
Hoffman KA, Green CA, Ford JH, Wisdom JP, Gustafson DH, McCarty D: Improving quality of care in substance abuse treatment using five key process improvement principles. J Behav Health Serv Res. 2012, 39: 234-244. 10.1007/s11414-011-9270-y.PubMedCentralCrossRefPubMed
19.
Aarons GA, Hurlburt M, Horwitz SM: Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011, 38: 4-23. 10.1007/s10488-010-0327-7.PubMedCentralCrossRefPubMed
20.
21.
Quanbeck AR, Gustafson DH, Ford JH, Pulvermacher A, French MT, McConnell KJ, McCarty D: Disseminating quality improvement: study protocol for a large cluster-randomized trial. Implement Sci. 2011, 6: 44-10.1186/1748-5908-6-44.PubMedCentralCrossRefPubMed
22.
Bauer JE, Duffy GL, Westcott RT: The Quality Improvement Handbook. 2002, Milwaukee, WI: ASQ Quality Press
23.
McCarty D, Gustafson DH, Wisdom JP, Ford J, Choi D, Molfenter T, Capoccia V, Cotter F: The network for the improvement of addiction treatment (NIATx): enhancing access and retention. Drug Alcohol Depend. 2007, 88: 138-145. 10.1016/j.drugalcdep.2006.10.009.PubMedCentralCrossRefPubMed
24.
Rodgers R, Hunter JE, Rogers D: Influence of top management commitment on management program success. J Appl Psychol. 1993, 78: 151-155.CrossRef
25.
Bachman SS, Duckworth K: Consensus building for the development of service infrastructure for people with dual diagnosis. Adm Policy Ment Health. 2003, 30: 255-266. 10.1023/A:1023584410590.CrossRefPubMed
26.
Fixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F: Implementation Research: A Synthesis of the Literature. 2005, Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network
27.
Powell AE, Rushmer RK, Davies HTO: A Systematic Narrative Review of Quality Improvement Models in Health Care. 2008
28.
Beidas RS, Kendall PC: Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clin Psychol (New York). 2010, 17: 1-30.
29.
Miller WR, Zweben J, Johnson WR: Evidence-based treatment: Why, what, where, when, and how?. J Subst Abuse Treat. 2005, 29: 267-276. 10.1016/j.jsat.2005.08.003.CrossRefPubMed
30.
Hunter SB, Chinman M, Ebener P, Imm P, Wandersman A, Ryan GW: Technical assistance as a prevention capacity-building tool: a demonstration using the getting to outcomes framework. Health Educ Behav. 2009, 36: 810-828. 10.1177/1090198108329999.CrossRefPubMed
31.
Rogers EM: Diffusion of Innovations. 1995, New York: Free Press, 4
32.
Bandura A: Social Foundations of Thought and Action: A Social Cognitive Theory. 1986, Prentice Hall: Englewood Cliffs
33.
Levesque DA, Prochaska JM, Prochaska JO: Stages of change and integrated service delivery. Consult Psychol J Pract Res. 1999, 51: 226-241.CrossRef
34.
Hunter SB, Ebener P, Chinman M: Promoting Success: A Getting to Outcomes® Guide to Implementing Continuous Quality Improvement for Community Service Organizations. 2010, Santa Monica, CA: RAND Corporation
35.
Cook TD, Campbell DT, Day A: Quasi-Experimentation: Design & Analysis Issues for Field Settings. 1979, Boston: Houghton Mifflin
36.
Gambia Hepatitis Study Group: The Gambia hepatitis intervention study. Canc Res. 1987, 47: 5782-5787.
37.
38.
Smith PG, Smith PG, Morrow RH: Field Trials of Health Interventions in Developing Countries: A Toolbox. 1996, London: Macmillan Education Ltd
39.
Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA): National Survey of Substance Abuse Treatment Services. 2005, Rockville, MD: Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA)
40.
Deming WE: Out of Crisis. 2000, Cambridge: MIT Press
41.
Nicolas W, Farley DO, Vaiana ME, Cretin S: Putting Practice Guidelines to Work in the Department of Defense Medical System: A Guide for Action. 2001, Santa Monica, CA: RAND Corporation
42.
Fetterman DM, Wandersman A: Empowerment Evaluation Principles in Practice. 2005, New York: The Guilford Press
43.
Simpson DD: A conceptual framework for transferring research to practice. J Subst Abuse Treat. 2002, 22: 171-182. 10.1016/S0740-5472(02)00231-3.CrossRefPubMed
44.
Prochaska JO, DiClemente CC, Norcross JC: In search of how people change. Applications to addictive behaviors. Am Psychol. 1992, 47: 1102-1114.CrossRefPubMed
45.
Kolb DA: Experiential Learning: Experience as the Source of Learning and Development. 1984, Englewood Cliffs: Prentice-Hall
46.
Lewin K: Action research and minority problems. J Soc Issues. 1946, 2: 34-36. 10.1111/j.1540-4560.1946.tb02295.x.CrossRef
47.
Rakovshik SG, McManus F: Establishing evidence-based training in cognitive behavioral therapy: a review of current empirical findings and theoretical guidance. Clin Psychol Rev. 2010, 30: 496-516. 10.1016/j.cpr.2010.03.004.CrossRefPubMed
48.
Maslach C, Jackson SE: Maslach Burnout Inventory—Human Services Survey (MBI-HSS). MBI Manual. Edited by: Maslach C, Jackson SE, Leiter MP. 1996, Palo Alto: Consulting Psychologists Press, 5-3
49.
Lehman WE, Greener JM, Simpson DD: Assessing organizational readiness for change. J Subst Abuse Treat. 2002, 22: 197-209. 10.1016/S0740-5472(02)00233-7.CrossRefPubMed
50.
Aarons GA: Mental health provider attitudes toward adoption of evidence-based practice: the Evidence-Based Practice Attitude Scale (EBPAS). Ment Health Serv Res. 2004, 6: 61-74.PubMedCentralCrossRefPubMed
51.
Hall GE, Hord SM: Implementing Change: Patterns, Principles, and Potholes. 2001, Boston: Allyn and Bacon
52.
Scheirer M, Hartling G, Hagerman D: Defining sustainability outcomes of health programs: illustrations from an on-line survey. Eval Program Plann. 2008, 31: 335-346. 10.1016/j.evalprogplan.2008.08.004.CrossRefPubMed
53.
Grol R, Wensing M: What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust. 2004, 180: S57-S60.PubMed
54.
Moore GC, Benbasat I: Development of an instrument to measure the perceptions of adopting an information technology innovation. Inf Syst Res. 1991, 2: 192-222. 10.1287/isre.2.3.192.CrossRef
55.
56.
57.
Landsverk J, Brown CH, Chamberlain P, Palinkas L, Ogihara M, Czaja S, Goldhaber-Fiebert JD, Rolls Reutz AJ, McCue Horowitz S: Design and Analysis in Dissemination and Implementation Research. Dissemination and Implementation Research in Health: Translating Science to Practice. Edited by: Brownson R, Colditz GA, Proctor EK. 2012, Oxford: Oxford University Press
58.
Little RJA: Pattern-mixture models for multivariate incomplete data. J Am Stat Assoc. 1993, 88: 125-134.
59.
Chinman M, Hunter SB, Ebener P, Paddock SM, Stillman L, Imm P, Wandersman A: The getting to outcomes demonstration and evaluation: an illustration of the prevention support system. Am J Community Psychol. 2008, 41: 206-224. 10.1007/s10464-008-9163-2.PubMedCentralCrossRefPubMed
60.
Schoenwald SK, Hoagwood K: Effectiveness, transportability, and dissemination of interventions: what matters when?. Psychiatr Serv. 2001, 52: 1190-1197. 10.1176/appi.ps.52.9.1190.CrossRefPubMed
61.
Ennett ST, Ringwalt CL, Thorne J, Rohrbach LA, Vincus A, Simons-Rudolph A, Jones S: A comparison of current practice in school-based substance use prevention programs with meta-analysis findings. Prev Sci. 2003, 4: 1-14. 10.1023/A:1021777109369.CrossRefPubMed
62.
McCormick LK, Steckler AB, McLeroy KR: Diffusion of innovations in schools: a study of adoption and implementation of school-based tobacco prevention curricula. Am J Health Promot. 1995, 9: 210-219. 10.4278/0890-1171-9.3.210.CrossRefPubMed
63.
Parcel GS, Eriksen MP, Lovato CY, Gottlieb NH, Brink SG, Green LW: The diffusion of school-based tobacco-use prevention programs; Project description and baseline data. Health Educ Res. 1989, 4: 111-124. 10.1093/her/4.1.111.CrossRef
64.
Rohrbach LA, D’Onofrio CN, Backer TE, Montgomery SB: Diffusion of school-based substance abuse prevention programs. Am Behav Sci. 1996, 39: 919-934. 10.1177/0002764296039007012.CrossRef
65.
Rohrbach LA, Graham JW, Hansen WB: Diffusion of a school-based substance abuse prevention program: predictors of program implementation. Prev Med. 1993, 22: 237-260. 10.1006/pmed.1993.1020.CrossRefPubMed
66.
Steckler A, Goodman RM, McLeroy KR, Davis S, Koch G: Measuring the diffusion of innovative health promotion programs. Am J Health Promot. 1992, 6: 214-224. 10.4278/0890-1171-6.3.214.CrossRefPubMed
67.
Rounsaville BJ, Carroll KM, Onken LS: A stage model of behavioral therapies research: getting started and moving on from stage I. Clin Psychol. 2001, 8: 133-142.
68.
Joint Commission on the Accreditation of Health Care Organizations: Striving Toward Improvement: Six Hospitals in Search of Quality. 1992, Oakbrook Terrace, IL: Joint Commission on the Accreditation of Health Care Organizations
Metadata
Title
Continuous quality improvement (CQI) in addiction treatment settings: design and intervention protocol of a group randomized pilot study
Authors
Sarah B Hunter
Allison J Ober
Susan M Paddock
Priscillia E Hunt
Deborah Levan
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2014
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/1940-0640-9-4

Other articles of this Issue 1/2014

Addiction Science & Clinical Practice 1/2014 Go to the issue

Research

Clinically relevant characteristics associated with early treatment drug use versus abstinence

Study Protocol

Study design to develop and pilot-test a web intervention for partners of military service members with alcohol misuse

Research

Opioid use in Albuquerque, New Mexico: a needs assessment of recent changes and treatment availability

Research

A chance to stop and breathe: participants’ experiences in the North American Opiate Medication Initiative clinical trial

Research

Inconsistencies between alcohol screening results based on AUDIT-C scores and reported drinking on the AUDIT-C questions: prevalence in two US national samples

Research

Outcomes among buprenorphine-naloxone primary care patients after Hurricane Sandy