The purpose of this FOA is to support the development and testing of implementation strategies to achieve system-level adoption of evidence-based interventions, guidelines, or practices to improve the delivery, quality, and sustainability of prevention or treatment services for substance use disorders.
Implementation science has become an integral component of health services research, including research related to the prevention and treatment of substance use disorders and HIV. However, to date, a major remaining challenge is how to facilitate – in a systematic, scalable, sustainable way – the adoption and delivery of evidence-based prevention and treatment services at a systems level, particularly given the historical fragmentation of the systems of care in which these services are delivered. In particular, research that meaningfully engages providers and is mindful of clinical workflows, organizational missions, and policy contexts has the potential to help systems achieve their goals and realize sustained public health impact.
This FOA seeks research projects that will test implementation strategies intended to achieve system-wide integration of evidence-based practices (interventions, guidelines, or service delivery models) to prevent or treat substance use disorders (broadly defined to include alcohol, tobacco and other drugs, as well as prescription medications). Areas of interest also include implementation of guidelines related to the appropriate use of opioids for pain management in individuals with or at risk for opioid use disorder. When clearly justified, applicants may propose to test strategies that are designed to achieve system-wide de-implementation of programs or clinical practices that are ineffective, unproven, wasteful or harmful.
Applicants are encouraged to test strategies that could achieve implementation on a large scale that is analogous to the way policy changes lead to system-wide changes in prevention and treatment service delivery. Achieving system-level improvements requires implementation strategies that are sufficiently flexible to address the variation in settings and contexts across the entities that comprise a given system, but that are also likely generalizable across multiple evidence-based practices. Thus, the purpose of this FOA is to identify effective strategies to produce systems-level change, while contributing generalizable knowledge about implementation that accounts for variation among service delivery settings and the types of treatments, interventions, and/or guidelines to be implemented.
The multi-site studies supported by this FOA should seek to contribute both practical and conceptual advances. In practical terms, these studies should aim to provide strategies that can be used to effectively deploy guidelines, practices, and policies across entire systems of care. In conceptual terms, these studies should also leverage the multi-site platform to test implementation science hypotheses, explore novel methodological approaches, or test new measures or models that can inform future implementation research in this or other health domains.
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Filed Under: Funding Opportunities