| Given the high prevalence and associated costs of mental and addictive disorders, it is
imperative to develop and validate implementation models to increase fidelitous delivery of
evidence-based treatments and practices (EBT/Ps), particularly in multidisciplinary community
healthcare settings. While research indicates that collaboration across service sectors improves
availability and sustainment of EBT/Ps, most extant implementation models target single
agencies and/or sectors with little long-term support. In contrast, the Community-Based
Learning Collaborative (CBLC) is an adaptation of the Learning Collaborative model designed
to bring about sustainable, multidisciplinary, and systemic change within a therapeutic
community and its support systems. Extant CBLC studies have reported strong results, but thus
far have solely examined its effectiveness in one context, i.e., child post-traumatic stress and
related EBT/Ps in South Carolina. Consequently, the current study examined the CBLC
implementation model in a novel, scaled-out context, including a new behavioral health
population (i.e., adults with opioid use disorders [OUD] and related substance use disorder
[SUD] and mental health problems), professional disciplines (e.g., prescribing clinicians as well
as behavioral clinicians, brokers, and senior leaders), targeted EBT/Ps (e.g., Medication-Assisted
Treatment [MAT] and Motivational Interviewing [MI]), and community (i.e., southeastern
Idaho) using data from the Idaho Rural Interdisciplinary Health Collaborative, a multi-year
dissemination and implementation project. Self-report data on SUD, OUD, MI, and MAT fidelity
was collected pre- to post-CBLC from four consecutive 1-year cohorts. After testing for nesting
effects, data from 37 CBLC participants (i.e., 32 behavioral clinicians, 3 prescribing clinicians,
and 2 case brokers) were
pooled and analyzed using paired sample t-tests. Results indicated that the CBLC produced
moderate to large, significant increases in SUD- and OUD-general competence (ds = 0.49–1.19),
MAT- and MI-specific competence (ds = 0.99–1.01), and MI-specific adherence (d = 0.53).
Collectively, these findings are the first to evince the CBLC model’s efficacy outside its original
context, including the first scale-out of community, professional disciplines, and targeted
EBT/Ps. The current study’s results not only support the CBLC’s utility for substance use
applications, and further validate the model’s generalizability for disseminating and
implementing varied EBT/Ps with fidelity across different multidisciplinary community settings.
Keywords: competence, adherence, fidelity, medication-assisted treatment, motivational
interviewing, learning collaborative, community-based learning collaborative, dissemination and
implementation |