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Principal Investigator: Lisa Saldana
Organization: OREGON SOCIAL LEARNING CENTER, INC.
Fiscal Year: 2020
Award: $150,092
Funding agency: National Institute on Drug Abuse
PARENT GRANT PROJECT SUMMARY/ABSTRACT
This proposal, in response to PAR-16-455, aims to test the impact of an empirically derived implementation
strategy—under real-world conditions and across multiple child service systems—on successful adoption and
sustainment of two evidence-based programs that address adolescent substance abuse: Treatment Foster
Care Oregon (TFCO; formerly Multidimensional Treatment Foster Care) and Multidimensional Family Therapy
(MDFT), both developed with funding from NIDA. Methods for this study utilize “technology-based approaches”
for “implementing large-scale change.” Leveraging previous data focused on developing and testing the 8-
staged Stages of Implementation Completion (SIC) tool, a measure of implementation progress from
Engagement (Stage 1) to development of Competency (Stage 8), a non-randomized cohort design is
proposed. Study activities include extending the SIC into the Sustainment Phase and testing a SIC Coaching
strategy to support the adoption of new evidence-based programs.
Previous findings with the SIC suggest its potential utility as a measure of implementation fidelity. The
overarching goal of this proposal is to evaluate if the integration of implementation fidelity (fidelity to the
implementation process) with intervention fidelity (fidelity to the clinical intervention) can increase the
probability that a new organizational site not only successfully adopts a program but, develops the
infrastructure to ensure it can sustain. Patterns of cost and resource allocation will be examined, using the
Cost of Implementing New Strategies (COINS) cost mapping strategy, an adjunct to the SIC, to assess how
resource use impacts program sustainability. A web-based SIC and COINS tool provides feedback about a
site's implementation behavior relative to other successful sites and will be used in the current study as part of
the SIC Coaching strategy. Purveyors for TFCO and MDFT will be trained to integrate SIC Coaching into their
existing coaching activities with sites that are adopting new programs. Within a rapid audit and feedback
system, it is hypothesized that sites that receive integrated implementation and intervention fidelity feedback as
part of their purveyor-site technical assistance will be more likely to develop sustainable programs than sites
that receive standard purveyor-driven implementation support.
Study targets include the following specific aims: (a) evaluate the effect of SIC Coaching on outcomes of
program adoption and sustainment, (b) extend the SIC to include measurement of sustainment, and (c)
examine cost and resource patterns most likely to yield sustainable programs. This data-driven approach to
guide new sites has the potential to help them to achieve the development of sustainable evidence-based
programs for adolescent substance abuse and other high-risk behaviors. If successful, the study will have a
significant impact for organizations adopting new programs and has the potential to have a substantial public
health impact by increasing the availability of evidence-based programs for costly public health problems.
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