investigational treatment, prevention, and control activities. The potential for adaptation of this model to the drug abuse treatment field is discussed in Chapter 5, with a recommendation following in Chapter 6. Chapter 5 includes other collaboration models as well. The practice-based research networks described in the next chapter (see Box 4.3) provides an alternative model developed in several medical specialties to involve clinicians in the development of knowledge to guide their practice.
Another trust-building model, the Agricultural Extension Service, has had a far-reaching impact on U.S. farm productivity in the past 50 years. As described to the committee by Everett Rogers of the University of New Mexico School of Communication, the agriculture extension model consists of a set of assumptions, principles, and organizational structures for diffusing the results of agricultural research to farmers. The success of the model is based on farmer participation in identifying local needs, serving on county-level committees to develop the research agenda, providing test plots for the agricultural research, and providing feedback to the state university researchers on the applicability of the results. It has built-in reward systems for farmers and researchers to encourage utilization of the new information. Agriculture extension specialists are in close social, political, and spatial contact with these county research committees and with agricultural researchers, which allows them to facilitate linking research-based knowledge to farmer problems. This model, funded by the U.S. Department of Agriculture, worked particularly well in diffusing agricultural production technology to family farmers in the early development of scientific farming (Rogers, 1995a; Rogers et al., 1976).
Many of the approaches to closing the gap rely on infrastructure changes within both treatment and research organizations. The next chapter focuses on the issue from the perspective of the treatment programs, the following one focuses on changes needed within the research enterprise. Even when effectiveness studies document that a treatment can be successfully implemented in a clinical setting, technology transfer to local drug abuse treatment centers is difficult. New treatments typically are adopted and implemented by trained staff, who may be in short supply in many CBOs. Challenges in the final stage of treatment transfer include training staff in delivering the new treatment, changing attitudes of the providers so they embrace the new treatment, and providing evidence that the new treatment is effective in improving the health status of drug abusers.
Each of these components of training must be planned, systematically delivered, and protective of the fidelity of the treatment. Many have suggested that the transfer of new treatment knowledge occurs best in the