FAIR (Families Actively Improving Relationships) is an evidence-based practice for parents referred to the child welfare system. Treatment addresses substance use (primarily opioids and/or methamphetamine), mental health, parenting, and ancillary needs. FAIR is community-based and relies on collaboration with service and community partners.
As part of the NIH Helping to End Addiction Long-term (HEAL) initiative, FAIR was adapted for upstream prevention to be evaluated for clinical effectiveness in a Hybrid Type 2 trial in four rural counties. Counties were selected in collaboration with state leadership. A clearly defined implementation process was followed at the county, clinic, and provider levels. Challenges and opportunities related to the outer context of a staggering increase in opioid and methamphetamine use in the participating regions and the COVID-19 pandemic will be highlighted. Implementation process (using the Stage of Implementation Completion) and the resources used to complete it (measured using the Cost of Implementing New Strategies) will be presented in relation to these different contexts.