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Stein L, Bassett SS, Welsh WN, Clair-Michaud M, Abdel-Salam S, Monico L, Gallagher C, Murgo C, Yang Y, Friedmann PD, Clarke JG. Implementation Strategy Fidelity and Organizational Outcomes in a Randomized Trial: Implications for Reentry from Corrections to Community Treatment. Subst Use Misuse 2023; 58:320-330. [PMID: 36629127 PMCID: PMC9969992 DOI: 10.1080/10826084.2022.2161311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: This study examined fidelity of implementation strategies used in an organizational process improvement intervention (OPII) designed to improve evidence-based practices related to assessments for drug-involved clients exiting incarceration. Leadership was studied as a moderating factor between fidelity and outcomes. Methods: A mixed-method cluster randomized design was used to randomize 21 sites to early- or delayed-start within 9 research centers. Parent study protocol was reviewed to develop fidelity constructs (i.e., responsiveness, dose, quality, adherence). Outcomes were site-level success in achieving goals and objectives completed during the OPII (e.g., percent goals achieved). Correlations, analyses of covariance, regressions and moderation analyses were performed. Qualitative interviews assessed facilitators/barriers to implementation. Results: Fidelity constructs related to outcomes. No differences were found in fidelity by early or delayed condition. At low levels of leadership, high staff responsiveness (i.e., engagement in the OPII) related to poorer outcome. Conclusions: It is important to consider contextual factors (e.g., leadership) that may influence implementation strategy fidelity when deploying evidence-based practices. Findings are relevant to researchers, clinicians, administrators and policy makers, and suggest that goal completion during implementation of evidence-based practices requires monitoring of leadership competence, fidelity to implementation strategies (i.e., staff responsiveness to strategies) and attendance to goal importance.
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Affiliation(s)
- L.A.R. Stein
- Dept of Psychology/ Social Sciences Research Ctr, Univ. of Rhode Island, Kingston, RI, USA
- Rhode Island Training School, Cranston, RI, USA
- Center for Alcohol & Addiction Studies and Dept of Behavioral & Social Sciences, Brown Univ. School of Public Health, Providence, RI, USA
| | | | - Wayne N. Welsh
- Dept of Criminal Justice, Temple Univ., Philadelphia, PA, USA
| | - Mary Clair-Michaud
- Dept of Psychology/ Social Sciences Research Ctr, Univ. of Rhode Island, Kingston, RI, USA
- Rhode Island Training School, Cranston, RI, USA
| | - Sami Abdel-Salam
- Dept of Criminal Justice, West Chester Univ., West Chester, PA, USA
| | - Laura Monico
- Friends Research Institute, Inc., Baltimore, MD, USA
| | | | - Cecilia Murgo
- Dept of Psychology/ Social Sciences Research Ctr, Univ. of Rhode Island, Kingston, RI, USA
| | - Yang Yang
- Institute of Behavioral Research, Texas Christian Univ, Fort Worth, TX, USA
| | | | - Jennifer G. Clarke
- Alpert Medical School of Brown Univ, Providence, RI, USA
- Rhode Island Dept of Corrections, Cranston, RI, USA
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Glasner S, Webb J, Michero D, Motschman C, Monico L, Ang A, Pielsticker P. Feasibility, Acceptability, and Preliminary Outcomes of an Integrated Telemedicine Intervention Combining Naltrexone and Cognitive Behavioral Therapy for Alcohol Use Disorder. Telemed Rep 2022; 3:184-190. [PMID: 36479135 PMCID: PMC9718429 DOI: 10.1089/tmr.2022.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND A small fraction of individuals in need of treatment for alcohol use disorders (AUDs) seek care, owing largely to barriers to accessing treatment. In the present pilot study, we examine the feasibility, acceptability, and preliminary outcomes of an m-health intervention combining cognitive behavioral therapy and pharmacotherapy for individuals with AUD. METHODS Adults with AUD (N = 26) recruited through online, social media-based advertising were enrolled in a 12-week, integrated telemedicine intervention combining psychosocial treatment with medical management: Quit Genius for AUD (QG-A). Feasibility, acceptability, perceived helpfulness, treatment engagement, retention, completion, and clinical outcomes including alcohol use and secondary mental health outcomes were assessed. RESULTS Participants found the QG-A intervention to be acceptable and helpful in facilitating action toward their therapeutic goals concerning alcohol use. Treatment completion, achieved by the majority (85%) of participants, was excellent. On average, participants reduced their past 30-day alcohol use from baseline (mean proportion of days of abstinent = 0.13) to follow-up (M = 0.59), t(19) = -4.97, p < 0.001, and consumed fewer drinks per drinking day from baseline (M = 6.7) to follow-up (M = 2.0), t(19) = 3.61, p < 0.001. Concurrently, reductions were observed in depressive (t[22] = 5.39, p < 0.001) and anxiety (t[22] = 2.87, p < 0.01) symptom severity, from the moderately severe range at baseline to the mild range at treatment-end, with increases in resilience (t[22] = -3.54, p < 0.001). CONCLUSIONS Addressing AUDs using an integrated m-health intervention to deliver evidence-based psychosocial and pharmacological treatment is feasible and may produce improvements in both alcohol use and psychiatric symptoms.
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Affiliation(s)
- Suzette Glasner
- Department of Clinical Affairs, Digital Therapeutics, Inc., San Francisco, California, USA
- Department of Psychiatry & Biobehavioral Sciences, UCLA Integrated Substance Abuse Programs, Los Angeles, California, USA
| | - Jamie Webb
- Department of Clinical Affairs, Digital Therapeutics, Inc., San Francisco, California, USA
| | - Darcy Michero
- Department of Clinical Affairs, Digital Therapeutics, Inc., San Francisco, California, USA
| | - Courtney Motschman
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri, USA
| | - Laura Monico
- Friends Research Institute, Baltimore, Maryland, USA
| | - Alfonso Ang
- Department of Clinical Affairs, Digital Therapeutics, Inc., San Francisco, California, USA
- Department of Psychiatry & Biobehavioral Sciences, UCLA Integrated Substance Abuse Programs, Los Angeles, California, USA
| | - Peyton Pielsticker
- Department of Clinical Affairs, Digital Therapeutics, Inc., San Francisco, California, USA
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Vlachou–Mogire C, Moretti P, Monico L, Chieli A, Iwanicka M, Targowski P, Detalle V, Bourguignon E, Laclavetine K, Mirambet F, Tong T, Pinchin S. Corrigendum to ‘A non-invasive multi-technique investigation of banqueting house whitehall rubens ceiling paintings’ [Microchem. J. 156 (2020) 104797]. Microchem J 2021. [DOI: 10.1016/j.microc.2021.106624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Waddell EN, Springer SA, Marsch LA, Farabee D, Schwartz RP, Nyaku A, Reeves R, Goldfeld K, McDonald RD, Malone M, Cheng A, Saunders EC, Monico L, Gryczynski J, Bell K, Harding K, Violette S, Groblewski T, Martin W, Talon K, Beckwith N, Suchocki A, Torralva R, Wisdom JP, Lee JD. Long-acting buprenorphine vs. naltrexone opioid treatments in CJS-involved adults (EXIT-CJS). J Subst Abuse Treat 2021; 128:108389. [PMID: 33865691 PMCID: PMC8384640 DOI: 10.1016/j.jsat.2021.108389] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/16/2021] [Accepted: 03/23/2021] [Indexed: 11/30/2022]
Abstract
The EXIT-CJS (N = 1005) multisite open-label randomized controlled trial will compare retention and effectiveness of extended-release buprenorphine (XR-B) vs. extended-release naltrexone (XR-NTX) to treat opioid use disorder (OUD) among criminal justice system (CJS)-involved adults in six U.S. locales (New Jersey, New York City, Delaware, Oregon, Connecticut, and New Hampshire). With a pragmatic, noninferiority design, this study hypothesizes that XR-B (n = 335) will be noninferior to XR-NTX (n = 335) in retention-in-study-medication treatment (the primary outcome), self-reported opioid use, opioid-positive urine samples, opioid overdose events, and CJS recidivism. In addition, persons with OUD not eligible or interested in the RCT will be recruited into an enhanced treatment as usual arm (n = 335) to examine usual care outcomes in a quasi-experimental observational cohort.
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Affiliation(s)
- Elizabeth Needham Waddell
- School of Public Health and OHSU School of Medicine, Oregon Health & Science University, United States of America
| | | | | | | | | | - Amesika Nyaku
- The State University of New Jersey, New Jersey Medical School, United States of America
| | - Rusty Reeves
- Rutgers, University Correctional Health Care, Rutgers - Robert Wood Johnson Medical School, United States of America
| | | | | | - Mia Malone
- Friends Research Institute, United States of America
| | - Anna Cheng
- Friends Research Institute, United States of America
| | | | - Laura Monico
- Friends Research Institute, United States of America
| | | | | | - Kasey Harding
- Community Health Center, Inc, United States of America
| | | | | | | | - Kasey Talon
- ROAD to a Better Life, United States of America
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Vlachou-Mogire C, Moretti P, Monico L, Chieli A, Iwanicka M, Targowski P, Detalle V, Bourguignon E, Laclavetine K, Mirambet F, Tong T, Pinchin S. A non-invasive multi-technique investigation of Banqueting House Whitehall Rubens ceiling paintings. Microchem J 2020. [DOI: 10.1016/j.microc.2020.104797] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gryczynski J, Mitchell SG, Schwartz RP, Kelly SM, Dušek K, Monico L, O'Grady KE, Brown BS, Oros M, Hosler C. Disclosure of Adolescent Substance Use in Primary Care: Comparison of Routine Clinical Screening and Anonymous Research Interviews. J Adolesc Health 2019; 64:541-543. [PMID: 30578116 PMCID: PMC6601606 DOI: 10.1016/j.jadohealth.2018.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE The American Academy of Pediatrics recommends substance use screening in adolescent primary care. Many studies of substance use prevalence and screening tool validation are conducted under research protocols that differ from routine clinical screening in context, consequences, and privacy implications. METHODS This study is a secondary analysis drawing from two projects focused on adolescent primary care patients, aged 12-17, conducted nearly contemporaneously in a Federally Qualified Health Center system. The first project conducted anonymous research interviews with patients (N = 525), while the other tracked routine clinical screening as part of a larger service implementation project (N = 5,971). Both projects assessed substance use with the CRAFFT screening tool. RESULTS Rates of substance use disclosure and substance use problems were over three and four times higher, respectively, in the anonymous research interview sample compared to rates found in routine clinical screening (p values < .001). CONCLUSIONS Routine clinical screening may underestimate substance use among adolescents.
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Affiliation(s)
- Jan Gryczynski
- Friends Research Institute, Social Research Center, Baltimore, Maryland.
| | | | - Robert P Schwartz
- Friends Research Institute, Social Research Center, Baltimore, Maryland
| | - Sharon M Kelly
- Friends Research Institute, Social Research Center, Baltimore, Maryland
| | - Kristi Dušek
- Friends Research Institute, Social Research Center, Baltimore, Maryland
| | - Laura Monico
- Friends Research Institute, Social Research Center, Baltimore, Maryland
| | | | - Barry S Brown
- University of North Carolina, Wilmington, North Carolina
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Abstract
This article describes the experience and outcomes of the National Institute on Drug Abuse-funded Criminal Justice Drug Abuse Treatment Studies 2 Improving Best Practices in Assessment and Case Planning for Offenders protocol in the state of New Jersey. The protocol was designed to test the effectiveness of an Organizational Process Improvement Intervention in improving four assessment and case planning domains for drug-involved offenders in correctional settings transferring to community treatment based agencies. This article describes the protocol and the change team model process through which correctional and community agency staff collaborated to improve assessment and case planning for offenders with substance abuse problems. The primary goal of these collaborative efforts was to link information across stages of the treatment continuum to improve service coordination. Data taken from qualitative interviews with agency participants are used to illustrate the common themes that emerged relating to the intervention process, barriers to implementing developed goals, and facilitative factors that contributed to successes. The findings from the current study provide indication that organizational process improvement strategies can be implemented within a correctional setting to reduce interorganizational barriers and to facilitate improvements in the continuum of care involved in the treatment of offenders with histories of substance abuse.
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Welsh WN, Prendergast M, Knight K, Knudsen H, Monico L, Gray J, Abdel-Salam S, Redden SM, Link N, Hamilton L, Shafer MS, Friedmann PD. CORRELATES OF INTERORGANIZATIONAL SERVICE COORDINATION IN COMMUNITY CORRECTIONS. Crim Justice Behav 2016; 43:483-505. [PMID: 27546925 PMCID: PMC4988680 DOI: 10.1177/0093854815607306] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Because weak interagency coordination between community correctional agencies (e.g., probation and parole) and community-based treatment providers has been identified as a major barrier to the use of evidence-based practices (EBPs) for treating druginvolved offenders, this study sought to examine how key organizational (e.g., leadership, support, staffing) and individual (e.g., burnout, satisfaction) factors influence interagency relationships between these agencies. At each of 20 sites, probation/parole officials (n = 366) and community treatment providers (n = 204) were surveyed about characteristics of their agencies, themselves, and interorganizational relationships with each other. Key organizational and individual correlates of interagency relationships were examined using hierarchical linear models (HLM) analyses, supplemented by interview data. The strongest correlates included Adaptability, Efficacy, and Burnout. Implications for policy and practice are discussed.
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Affiliation(s)
| | | | | | | | - Laura Monico
- University of Delaware, Friends Research Institute
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Monico L, Schwartz RP, Gryczynski J, O'Grady KE, Mitchell SG. Two Models of Integrating Buprenorphine Treatment and Medical Staff within Formerly "Drug-Free" Outpatient Programs. J Psychoactive Drugs 2016; 48:101-8. [PMID: 26940870 DOI: 10.1080/02791072.2015.1130884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
"Drug-free" outpatient programs deliver treatment to the largest number of patients of all treatment modalities in the U.S., providing a significant opportunity to expand access to medication treatments for substance use disorders. This analysis examined staff perceptions of organizational dynamics associated with the delivery of buprenorphine maintenance within three formerly "drug-free" outpatient treatment programs. Semi-structured interviews (N = 15) were conducted with counseling and medical staff, and respondents were predominantly African American (n = 11) and female (n = 12). Themes and concepts related to medical staff integration emerged through an inductive and iterative coding process using Atlas.ti qualitative analysis software. Two treatment clinics incorporated buprenorphine maintenance into their programs using a co-located model of care. Their staff generally reported greater intra-organizational discord regarding the best ways to combine medication and counseling compared to the clinic using an integrated model of care. Co-located program staff reported less communication between medical and clinical staff, which contributed to some uncertainty about proper dosing and concerns about the potential for medication diversion. Clinics that shift from "drug-free" to incorporating buprenorphine maintenance should consider which model of care they wish to adapt and how to train staff and structure staff communication.
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Affiliation(s)
- Laura Monico
- a Research Associate, Friends Research Institute , Baltimore , MD , USA
| | - Robert P Schwartz
- b Medical Director/Senior Research Scientist, Friends Research Institute , Baltimore , MD , USA
| | - Jan Gryczynski
- c Senior Research Scientist, Friends Research Institute , Baltimore , MD , USA
| | - Kevin E O'Grady
- d Associate Professor, University of Maryland , Department of Psychology , College Park , MD , USA
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Brunetti B, Miliani C, Rosi F, Doherty B, Monico L, Romani A, Sgamellotti A. Non-invasive Investigations of Paintings by Portable Instrumentation: The MOLAB Experience. Top Curr Chem (Cham) 2016; 374:10. [DOI: 10.1007/s41061-015-0008-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 12/17/2015] [Indexed: 11/30/2022]
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Welsh WN, Knudsen HK, Knight K, Ducharme L, Pankow J, Urbine T, Lindsey A, Abdel-Salam S, Wood J, Monico L, Link N, Albizu-Garcia C, Friedmann PD. Effects of an Organizational Linkage Intervention on Inter-Organizational Service Coordination Between Probation/Parole Agencies and Community Treatment Providers. Adm Policy Ment Health 2016; 43:105-21. [PMID: 25559124 PMCID: PMC4492902 DOI: 10.1007/s10488-014-0623-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Weak coordination between community correctional agencies and community-based treatment providers is a major barrier to diffusion of medication-assisted treatment (MAT)--the inclusion of medications (e.g., methadone and buprenorphine) in combination with traditional counseling and behavioral therapies to treat substance use disorders. In a multisite cluster randomized trial, experimental sites (j = 10) received a 3-h MAT training plus a 12-month linkage intervention; control sites (j = 10) received the 3-h training alone. Hierarchical linear models showed that the intervention resulted in significant improvements in perceptions of interagency coordination among treatment providers, but not probation/parole agents. Implications for policy and practice are discussed.
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Affiliation(s)
| | | | | | - Lori Ducharme
- The National Institute on Alcohol Abuse and Alcoholism (NIAAA), Rockville, MD, USA
| | | | | | | | | | | | | | | | | | - Peter D Friedmann
- Providence Veteran Affairs Medical Center and Brown University, Providence, USA
- Rhode Island Hospital, Providence, USA
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Welsh WN, Lin HJ, Peters RH, Stahler GJ, Lehman WEK, Stein LAR, Monico L, Eggers M, Abdel-Salam S, Pierce JC, Hunt E, Gallagher C, Frisman LK. Effects of a strategy to improve offender assessment practices: Staff perceptions of implementation outcomes. Drug Alcohol Depend 2015; 152:230-8. [PMID: 25896737 PMCID: PMC4458146 DOI: 10.1016/j.drugalcdep.2015.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/24/2015] [Accepted: 03/28/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND This implementation study examined the impact of an organizational process improvement intervention (OPII) on a continuum of evidence based practices related to assessment and community reentry of drug-involved offenders: Measurement/Instrumentation, Case Plan Integration, Conveyance/Utility, and Service Activation/Delivery. METHODS To assess implementation outcomes (staff perceptions of evidence-based assessment practices), a survey was administered to correctional and treatment staff (n=1509) at 21 sites randomly assigned to an Early- or Delayed-Start condition. Hierarchical linear models with repeated measures were used to examine changes in evidence-based assessment practices over time, and organizational characteristics were examined as covariates to control for differences across the 21 research sites. RESULTS Results demonstrated significant intervention and sustainability effects for three of the four assessment domains examined, although stronger effects were obtained for intra- than inter-agency outcomes. No significant effects were found for Conveyance/Utility. CONCLUSIONS Implementation interventions such as the OPII represent an important tool to enhance the use of evidence-based assessment practices in large and diverse correctional systems. Intra-agency assessment activities that were more directly under the control of correctional agencies were implemented most effectively. Activities in domains that required cross-systems collaboration were not as successfully implemented, although longer follow-up periods might afford detection of stronger effects.
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Janssens K, Monico L, Radepont M, De Nolf W, Van der Snickt G, Cotte M. Degradation studies of cultural heritage materials using µ-XANES and µ-XRD. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311095080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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