Fostering MAT Use in Justice Populations

University of Wisconsin (UW)

Status: Completed

Conditions: Opioid-use Disorder; Recidivism

Treatments: Behavioral: NIATx Coaching; Behavioral: ECHO

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04363320

3U2CDA050097-01S1 (U.S. NIH Grant/Contract)

20200548 (Other Identifier)

A195010 (Other Identifier)

ENGR/CHESS PROGRAM (Other Identifier)

2019-1473

Details and patient eligibility

About

The grant will test two timely and successful evidence-based implementation practices, NIATx Coaching and ECHO, with jail/community-based healthcare providers to increase medication assisted treatment (MAT) use with justice populations.

Full description

In this trial, the investigators will test two implementation interventions being applied to medications for opioid use disorder (MOUD) dissemination and implementation in justice settings for justice-involved populations: NIATx Coaching and the Extension for Community Healthcare Outcomes (ECHO) model. NIATx Coaches provide expertise in MOUD implementation and organizational change to help treatment organizations and staff make, sustain, and spread MOUD. The ECHO platform focuses only on the provider side by connecting the primary care provider with expert MOUD prescribers to promote high-quality MOUD practices. This will be the first trial that assesses the comparative effectiveness of these approaches overall, and in justice settings.

The trial will be conducted with a combination of 48 jails and community-based organizations that treat individuals with opioid use disorders (OUDs) post-incarceration. Sites will be randomly assigned to one of four study arms, with 12 sites in each arm: High-Dose Coaching/ECHO, Low-Dose Coaching/ECHO, High-Dose Coaching/No ECHO, and Low-Dose Coaching/No ECHO. The intervention period will be over a 12-month span with an additional 12-months for sustainability.

Enrollment: 256 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Site Inclusion Criteria:

• Have an interest in embedding or increasing the use of MOUD within their site.
• Have the funds to pay for medications for the duration of the study (24 months); whether it be from grants, insurance or private pay.
• Sites agree to implement or continue to use at least one medication, although they will be encouraged to offer more than one medication.
• Have leadership support at all levels.
• Agree to provide data described in the MOU or Information Sheet.

Exclusion Criteria:

• N/A

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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256 participants in 4 patient groups

High-Dose NIATx Coaching & ECHO

Experimental group

Description:

* Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls

Treatment:

Behavioral: ECHO

Behavioral: NIATx Coaching

Low-Dose NIATx Coaching & ECHO

Experimental group

Description:

* Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls

Treatment:

Behavioral: ECHO

Behavioral: NIATx Coaching

High-Dose NIATx Coaching & No ECHO

Experimental group

Description:

* Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team

Treatment:

Behavioral: NIATx Coaching

Low-Dose NIATx Coaching & No ECHO

Experimental group

Description:

* Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team

Treatment:

Behavioral: NIATx Coaching