Educational Services Inc., Bethesda, MD
May 22-23, 2008

NIDA Chairs:
Tom Brady, Ph.D., Redonna Chandler, Ph.D.

Meeting Purpose and Intent:

• Discuss how to measurably improve outcomes in community-based care for the prevention and treatment of drug abuse and mental disorders.
• Consider the utility of various research-to-practice investigations, practice-implementation research, and sustained use of evidence-based therapeutic innovations.

The meeting's objectives were to strengthen community-based-organization's capacity for future research by:

• Building familiarity with the NIH grant making process;
• Sharing implementation experiences and encouraging networking among grantees;
• Highlighting relevant areas for additional research opportunities;
• Surveying current health services research at NIDA and at NIMH, and
• Developing relevant research questions and giving feedback on possible grant applications via 1:1 consultation with NIH program officials.

Brief Discussion of Meeting Outcome:

Early in the program, it was noted that there was a need to 1) improve addiction treatment process and outcomes for patients, 2) reach a larger audience of providers and scientists, and 3) address treatment needs. This could be done through building community-based research networks and by strengthening community based organizations' ability to conduct research.

Day One:

The major activity of day one was to allow each community based organization to present their research. Below are summaries of those talks:

Patient Satisfaction with a Telemedicine-based Evaluation in an Addiction Program—Rano Mathew, M.D., reported on this study at the Coastal Horizons Center, which is evaluating the feasibility of telemedicine-based treatment for patients with co-occurring disorders and HIV risk. This study of telemedicine targets patients in rural areas with limited access to addiction treatment.

Developing a CQI intervention to Improve Mental Health Services in a CBO—Debra Pantin, M.S.W., reported on the findings of a Palladia study that assessed CQI's impact on enhancing mental health services delivery by the Bronx, NY CBO. The study aims to develop and assess implementation of CQI interventions, examine the impact of CQI on staff attitudes and readiness for change, and assess the impact of CQI on enhancing the delivery of mental health services.

Enhancing Substance Abuse Treatment Services for Women Offenders—Kimberly Bond M.F.T. reported that Mental Health Systems, Inc. is using coordinated, integrated women-focused services and effective fidelity measures to increase its recruitment pool and improve staff competency for this study.

Technology Transfer: Promoting Change in the Therapeutic Community—Britta Muehlbach, M.S.W., said Daytop Village, Inc.'s counselors and supervisors have endorsed the positive effect of therapeutic communities and motivational interviewing in improving treatment outcomes. The Daytop study aims to show that: (1) integrating evidence-based practices improves treatment practices and outcomes; and (2) understanding technology transfer in the TC would improve positive conditions for change.

Organizational Factors Influencing Practice Improvement in Community-Based Care—James May, Ph.D., noted that this study aims to develop a pilot protocol for community-based self assessment (SA) as a tool for the eventual systematic implementation of an SA and improvement protocol.

Electronic Information System to Enhance Practice at an Opioid Treatment Program—Lawrence S. Brown, Jr., M.D., M.P.H., said this study found that only 27 percent of respondents felt ready to perform job functions; and 70 percent said lack of access to information from another discipline impaired their ability to deliver care. Among the lessons learned: (1) senior management should support and direct involvement, (2) concise objectives and interdivisional interaction are critical; (3) electronic cross-walk demonstrates the different data elements between government agencies.

Integrated Behavioral Program for Prescription Opiate Addiction and Chronic Pain—Joseph Troncale, M.D., reported that this study was to determine the outcomes of integrated cognitive behavioral therapy and physical therapy treatment for two sets of patients.

Day Two:

Day two activities identified future health services research opportunities community-based organizations should consider. The lectures included discussions of health services research opportunities at NIDA and NIMH, opportunities for economics research at NIDA, and an overview of recent addiction treatment outcomes research. In health services, some of the most promising research areas are those that determine the costs and how to save money if a given intervention is implemented, such as innovative business practices that improve efficiency; treatment effectiveness for commonly used interventions and practices; strategies that promote Evidence-Based Practice (EBP) diffusion, adoption, and sustainability; and assessment of the effects of organization/management, economics, and policies on implementation and EBP effectiveness.

A community-based organization roadmap for implementation research opportunities at NIH to make interventions more service-oriented was discussed. There are encouraging developments for implementation research; funding streams that support effective evidence-based treatment interventions; development and dissemination of health information and intervention materials based on science; and a strong demand for new R01 investigators in this scientific area.

Areas of needed technical assistance for grantees were identified, including:

• Integrated interventions;
• Outcome reporting;
• Data collection;
• Record keeping;
• Tracking and follow-up procedures;
• Fundraising;
• Preparing and targeting grant applications;
• Training; and
• Strategies to ensure patient satisfaction with services.

A very thorough introductory workshop was provided outlining the major steps of grant development. The conference ended with grantees meeting individually with NIH program staff to discuss future research opportunities.

Speakers (PDF Format, 52k)
Agenda (PDF Format, 180k)