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. 2020 Oct 23;15(1):94.
doi: 10.1186/s13012-020-01053-4.

NIATx-TI versus typical product training on e-health technology implementation: a clustered randomized controlled trial study protocol

Veronica M White  1 , Todd Molfenter  2 , David H Gustafson  2 , Julie Horst  2 , Rachelle Greller  2 , David H Gustafson Jr  2 , Jee-Seon Kim  3 , Eric Preuss  4 , Olivia Cody  2 , Praan Pisitthakarm  2 , Alexander Toy  2
Affiliations

NIATx-TI versus typical product training on e-health technology implementation: a clustered randomized controlled trial study protocol

Veronica M White et al. Implement Sci. .

Abstract

Background: Substance use disorders (SUDs) lead to tens-of-thousands of overdose deaths and other forms of preventable deaths in the USA each year. This results in over $500 billion per year in societal and economic costs as well as a considerable amount of grief for loved ones of affected individuals. Despite these health and societal consequences, only a small percentage of people seek treatment for SUDs, and the majority of those that seek help fail to achieve long-term sobriety. E-health applications in healthcare have proven to be effective at sustaining treatment and reaching patients traditional treatment pathways would have missed. However, e-health adoption and sustainment rates in healthcare are poor, especially in the SUD treatment sector. Implementation engineering can address this gap in the e-health field by augmenting existing implementation models, which explain organizational and individual e-health behaviors retrospectively, with prospective resources that can guide implementation.

Methods: This cluster randomized control trial is designed to test two implementation strategies at adopting an evidence-based mobile e-health technology for SUD treatment. The proposed e-health implementation model is the Network for the Improvement of Addiction Treatment-Technology Implementation (NIATx-TI) Framework. This project, based in Iowa, will compare a control condition (using a typical software product training approach that includes in-person staff training followed by access to on-line support) to software implementation utilizing NIATx-TI, which includes change management training, followed by coaching on how to implement and use the mobile application. While e-health spans many modalities and health disciplines, this project will focus on implementing the Addiction Comprehensive Health Enhancement Support System (A-CHESS), an evidence-based SUD treatment recovery app framework. This trial will be conducted in Iowa at 46 organizational sites within 12 SUD treatment agencies. The control arm consists of 23 individual treatment sites based at five organizations, and the intervention arm consists of 23 individual SUD treatment sites based at seven organizations DISCUSSION: This study addresses an issue of substantial public health significance: enhancing the uptake of the growing inventory of patient-centered evidence-based addiction treatment e-health technologies.

Trial registration: ClinicalTrials.gov , NCT03954184 . Posted 17 May 2019.

Keywords: Coaching; Evidence-based practice implementation; Mobile technology; Substance use disorder treatment; Technology implementation model.

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Conflict of interest statement

Todd Molfenter is a faculty member at CHESS. In addition to his academic affiliation, Dr. Molfenter has a less than .1% ownership with CHESS Health, the organization responsible for making the A-CHESS addiction recovery app commercially available to the public. Dr. Molfenter has worked extensively with his institution to manage any conflicts of interest. An external advisory board approved all survey instruments applied, and the individuals who will conduct the data collection and interpretation for this study will have no affiliation with CHESS Health. Also, parts of the NIATx organizational change model used in part of this trial were developed by the Center for Health Enhancement System Studies (CHESS) at the University of Wisconsin–Madison, where Dr. Molfenter is a faculty member. Dr. Molfenter is also affiliated with the NIATx Foundation, the organization responsible for making the NIATx organizational change model available to the public. For this scenario, Dr. Molfenter also has an institutionally approved plan to manage potential conflicts of interest. The individuals who will conduct the data collection and interpretation for this study manuscript will have no affiliation with the NIATx Foundation.

David Gustafson is a part-owner of CHESS Health, devoted to marketing information technologies to agencies that deliver addiction treatment. He is also on the board of directors of the not-for-profit NIATx Foundation, as well as a small consulting company doing business as David H. Gustafson and Associates. These relationships do not carry with them any restrictions on publication, and any associated intellectual property will be disclosed and processed according to his institution’s policies.

Figures

Fig. 1
Fig. 1
Consort diagram: RISE-Iowa study recruitment
Fig. 2
Fig. 2
Product training and NIATx-TI framework overview
See this image and copyright information in PMC

References

    1. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Prev Chronic Dis. 2014;11:E109. doi: 10.5888/pcd11.130293. - DOI - PMC - PubMed
    1. National Drug Intelligence Center (NDIC) The economic impact of illicit drug use on American society. Washington, DC: United States Department of Justice; 2011.
    1. Hedegaard H, Miniño AM, Warner M. Drug overdose deaths in the United States, 1999–2017. NCHS data brief no. 329. National Center for Health Statistics: Hyattsville, MD; 2018. - PubMed
    1. Council of Economic Advisers (CEA). The underestimated cost of the opioid crisis. 2017. Available from: https://www.whitehouse.gov/briefings-statements/cea-report-underestimate....
    1. Center for Behavioral Health Statistics and Quality. Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health. HHS Publication No. SMA 15-4927, NSDUH Series H-50. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2015. Available from: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FR....

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