Dissemination, Implementation and Sustainability

Dissemination, Implementation and Sustainability research represents a rapidly expanding area of funding in healthcare for many federal and private granting organizations. With this support, researchers seek to understand and identify effective processes for spreading knowledge and information; explore implementation strategies that influence the integration of evidence-based interventions or methods into practice settings; and to examine organizational attributes influencing the capacity of health care providers to sustain changes once implemented in the organization.

CHSRA researchers are actively engaged in the development and implementation of dissemination, implementation and sustainability research projects. Our research in this field focuses on two areas:

Quality Improvement and Implementation Strategies

Our research in this are tests and evaluates innovative implementation strategies including approaches to coaching in a quality improvement collaborative to improve processes of care for patients and residents of long-term care, community and behavioral healthcare providers.

Sustainability of Organizational Change

CHSRA researchers have conducted extensive research in this area seeking to assess environmental, organizational and innovation attributes influencing the likelihood that organizations will sustain changes and develop models that allow organizations and researchers to explore the impact of implementation strategies on the sustainment of outcomes.

Additional sustainability research has explored attributes influencing the sustainment of A-CHESS, an innovative smart phone app for individuals with substance use disorders; explore sustainment of outcome improvements in substance use providers after implementing NIATx strategies to improve wait time, retention and admissions; and developed a model to predict sustainability of change in health care settings.

Related Projects

  • Substance Abuse Treatment to HIV care (SAT2HIV) The research project is a Type 2 Effectiveness-Implementation Hybrid Trial35 to simultaneously test: (a) the effectiveness of BI for substance use relative to usual care (UC; i.e., referral to treatment), and (b) the effectiveness of an organizational-level implementation intervention called “Implementation & Sustainment Facilitation” (ISF), relative to the standard implementation strategy used by SAMHSA-funded Addiction Technology Treatment Centers (ATTCs; i.e., staff workshop training and ongoing feedback/coaching provided by ATTC trainers).
  • Using NIATx Strategies to Implement Integrated Service in Routine Care The overarching goal of this research is to determine if NIATx strategies are effective in implementing integrated services for persons with co-occurring substance use and mental health disorders.
  • Integrating Addiction Treatment and Medical Care in a Commercial Health Plan (Medication Research Partnership) The Partnership extended the Advancing Recovery model, developed in publicly funded systems of care to facilitate organizational change and promote the adoption of evidence-based practices for the treatment of alcohol and drug use disorders, to a commercial health plan and tested the model’s generalizability to increase use of medications for members covered by a commercial health plan.
  • Advancing Patient-Center Outcomes in Addiction Psychiatry Practice The overall aim of this project was to utilize the Maintenance of Certification (MOC) process to motivate addiction psychiatrists to learn skills taught by traditional and/or social media routes that will enable them to employ patient centered outcomes research (PCOR) in the care of their patients.
  • Impact of Staff Learning and Coach Teaching Styles in Quality Improvement Coaching is a key component of quality improvement collaboratives. Understanding coach effectiveness and how the “teacher-student” relationship supports knowledge acquisition is a missing element in quality improvement research. In this study, we adapted scales developed and validated in educational settings and used the revised scales to individual learning and teaching styles in a quality improvement collaborative.
  • Sustaining Change After NIATx200 Multi-organizational quality improvement collaboratives (QICs) are effective strategies for implementing evidence-based practices and improving patient care.
  • Veterans Health Administration Three studies in the Veterans Health Administration (VHA) used the British National Health Service Sustainability Index to explore staff sustainability perceptions. Study 1: Examined staff perceptions about the likelihood that changes from a national rollout of a mental health system redesign would be sustained. Study 2: Explored how staff sustainability perceptions and their commitment to an integration of primary care and mental health services in VA hospitals in two Veteran Integrated Services Network. Study 3: involved Polytrauma Rehabilitation Centers (PRC) staff and studied perceptions that the Family Care Map (FCM) would be sustained.