Bridging the Gap Between Practice and Research Forging Partnerships with Community-Based Drug and Alcohol Treatment (1998) / Chapter Skim
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3 Approaches to Closing the Gaps
3 Approaches to Closing the Gaps
Pages 56-72
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From page 56... ...
Other areas of medical care have developed strategies to facilitate an integration of treatment, research, and policy. These include models for technology transfer, financial and other incentives to encourage organizational change, as well as methods to develop consensus on evidence-based practices and promote their use.
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From page 57... ...
, and between technologies that are "high" (requiring substantial capital) and "low" (requiring relatively little investment)
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From page 58... ...
The National Institute on Drug Abuse and the Center for Substance Abuse Treatment both have technology transfer programs which include knowledge exchange as well as dissemination activities. NIDA dissemination tools include videotapes, program assessment packages, and clinical reports (see for example NIDA t19931~.
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From page 59... ...
A CSAT knowledge exchange activity is the Treatment Improvement Exchange (TIE) program to promote information exchange between CSAT staff and state and local alcohol and drug abuse agencies.
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From page 60... ...
Even when the innovation supports important organizational goals, innovative programming requires managerial support, adequate financial and human resources, and an organizational culture that values scientifically based practice, problem solving, and creativity (Crump et al., 1996~. It is not only small CBOs that are finding it hard to meet these tests.2 A description of the attributes associated with successful innovation is shown in Box 3.1.
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From page 61... ...
The psychiatric practice guidelines are based on review and synthesis of the currently available treatment literature, complimented where appropriate by the experience of a group of skilled clinician reviewers. Sequential drafts of the guidelines were reviewed by a national sample of individual clinicians and researchers, as well as numerous professional organizations and governmental agencies in the addictions field.
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From page 62... ...
Despite the potential benefits of incorporating advances in clinical research into clinical care delivery, many barriers exist to the successful dissemination and adoption of evidence-based practice guidelines within the drug abuse treatment community. A number of factors may contribute to this situation.
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From page 63... ...
It will be necessary to devise strategies by which the acceptability and ultimate utility of practice guidelines in drug and alcohol abuse treatment can be measured. Compared to practice guidelines that have been developing for more than a decade, the science of consumer scorecards in health care is in an early state (Hanes and Greenlick, 1998~.
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From page 64... ...
Techniques such as the consensus conference mechanism and the evidence-based reviews approach might begin to close the gap and to improve treatment, as well as to enhance the potential for broader use of treatment guidelines in drug abuse treatment. The first NIH Consensus Development Statement on drug abuse treatment is included as Appendix F
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From page 65... ...
Recognizing that data resources and measurement methods need improvement, the panel recommends that DHHS continue to work with states toward several infrastructure goals: developing common definitions and measurement methods; encouraging efficient development of data resources that support multiple public health, mental health, and substance abuse needs; incorporating state data priorities in national infrastructure development efforts; and promoting states' data collection and analytic capabilities. Assessment of Performance Measures for Public Health, Substance Abuse, and Mental Health, Phase 1 Report; NRC (1997)
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From page 66... ...
MODELS THAT INCORPORATE TRUST-BUILDING EXPERIENCES Knowledge exchange and the development of two-way communication between treatment personnel and researchers requires the development of trust. Trust takes time to develop.
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From page 67... ...
For example, approaches that involve personal contact were found to result in greater adoption of a job seekers' workshop in drug treatment programs than dissemination approaches that provided only written materials (Sorensen et al., 1988~. Personal consultation was similarly important in the VA successes described to the commit tee.
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From page 68... ...
In an attempt to improve the quality of care provided in the local communities, various organizations have issued guidelines for effective treatment procedures, but like the Treatment Improvement Protocols in the drug abuse area, writing a guideline does not guarantee that providers will comply (Czaja et al., 1997; Ford et al., 1987; Klabunde et al., 1997~. The National Cancer Institute's Community Clinical Oncology Program (CCOP)
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From page 69... ...
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.
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From page 70... ...
1996. American Psychiatric Association: Practice Guidelines.
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From page 71... ...
1997. Linking substance abuse treatment funding to performance measurement will take time.
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From page 72... ...
1988. Dissemination of a job seekers' workshop to drug treatment programs.
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