A multilevel approach to predicting community addiction treatment attitudes about contingency management.

Adoption of contingency management (CM) by the addiction treatment community is limited to date despite much evidence for its efficacy. This investigation examined systemic and idiographic staff predictors of CM adoption attitudes via archival data collected from treatment organizations affiliated with the National Drug Abuse Treatment Clinical Trials Network (CTN) (part of protocol CTN-0008). Multilevel modeling analyses evaluated potential predictors from organizational, treatment unit, and workforce surveys. Among these were individual and shared perceptions of staff concerning aspects of their clinic culture and climate. Modeling analyses identified three systemic predictors (clinic provision of opiate agonist services, national accreditation, and lesser shared perception of workplace stress) and five idiographic predictors (staff with a graduate degree, longer service tenure, managerial position, e-communication facility, and openness to change in clinical procedures).

Findings are discussed as they relate to extant literature on CM attitudes, established implementation science constructs, and practical implications. It is hoped these findings may spur further research into how effectively CM (and other empirically supported practices) transition from academic innovators to the treatment community.

Related protocols: CTN-0008