Bridging the Gap Between Practice and Research Forging Partnerships with Community-Based Drug and Alcohol Treatment (1998) / Chapter Skim
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5 Benefits and Challenges of Community-Based Collaboration for Researchers
5 Benefits and Challenges of Community-Based Collaboration for Researchers
Pages 89-110
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From page 89... ...
s Benefits and Challenges of Community-Based Collaboration for Researchers A subtle smile, twinkling eyes, and Southern charm helped Selbert Wood, President and Chief Executive Officer of STEP ONE, a North Carolina-based drug and alcohol abuse treatment program, illustrate, the gulf between research and practice in the field of addictions treatment and prevention. He sought advice from friends and colleagues on what he "ought to tell a bunch of Ph.D.s and policy folks" in Washington, DC.
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HISTORICAL APPROACHES TO COLLABORATION FOR RESEARCH Rapid development of community-based drug abuse treatment programs requires partnerships among investigators trained in theory and methods, clinical practitioners schooled in working with clients, administrators oriented toward problem resolution, and policymakers who fund and regu
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The origins include Kurt Lewin's formulation of action research, subsequent developments in applied social science and program evaluation methods, and the emergence of health services research. Action Research Researchers and practitioners have struggled for at least five decades to develop meaningful collaborations that simultaneously contribute to theory and knowledge development and to effective responses to social and clinical problems.
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, p. 169 Although he never studied treatment programs for alcohol and drug dependence, Lewin's observations remain clearly applicable to the integration of research and practice in substance abuse treatment programs.
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and for treatment agencies that permit access. These influences and tensions have been apparent in the development of health services research.
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The Act placed the research institutes (National Institute of Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and National Institute of Mental Health) under the auspices of the National Institutes of Health.
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Because services research is still emerging on treatment and prevention for alcohol and drug abuse and dependence, influences on policy and practice have been limited and there is much to be learned. MODELS FOR COLLABORATION Collaboration between research and practice takes many forms in the substance abuse treatment field and a number of collaboration models that impressed the committee are presented below.
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and service system (traditional practices) that would otherwise be difficult to investigate; the Navajo Nation gains through increased support from federal funding authorities and enhanced credibility of the findings from demonstration programs.
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Investigators who work through the Consortium structure may request letters of support from treatment providers and the state substance abuse authority when they apply for services research funds from federal, state, and local governments. The support letters strengthen applications and demonstrate a history of collaboration.
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CASAA worked with treatment providers in the Navajo Nation to evaluate an alcohol treatment program addressing the underlying cultural conflicts that contribute to high alcoholism rates among the Navajo. The approach was consistent with the high value the Navajo place on achieving balance and harmony with nature, family, and spirits.
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After these issues were worked out to each party's satisfaction, projects were undertaken. Drug Outcome Monitoring System Two large community-based drug abuse treatment providers in Illinois designed and implemented a performance measurement system to monitor client outcomes and enhance their accountability with purchasers and consumers.
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Developed with funding from NIAAA and CSAT, the Drug Outcome Monitoring System illustrates an important strategy for integrating services and research and meeting the needs for both sets of stakeholders. Because the data are of clinical value, counselors are likely to be more careful completing interviews and responding to data elements, thus enhancing data quality for research studies and policy analyses.
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For example, the American Association of Health Plans has recently adopted a new policy intended to encourage their member HMOs to participate in clinical trials sponsored by NIH, and there appear to be an increasing number of research partnerships between managed care organizations and cancer centers (Glass and Greenlick, 1989; Myers et al., 1997) , as well as new partnerships for research developing among managed care organizations (Durham, 1998~.
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From page 102... ...
The institutes used a variety of funding and management mechanisms to promote prevention programs, develop services for homeless men and women, and test strategies to reduce the risk of HIV infection among drug users. Three sets of demonstration initiatives are examined to identify lessons for research-practice collaborations in community-based drug treatment.
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A special issue of the Alcoholism Treatment Quarterly (McCarty, 1990) and reports from NIAAA (Murray, 1993; Shane et al., 1993)
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Details on the study sites are provided in a special issue of the Alcoholism Treatment Quarterly (Conrad et al., 1993) and an issue of New Directions for Program Evocation (Conrad, 1994~.
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NIDA also used a cooperative agreement mechanism to support multisite studies to monitor HIV risk behaviors and test outreach interventions among out-of-treatment drug users. Collaboration among the 23 study sites permitted more rapid data collection on infrequent behaviors and small populations (NIDA, 1996~.
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Applicants must demonstrate a comprehensive understanding of the connections to drug abuse and not merely seek additional funding. Finally, Oetting (1990)
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Services research in community-based substance abuse treatment settings requires investigators who can build meaningful partnerships with drug abuse treatment programs and who have the skills to design and implement high quality research studies that will contribute to the evolution and refinement of community-based treatment interventions. There is no single best approach to promoting collaborations.
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within community-based drug abuse treatment services. Finally, the collaboration between CASAA and the Navajo Nation shows the importance of long-term relationships.
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1993. Community Demonstration Grant Projects for Alcohol and Drug Abuse Treatment of Homeless Individuals: Innovative Strategies for Treating Alcohol and Drug Abuse Problems Among Homeless Men and Women.
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1993. Community Demonstration Grant Projects for Alcohol and Drug Abuse Treatment of Homeless Individuals: Final Evaluation Report.
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