costs, access to state-of-the-art treatment interventions, staff pride, and more informed consumers.

Research participation becomes a possibility for treatment providers when community-based organizations are compensated for the true costs of research participation, and when program staff and investigators collaborate in construction of hypotheses, research design, and data collection, analysis, and interpretation.

Only a small proportion of community-based agencies currently have the capacity to participate fully in long-term partnerships with teams of investigators. The level of participation in research collaborations depends on an agency's stage of organizational development, the compatibility of the studies with the organization's mission and culture, and its financial stability. Thus, participation may vary from relatively passive participation (completing surveys and submitting data to state databases) to involvement as a partner in the development of research questions, data collection, and data interpretation. However, incentives must change for all parties if real progress is to be made.

The trust necessary for long-term collaboration is generally based on a history of increasing involvement. Successful collaborative programs from other health fields include support for a permanent infrastructure that facilitates long-term development. The National Cancer Institute's Community Clinical Oncology Program (CCOP) uses this strategy to bring state-of-the-art oncology research to community-based cancer treatment programs. CCOP facilitates research collaborations and enhances the ability of treatment programs to apply research findings to the general patient population. Development of a similar mechanism for use in community-based drug abuse treatment programs could catalyze research/practice collaborations and stimulate improvements in practice. The CCOPs are not inexpensive and they present a significant managerial challenge. The infrastructure alone at each clinical site can exceed $200,000. However, the infrastructure recommendation that follows does not necessarily require a model with that complexity. It could begin as a demonstration project involving a basic infrastructure enhancement of perhaps one full-time equivalent staff person and some computer support to a small set of diverse treatment sites. This level of support would be the target, whichever of the various network collaboration models is finally implemented.

Based on these findings, the committee offers two recommendations and identifies certain key characteristics that will facilitate their successful implementation.



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