Publications
A Pragmatic Measure of Context at the Organizational Level: The Inventory of Factors Affecting Successful Implementation and Sustainment (IFASIS)
Background: Successful implementation and sustainment of interventions is heavily influenced by context. Yet the complexity and dynamic nature of context make it challenging to connect and translate findings across implementation efforts. Existing methods to assess context are typically qualitative, limiting potential replicability and utility. Existing quantitative measures and the siloed nature of implementation efforts limit…
Read MoreSystemic Barriers and Stigma: Healthcare Provider Perspectives on Perinatal and Neonatal Care in the Fentanyl Crisis
The rise in fentanyl use during pregnancy has introduced new and complex challenges in caring for women with opioid use disorders (OUD) and their infants diagnosed with neonatal abstinence syndrome or neonatal opioid withdrawal syndrome (NAS/NOWS). Despite the increasing prevalence of opioid-affected mother-infant dyads, limited research exists on healthcare providers’ perspectives regarding fentanyl’s impact on…
Read MoreUnderstanding Inequitable Healthcare: Methodological Approaches, Challenges, and Opportunities
This paper considers methodological approaches that can help better understand inequity in healthcare, focusing on five key domains: availability, patient-centeredness, access, effectiveness, and implementation. We present conceptual definitions of each of these domains, example research questions pertaining to inequity in each domain, and methodological approaches that can contribute to research about health inequities. We discuss…
Read MoreRollout Trial Designs in Implementation Research are Often Necessary and Sometimes Preferred
Background: Rollout designs, which include stepped wedge designs, are defined by staggered implementation of new or alternative programs or services. Critiques of stepped wedge and other rollout designs have raised concerns regarding the confounding of true implementation or program effects with unrelated, global changes in service delivery, with some recommending they only be used when…
Read MoreThe Difference-Making Role of Staff Support in Implementing Nurse Care Management for Opioid Use Disorder Treatment: A Configurational Analysis.
Introduction: Understanding conditions in which interventions succeed or fail is critical. The PRimary care Opioid Use Disorders treatment (PROUD) trial, a cluster-randomized hybrid study, tested whether implementation of office-based addiction treatment supported by a nurse increased medication of OUD. Six health systems each provided two primary care (PC) clinics that were randomly assigned to implement…
Read MoreA Framework for Designing Hybrid Effectiveness-Implementation Trials for Digital Health Interventions
This article proposes methods for designing randomized controlled trials studying the implementation and effectiveness of digital interventions, meaning websites or applications (“apps”) that patients use in healthcare. Deploying digital interventions for behavioral health differs from implementing traditional interventions such as medications or human-delivered therapy. Prior trial design guidance has ignored the existence of international governmental…
Read MoreEffectiveness of Mutual Health Groups for Illicit Drug Use Disorders: A Review of the Current Literature
Purpose of Review: Evaluate literature examining whether mutual help groups (MHGs) for illicit drug use disorders benefit participants. Recent Findings: Recent studies consistently show that MHG attendance and involvement predict reductions in drug use and addiction severity. More rigorous methodologies offer stronger evidence of effectiveness, but additional controlled trials are needed. Drug-focused MHG challenges include…
Read MoreUS Payment Policy for Medications to Treat Opioid Use Disorder: Landscape and Opportunities
Offering patients medications for opioid use disorder (MOUD) is the standard of care for opioid use disorder (OUD), but an estimated 75%–90% of people with OUD who could benefit from MOUD do not receive medication. Payment policy, defined as public and private payers’ approaches to covering and reimbursing providers for MOUD, is 1 contributor to…
Read MoreModel-Driven Decision Support: A Community-Based Meta-Implementation Strategy to Predict Population Impact.
Purpose: Standard tools for public health decision making such as data dashboards, trial repositories, and intervention briefs may be necessary but insufficient for guiding community leaders in optimizing local public health strategy. Predictive modeling decision support tools may be the missing link that allows community level decision makers to confidently direct funding and other resources…
Read MoreOverdose Deaths Before and During the COVID-19 Pandemic in a US County
Globally, overdose deaths increased near the beginning of the COVID-19 pandemic, which created availability and access barriers to addiction and social services. Especially in times of a crisis like a pandemic, local exposures, service availability and access, and system responses have major influence on people who use drugs. For policy makers to be effective, an…
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