Translating research findings into practice: example of treatment services for adolescents in managed care

Stacy Sterling, Constance Weisner, Stacy Sterling, Constance Weisner

Abstract

An important question in the alcoholism treatment field is how research findings can be translated into real-world clinical practice. Researchers have developed a new research-practice integration (RPI) model that can both drive the formulation of studies and new research questions and promote improvements in treatment quality. The hallmark of this model is a collaborative relationship between the key stakeholders in both alcohol and other drug (AOD) treatment and research, including health plan administrators and clinicians, treatment program administrators, psychiatry and primary care departments, patients and their families, purchasers, and researchers. The issue of technology transfer is especially relevant in the realm of adolescent AOD treatment. The implementation and feasibility of the RPI model are illustrated by a case study of a managed health care plan's treatment services for adolescents with AOD dependence. In this setting, key research findings are being used to shape the plan's adolescent health services.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/6470908/bin/11-18f1.jpg
A model of research–practice integration. * Stakeholders include: consumers, program administrators, researchers, primary care and psychiatry providers, AOD clinicians, purchasers/employers, health plan regional/national leadership, and accreditation bodies (e.g., National Committee for Quality Assurance).

References

    1. Addiction Transfer Technology Center (ATTC) Network. The Change Book. A Blueprint for Technology Transfer. 2d ed. Kansas City, MO: ATTC National Office; 2004.
    1. American Academy of Pediatrics, Division of Child Health Research. Periodic Survey of Fellows: 45% of Fellows Routinely Screen for Alcohol Use. [Accessed December 16, 2002]. Available at: .
    1. Backer TE. Assessing and enhancing readiness for change: Implications for technology transfer. In: Backer TE, David SL, Saucy G, editors. Reviewing the Behavioral Science Knowledge Base on Technology Transfer. Rockville, MD: NIDA; 1995. pp. 21–41. (National Institute on Drug Abuse (NIDA) Research Monograph 155).
    1. Backer TE, Liberman RP, Kuehnel TG. Dissemination and adoption of innovative psychosocial interventions. Journal of Consulting and Clinical Psychology. 1986;54:111–118.
    1. Backer TE, David SL, Saucy G, editors. Reviewing the Behavioral Science Knowledge Base on Technology Transfer. Rockville, MD: NIDA; 1995. pp. 21–41. (National Institute on Drug Abuse (NIDA) Research Monograph 155).
    1. Bethell C, Klein J, Peck C. Assessing health system provision of adolescent preventive services: The Young Adult Health Care Survey. Medical Care. 2001;39:478–490.
    1. Booth RE, Kwiatkowski CF. Substance abuse treatment for high-risk adolescents. Current Psychiatry Reports. 1999;1:185–190.
    1. Brown BS. From research to practice: The bridge is out and the water’s rising. Advances in Medical Sociology. 2000;7:345–365.
    1. Brown VB. Integrating research into a treatment program. In: Sorensen JL, Rawson RA, Guydish J, Zweben JE, editors. Drug Abuse Treatment Through Collaboration: Practice and Research Partnerships That Work. Washington, DC: American Psychological Association; 2003. pp. 249–264.
    1. Catalano RF, Hawkins JD, Wells EA, et al. Evaluation of the effectiveness of adolescent drug abuse treatment, assessment of risks for relapse, and promising approaches for relapse prevention. International Journal of the Addictions. 1990–91;25:1085–1140.
    1. Deas D, Thomas SE. An overview of controlled studies of adolescent substance abuse treatment. American Journal on Addictions. 2001;10:178–189.
    1. Escobedo LG, Reddy M, Giovino GA. The relationship between depressive symptoms and cigarette smoking in U.S. adolescents. Addiction. 1998;93:433–440.
    1. Fleming MF, Barry KL, Manwell LB, et al. Brief physician advice for problem alcohol drinkers: A randomized controlled trial in community-based primary care practices. JAMA: Journal of the American Medical Association. 1997;277:1039–1045.
    1. Grella CE, Hser YI, Joshi V, Rounds-Bryand J. Drug treatment outcomes for adolescents with comorbid mental and substance use disorders. Journal of Nervous and Mental Disease. 2001;189:384–392.
    1. Hser YI, Grella CE, Hubbard RL, et al. An evaluation of drug treatments for adolescents in 4 U.S. cities. Archives of General Psychiatry. 2001;58:689–695.
    1. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001. Available at: .
    1. Institute of Medicine. Quality Chasm Series. Washington, DC: National Academies Press; 2005. Improving the Quality of Health Care for Mental and Substance-Use Conditions.
    1. Jainchill N. Substance dependency treatment for adolescents: Practice and research. Substance Use & Misuse. 2000;35:2031–2060.
    1. Lamb S, Greenlick MR, McCarty D, editors. Bridging the Gap Between Practice and Research: Forging Partnerships with Community-Based Drug and Alcohol Treatment. Washington, DC: National Academy Press; 1998.
    1. Lehman WE, Greener JM, Simpson DD. Assessing organizational readiness for change. Journal of Substance Abuse Treatment. 2002;22:197–209.
    1. Link BG, Phelan JC, Bresnahan M, et al. Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health. 1999;89:1328–1333.
    1. Lomas J. Retailing research: Increasing the role of evidence in clinical services for childbirth. Milbank Quarterly. 1993;71:439–475.
    1. Morrison MA, Smith DE, Wilford BB, et al. At war in the fields of play: Current perspectives on the nature and treatment of adolescent chemical dependency. Journal of Psychoactive Drugs. 1993;25:321–330.
    1. Petry NM. A comprehensive guide to the application of contingency management procedures in clinical settings. Drug and Alcohol Dependence. 2000;58:9–25.
    1. Rao U, Daley SE, Hammen C. Relationship between depression and substance use disorders in adolescent women during the transition to adulthood. Journal of the American Academy of Child & Adolescent Psychiatry. 2000;39:215–222.
    1. Simpson DD. A conceptual framework for transferring research to practice. Journal of Substance Abuse Treatment. 2002;22:171–182.
    1. Singer MI, Petchers MK, Anglin TM. Detection of adolescent substance abuse in a pediatric outpatient department: A double-blind study. Journal of Pediatrics. 1987;111:938–941.
    1. Sobell LC. Bridging the gap between scientists and practitioners: The challenge before us. Behavior Therapy. 1996;27:297–320.
    1. Sorensen JL, Clark WW. A field-based dissemination component in a drug abuse research center. In: Backer TE, David SL, Saucy G, editors. Reviewing the Behavioral Science Knowledge Base on Technology Transfer. Rockville, MD: NIDA; 1995. pp. 186–197. (National Institute on Drug Abuse (NIDA) Research Monograph 155).
    1. Sterling S, Weisner C. Chemical dependency and psychiatric services for adolescents in private managed care: Implications for outcomes. Alcoholism: Clinical and Experimental Research. 2005;25:801–809.
    1. Sterling S, Kohn CS, Lu Y, Weisner C. Pathways to chemical dependency for adolescents in an HMO. Journal of Psychoactive Drugs. 2004;36:439–453.
    1. Substance Abuse and Mental Health Services Administration (SAMHSA) Report to Congress on the Prevention and Treatment of Co-occurring Substance Abuse Disorders and Mental Disorders. Bethesda, MD: SAMHSA; 2002.
    1. U.S. Department of Health and Human Services (DHHS), Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. Improving Substance Abuse Treatment: The National Treatment Plan Initiative—Panel Reports, Public Hearings, and Participant Acknowledgments: Changing the Conversation. Washington, DC: DHHS; 2000. (DHHS Pub. No. (SMA)–00-3479). Available at: .
    1. Waldron HB, Kaminer Y. On the learning curve: The emerging evidence supporting cognitive-behavioral therapies for adolescent substance abuse. Addiction. 2004;99(Suppl 2):93–105.
    1. Weisner C, Mertens J, Parthasarathy S, et al. Integrating primary medical care with addiction treatment: A randomized controlled trial. JAMA: Journal of the American Medical Association. 2001;286:1715–1723.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir