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Kennedy-Hendricks A, Song M, McCourt AD, Sharfstein JM, Eisenberg MD, Saloner B. Licensure Policies May Help States Ensure Access To Opioid Use Disorder Medication In Specialty Addiction Treatment. Health Aff (Millwood) 2024; 43:732-739. [PMID: 38709972 DOI: 10.1377/hlthaff.2023.01306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Despite the devastating toll of the overdose crisis in the United States, many addiction treatment programs do not offer medications for opioid use disorder (MOUD). Several states have incorporated MOUD requirements into their standards for treatment program licensure. This study examined policy officials' and treatment providers' perspectives on the implementation of these policies. During 2020-22, we conducted thirty-one semistructured interviews with forty policy officials and treatment providers in nine states identified through a legal analysis. Of these states, three states required treatment organizations to offer MOUD, and two prohibited organizations from denying admission to people receiving MOUD. Qualitative findings revealed that licensure policies were part of a broader effort to transition the specialty treatment system to a model of care more consistent with medical evidence; states perceived tension between raising quality standards and maintaining adequate treatment capacity; aligning other state policies with MOUD access goals facilitated implementation of the licensure requirement; and measuring compliance was challenging. Licensure may offer states an opportunity to take a more active role in ensuring access to effective treatment.
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Stahler GJ, Mennis J, Stein LAR, Belenko S, Rohsenow DJ, Grunwald HE, Brinkley-Rubinstein L, Martin RA. Treatment outcomes associated with medications for opioid use disorder (MOUD) among criminal justice-referred admissions to residential treatment in the U.S., 2015-2018. Drug Alcohol Depend 2022; 236:109498. [PMID: 35605535 DOI: 10.1016/j.drugalcdep.2022.109498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/03/2022]
Abstract
AIMS To examine the use and association of medications for opioid use disorder (MOUD) with treatment completion and retention for criminal justice referred (CJR) admissions to residential treatment. METHODS A retrospective analysis of the Treatment Episode Dataset-Discharge (TEDS-D; 2015-2018) for adults (N = 205,348) admitted to short-term (ST) (< 30 days) or long-term (LT) (>30 days) residential treatment for OUD. Outcomes were MOUD in treatment plans, and treatment completion and retention (ST >10 days; LT > 90 days). Logistic regression analyses were conducted separately for ST and LT settings. RESULTS CJR admissions were less likely to have MOUD than non-CJR admissions (ST, 11% vs. 21%; LT, 10% vs. 24%, respectively) and were more likely to complete and be retained in treatment. In ST settings, MOUD was associated with higher likelihood of treatment completion and retention. In LT settings, MOUD was associated with higher likelihood of treatment retention and lower likelihood of treatment completion. These associations tended to be slightly weaker for CJR admissions, with the exception of treatment completion in LT settings, but the moderating effect size of CJR status in all models was very small. Small differences in the moderating effect of CJR status by race and ethnicity were observed in LT settings. CONCLUSIONS MOUD is greatly under-utilized for CJR patients, and given that MOUD was associated with positive outcomes, there is a critical need to find ways to increase access to MOUD for CJR patients in residential treatment. Race and ethnicity appear to have relatively little impact on outcomes.
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Affiliation(s)
- Gerald J Stahler
- Department of Geography and Urban Studies, Temple University, United States.
| | - Jeremy Mennis
- Department of Geography and Urban Studies, Temple University, United States
| | - L A R Stein
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, United States; Department of Psychology, The University of Rhode Island, United States
| | - Steven Belenko
- Department of Criminal Justice, Temple University, United States
| | - Damaris J Rohsenow
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, United States
| | | | | | - Rosemarie A Martin
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, United States
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Panza KE, Kline AC, Na PJ, Potenza MN, Norman SB, Pietrzak RH. Epidemiology of DSM-5 alcohol use disorder in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Drug Alcohol Depend 2022; 231:109240. [PMID: 34974271 DOI: 10.1016/j.drugalcdep.2021.109240] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Alcohol use disorder (AUD) is a prevalent public health concern in the U.S. that disproportionately affects veterans relative to civilians. Given changes to the demographic composition of the veteran population and AUD diagnostic criteria in the DSM-5, updated knowledge regarding the epidemiology of DSM-5 AUD in a national sample of veterans is critical to informing the population-based burden of this disorder. METHODS Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 4069 U.S. veterans. Lifetime DSM-5 AUD (mild, moderate, severe) and past-year DSM-5 AUD were assessed using validated self-report measures, and sociodemographic, military, and psychiatric characteristics associated with lifetime and past-year AUD were evaluated. RESULTS Prevalences of lifetime and past-year DSM-5 AUD were 40.8% (95% confidence interval [CI]=39.2-42.3%) and 10.5% (95%CI=9.6-11.5%), respectively. Lifetime prevalences of mild, moderate, and severe AUD were 20.5%, 8.3%, and 12.0%, respectively. Veterans with lifetime AUD had elevated rates of psychiatric disorders and suicidal behavior, which generally increased as a function of AUD severity. Lifetime AUD was also associated with being younger, male, white, unmarried, retired and experiencing more adverse childhood experiences and traumas. For past-year AUD, being younger, male, white, having more adverse childhood experiences, and experiencing lifetime PTSD were significant correlates. CONCLUSIONS AUD is highly prevalent among U.S. veterans and associated with substantial psychopathology, including elevated odds of suicidal behaviors. Results underscore the importance of comprehensive screening and preventive efforts for AUD, and interventions that concurrently target overlapping alcohol use and psychiatric difficulties.
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Affiliation(s)
- Kaitlyn E Panza
- VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California, San Diego, CA 92093, USA.
| | - Alexander C Kline
- VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06516, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06516, USA; Department of Neuroscience, Yale University, New Haven, CT 06516, USA; Child Study Center, Yale School of Medicine, New Haven, CT 06516, USA; Connecticut Mental Health Center, New Haven, CT 06516, USA; Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
| | - Sonya B Norman
- VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California, San Diego, CA 92093, USA; VA Center of Excellence for Stress and Mental Health, San Diego, CA 92161, USA; National Center for PTSD, White River Junction, VT 05009, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06516, USA; National Center for PTSD, West Haven, CT 06516, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06511, USA
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Jacobson N, Horst J, Wilcox-Warren L, Toy A, Knudsen HK, Brown R, Haram E, Madden L, Molfenter T. Organizational Facilitators and Barriers to Medication for Opioid Use Disorder Capacity Expansion and Use. J Behav Health Serv Res 2020; 47:439-448. [PMID: 32347426 PMCID: PMC7578054 DOI: 10.1007/s11414-020-09706-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Medication for opioid use disorder (MOUD) is a key strategy for addressing the opioid use disorder crisis, yet gaps in MOUD provision impede this strategy's benefits. The research reported here sought to understand what distinguishes low- and high-performing organizations in building and using capacity to provide MOUD. As part of a mixed methods MOUD implementation trial, semi-structured telephone interviews were conducted with personnel from low- and high-performing MOUD-providing organizations. Seventeen individuals from 17 organizations were interviewed. Findings demonstrate the importance of individual, organization, and community-level factors in supporting the building and use of MOUD capacity. Low- and high-performing organizations showed different patterns of facilitators and barriers during the implementation process. The key difference between low- and high-performing organizations was the level of organizational functioning. A better understanding of an organization's assets and deficits at the individual, organizational, and community levels would allow decision-makers to tailor their approaches to MOUD implementation.
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Affiliation(s)
- Nora Jacobson
- University of Wisconsin, Institute for Clinical and Translational Research, Signe Skott Cooper Hall, 701 Highland Avenue, Madison, WI, 53703, USA.
| | - Julie Horst
- University of Wisconsin Center for Health Enhancement Systems Studies, Mechanical Engineering Building, 1513 University Ave, Madison, WI, 53703, USA
| | - Liam Wilcox-Warren
- University of Wisconsin Center for Health Enhancement Systems Studies, Mechanical Engineering Building, 1513 University Ave, Madison, WI, 53703, USA
| | - Alex Toy
- University of Wisconsin Center for Health Enhancement Systems Studies, Mechanical Engineering Building, 1513 University Ave, Madison, WI, 53703, USA
| | - Hannah K Knudsen
- Robert Straus Behavioral Science Laboratory, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Randy Brown
- University of Wisconsin Center for Health Enhancement Systems Studies, Mechanical Engineering Building, 1513 University Ave, Madison, WI, 53703, USA
| | - Eric Haram
- Haram Counseling, 66 Baribeau Dr Ste 8, Brunswick, ME, 04011, USA
| | - Lynn Madden
- Yale School of Medicine, APT Foundation, One Long Wharf Drive, Suite 321, New Haven, CT, 06511, USA
| | - Todd Molfenter
- University of Wisconsin Center for Health Enhancement Systems Studies, Mechanical Engineering Building, 1513 University Ave, Madison, WI, 53703, USA
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Prevention, screening, and treatment for heavy drinking and alcohol use disorder. Lancet Psychiatry 2019; 6:1054-1067. [PMID: 31630982 PMCID: PMC6883141 DOI: 10.1016/s2215-0366(19)30213-5] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 12/21/2022]
Abstract
Heavy drinking and alcohol use disorder are major public health problems. Practitioners not specialising in alcohol treatment are often unaware of the guidelines for preventing, identifying, and treating heavy drinking and alcohol use disorder. However, a consensus exists that clinically useful and valuable tools are available to address these issues. Here, we review existing information and developments from the past 5 years in these areas. We also include information on heavy drinking and alcohol use disorder among individuals with co-occurring psychiatric disorders, including drug use disorders. Areas covered include prevention; screening, brief intervention, and referral for treatment; evidence-based behavioural interventions; medication-assisted treatment; technology-based interventions (eHealth and mHealth); and population-level interventions. We also discuss the key topics for future research.
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Reif S, Brolin MF, Stewart MT, Fuchs TJ, Speaker E, Mazel SB. The Washington State Hub and Spoke Model to increase access to medication treatment for opioid use disorders. J Subst Abuse Treat 2019; 108:33-39. [PMID: 31358328 DOI: 10.1016/j.jsat.2019.07.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/08/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The federal Opioid State Targeted Response (Opioid STR) grants provided funding to each state to ramp up the range of responses to reverse the ongoing opioid crisis in the U.S. Washington State used these funds to develop and implement an integrated care model to expand access to medication treatment and reduce unmet need for people with opioid use disorders (OUD), regardless of how they enter the treatment system. This paper examines the design, early implementation and results of the Washington State Hub and Spoke Model. METHODS Descriptive data were gathered from key informants, document review, and aggregate data reported by hubs and spokes to Washington State's Opioid STR team. RESULTS The Washington State Hub and Spoke Model reflects a flexible approach that incorporates primary care and substance use treatment programs, as well as outreach, referral and social service organizations, and a nurse care manager. Hubs could be any type of program that had the required expertise and capacity to lead their network in medication treatment for OUD, including all three FDA-approved medications. Six hub-spoke networks were funded, with 8 unique agencies on average, and multiple sites. About 150 prescribers are in these networks (25 on average). In the first 18 months, nearly 5000 people were inducted onto OUD medication treatment: 73% on buprenorphine, 19% on methadone, and 9% on naltrexone. CONCLUSIONS The Washington State Hub and Spoke Model built on prior approaches to improve the delivery system for OUD medication treatment and support services, by increasing integration of care, ensuring "no wrong door," engaging with community agencies, and supporting providers who are offering medication treatment. It used essential elements from existing integrated care OUD treatment models, but allowed for organic restructuring to meet the population needs within a community. To date, there have been challenges and successes, but with this approach, Washington State has provided medication treatment for OUD to nearly 5000 people. Sustainability efforts are underway. In the face of the ongoing opioid crisis, it remains essential to develop, implement and evaluate novel models, such as Washington's Hub and Spoke approach, to improve treatment access and increase capacity.
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Affiliation(s)
- Sharon Reif
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02453, USA.
| | - Mary F Brolin
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02453, USA
| | - Maureen T Stewart
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02453, USA
| | - Thomas J Fuchs
- Division of Behavioral Health and Recovery, Washington State Health Care Authority, 626 8th Avenue SE, P.O. Box 45330, Olympia, WA 98504, USA
| | - Elizabeth Speaker
- Research and Data Analysis, Washington State Department of Social and Health Services, 1115 Washington Street, P.O. Box 4520, Olympia, WA 98504, USA
| | - Shayna B Mazel
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02453, USA
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Bartholow LAM, Pope J. Use of Buprenorphine to Treat Opioid Use Disorder. J Psychosoc Nurs Ment Health Serv 2018; 56:9-12. [PMID: 30383881 DOI: 10.3928/02793695-20181012-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As the opioid crisis continues to worsen in the United States, nurses must take on a central role of intervention, which includes use of the opioid agonist medication, buprenorphine. The current article addresses the need to understand opioid use disorder as a chronic condition and increase access to treatment with pharmacotherapies, particularly buprenorphine, in outpatient settings. The pharmacological activity of buprenorphine is discussed, as well as the reasons for its underutilization, specifically stigma. Nurses can be frontline leaders in the fight against the opioid crisis by addressing stigma and increasing access to the life-saving medication, buprenorphine. [Journal of Psychosocial Nursing and Mental Health Services, 56(11), 9-12.].
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Reif S, Horgan CM, Hodgkin D, Matteucci AM, Creedon TB, Stewart MT. Access to Addiction Pharmacotherapy in Private Health Plans. J Subst Abuse Treat 2016; 66:23-9. [PMID: 27211993 PMCID: PMC4879589 DOI: 10.1016/j.jsat.2016.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 03/01/2016] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND An increasing number of medications are available to treat addictions. To understand access to addiction medications, it is essential to consider the role of private health plans. To contain medication expenditures, most U.S. health plans use cost-sharing and administrative controls, which may impact physicians' prescribing and patients' use of addiction medications. This study identified health plan approaches to manage access to and utilization of addiction medications (oral and injectable naltrexone, acamprosate, and buprenorphine). METHODS Data are from a nationally representative survey of private health plans in 2010 (n=385 plans, 935 products; response rate 89%), compared to the same survey in 2003. The study assessed formulary inclusion, prior authorization, step therapy, overall restrictiveness, and if and how health plans encourage pharmacotherapy. RESULTS Formulary exclusions were rare in 2010, with acamprosate excluded most often, by only 9% of products. Injectable naltrexone was covered by 96% of products. Prior authorization was common for injectable naltrexone (85%) and rare for acamprosate (3%). Step therapy policies were used only for injectable naltrexone (41%) and acamprosate (20%). Several medications were often on the most expensive tier. Changes since 2003 include fewer exclusions, yet increased use of other management approaches. Most health plans encourage use of addiction pharmacotherapy, and use a variety of methods to do so. CONCLUSIONS Management of addiction medications has increased over time but it is not ubiquitous. However, health plans now also include all medications on formularies and encourage providers to use them, indicating that they value addiction pharmacotherapy as an evidence-based practice.
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Affiliation(s)
- Sharon Reif
- Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02453, USA..
| | - Constance M Horgan
- Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02453, USA..
| | - Dominic Hodgkin
- Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02453, USA..
| | - Ann-Marie Matteucci
- Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02453, USA.; Department of Health Management and Policy, University of New Hampshire, 4 Library Way, Durham, NH 03824, USA.
| | - Timothy B Creedon
- Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02453, USA..
| | - Maureen T Stewart
- Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02453, USA..
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Pade P, Fehling P, Collins S, Martin L. Opioid overdose prevention in a residential care setting: Naloxone education and distribution. Subst Abus 2016; 38:113-117. [DOI: 10.1080/08897077.2016.1176978] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Patricia Pade
- Department of Family Medicine, Center for Dependency, Addiction and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Patrick Fehling
- Department of Psychiatry, Center for Dependency, Addiction and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Sophie Collins
- Center for Dependency, Addiction and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Laura Martin
- Department of Psychiatry, Center for Dependency, Addiction and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA
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Knudsen HK, Roman PM. Medicaid, Private Insurance, and the Availability of Smoking Cessation Interventions in Substance Use Disorder Treatment. Psychiatr Serv 2015; 66:1213-20. [PMID: 26234332 PMCID: PMC4630091 DOI: 10.1176/appi.ps.201400451] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Integration of smoking cessation services in substance use disorder treatment would benefit many patients. Although prior studies have identified organizational characteristics associated with delivery of these services, less is known regarding associations between financial factors and the availability of smoking cessation services. This study examined whether reliance on Medicaid and private insurance revenues is associated with the availability of a formal counseling-based smoking cessation program and medications (sustained-release bupropion, varenicline, and nicotine replacement) within U.S. specialty treatment organizations. METHODS Administrators of a national sample of 372 treatment organizations participated in face-to-face structured interviews from October 2011 to December 2013. Participants provided data regarding smoking cessation services, revenue sources, and other organizational characteristics. Multiple imputation was used to address missing data, and models were estimated by using logistic regression with adjustment for clustering of organizations within states. RESULTS Greater reliance on Medicaid revenues was positively associated with the odds of offering counseling-based smoking cessation programs, sustained-release bupropion, varenicline, and nicotine replacement. For example, a 10-percentage point increase in Medicaid revenues was associated with a 12% increase in the odds of offering a smoking cessation program. Reliance on private insurance revenues was positively associated with the odds of offering the three medications. CONCLUSIONS The findings point to future potential increases in the availability of smoking cessation services in the context of expanding insurance coverage under health care reform. Longitudinal research will be needed to examine whether this impact is realized.
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Affiliation(s)
- Hannah K Knudsen
- Dr. Knudsen is with the Department of Behavioral Science, University of Kentucky, Lexington (e-mail: ). Dr. Roman is with the Department of Sociology and the Owens Institute for Behavioral Research, University of Georgia, Athens
| | - Paul M Roman
- Dr. Knudsen is with the Department of Behavioral Science, University of Kentucky, Lexington (e-mail: ). Dr. Roman is with the Department of Sociology and the Owens Institute for Behavioral Research, University of Georgia, Athens
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Means SN, Magura S, Burkhardt JT, Schröter DC, Coryn CL. Comparing rating paradigms for evidence-based program registers in behavioral health: evidentiary criteria and implications for assessing programs. EVALUATION AND PROGRAM PLANNING 2015; 48:100-16. [PMID: 25450778 PMCID: PMC4308470 DOI: 10.1016/j.evalprogplan.2014.09.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Decision makers need timely and credible information about the effectiveness of behavioral health interventions. Online evidence-based program registers (EBPRs) have been developed to address this need. However, the methods by which these registers determine programs and practices as being “evidence-based” has not been investigated in detail. This paper examines the evidentiary criteria EBPRs use to rate programs and the implications for how different registers rate the same programs. Although the registers tend to employ a standard Campbellian hierarchy of evidence to assess evaluation results, there is also considerable disagreement among the registers about what constitutes an adequate research design and sufficient data for designating a program as evidence-based. Additionally, differences exist in how registers report findings of “no effect,” which may deprive users of important information. Of all programs on the 15 registers that rate individual programs, 79% appear on only one register. Among a random sample of 100 programs rated by more than one register, 42% were inconsistently rated by the multiple registers to some degree.
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Affiliation(s)
- Stephanie N. Means
- The Evaluation Center at Western Michigan University, 1903 W Michigan Ave Kalamazoo, MI 49007
| | - Stephen Magura
- The Evaluation Center at Western Michigan University, 1903 W Michigan Ave Kalamazoo, MI 49007
| | - Jason T. Burkhardt
- The Evaluation Center at Western Michigan University, 1903 W Michigan Ave Kalamazoo, MI 49007
| | - Daniela C. Schröter
- The Evaluation Center at Western Michigan University, 1903 W Michigan Ave Kalamazoo, MI 49007
| | - Chris L.S. Coryn
- Interdisciplinary Ph.D. in Evaluation, Western Michigan University, 1903 W Michigan Ave Kalamazoo, MI 49007
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