Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA 98105-4631, USA.
J Subst Abuse Treat. 2012 Mar;42(2):213-21. doi: 10.1016/j.jsat.2011.10.012. Epub 2011 Dec 3.
Adoption of contingency management (CM) by the addiction treatment community is limited to date despite much evidence for its efficacy. This study examined systemic and idiographic staff predictors of CM adoption attitudes via archival data collected from treatment organizations affiliated with the National Drug Abuse Treatment Clinical Trials Network. Multilevel modeling analyses evaluated potential predictors from organizational, treatment unit, and workforce surveys. Among these were individual and shared perceptions of staff concerning aspects of their clinic culture and climate. Modeling analyses identified three systemic predictors (clinic provision of opiate agonist services, national accreditation, and lesser shared perception of workplace stress) and five idiographic predictors (staff with a graduate degree, longer service tenure, managerial position, e-communication facility, and openness to change in clinical procedures). Findings are discussed as they relate to extant literature on CM attitudes and established implementation science constructs, and their practical implications are discussed.
尽管有大量证据表明其有效性，但应急管理（CM）在成瘾治疗领域的采用至今仍受到限制。本研究通过从隶属于国家药物滥用治疗临床试验网络的治疗组织收集的档案数据，检查了系统和个体员工对 CM 采用态度的预测因素。多层次建模分析评估了来自组织、治疗单位和劳动力调查的潜在预测因素。其中包括员工对诊所文化和氛围各个方面的个人和共同看法。模型分析确定了三个系统预测因素（诊所提供阿片类激动剂服务、国家认可和对工作场所压力的共同看法减少）和五个个体预测因素（具有研究生学位的员工、较长的服务任期、管理职位、电子通信设施和对临床程序变更的开放性）。研究结果与 CM 态度和既定实施科学结构的现有文献进行了讨论，并讨论了其实践意义。
