Disseminating contingency management: Impacts of staff training and implementation at an opiate treatment program.

Guided by a comprehensive implementation model, this CTN-platform study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a National Drug Abuse Treatment Clinical Trials Network-affiliated opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (intervention cost, feasibility, sustainability) were assessed at study conclusion in a qualitative interview with OTP management. Intervention effectiveness was also assessed via independent chart review of trial CM implementation vs. a history control period. Results included: 1) robust, durable increases in delivery skill, knowledge, and adoption readiness among trained staff; 2) positive managerial perspectives of intervention cost, feasibility, and sustainability; and 3) significant clinical impacts on targeted design and the applied, skills-based focus of staff training processes.

Conclusions: Collective results offer preliminary support for the collaborative approach taken to design of the focal CM intervention and the applied, skills-based focus of the staff training processes. Given the disparity between voluminous empirical support for efficacy of CM methods and their limited community dissemination, the current work may offer a useful template for processes of planning and design, training and consultation, and trial implementation and evaluation that enabled this CM intervention to be effectively transported for use by this community-based substance abuse treatment setting. Additional implications for CM dissemination are discussed.