Molfenter Todd, McCarty Dennis, Capoccia Victor, Gustafson David
University of Wisconsin - Madison, 1513 University Avenue, Madison, Wisconsin, USA.
Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Rd., Portland, Oregon 97239-3098, USA.
Public Health Front. 2013 Mar 1;2(1):11-20. doi: 10.5963/PHF0201002.
Implementing specific evidence-based practices (EBPs) across a set of addiction treatment providers have been a persistent challenge. In the Advancing Recovery(AR) demonstration project, single state agencies, the entities that distribute federal funds for substance use disorder prevention and treatment services, worked in partnership with providers to increase the use of EBPs in the treatment of addiction. The project supported two cohorts of six 2-year awards. Field observations from the first year of implementation guided development of a multilevel framework (the Advancing Recovery Framework). Government entities and other payers can use the framework as a guide for implementing evidence-based clinical practices within treatment networks. The Advancing Recover Framework calls for a combination of policy and organizational changes at both the payer (government agency) and provider levels. Using the Advancing Recovery Framework, 11 of the 12 AR payer/provider partnerships increased use of clinical EPBs. This article identifies key payer policy changes applied during different phases of EBP program implementation. The public health benefit of the demonstration project was broader use of medication-assisted therapy and continuing care in addiction treatment services.
在一系列成瘾治疗机构中实施特定的循证实践（EBP）一直是一项长期挑战。在推进康复（AR）示范项目中，单一州机构，即负责分配用于物质使用障碍预防和治疗服务的联邦资金的实体，与各治疗机构合作，以增加EBP在成瘾治疗中的应用。该项目为两个队列提供了六项为期两年的资助。实施第一年的实地观察为一个多层次框架（推进康复框架）的制定提供了指导。政府实体和其他付款人可以将该框架用作在治疗网络中实施循证临床实践的指南。推进康复框架要求付款人（政府机构）和治疗机构层面都进行政策和组织变革。利用推进康复框架，12个AR付款人/治疗机构合作伙伴关系中有11个增加了临床EBP的使用。本文确定了在EBP项目实施的不同阶段所应用的关键付款人政策变革。该示范项目的公共卫生效益在于在成瘾治疗服务中更广泛地使用药物辅助治疗和持续护理。
