Format

Send to

Choose Destination
J Subst Abuse Treat. 2020 Jan;108:104-114. doi: 10.1016/j.jsat.2019.06.012. Epub 2019 Jun 20.

Evaluating the implementation of a prisoner re-entry initiative for individuals with opioid use and mental health disorders: Application of the consolidated framework for implementation research in a cross-system initiative.

Author information

1
Center for Behavioral Health and Justice, Wayne State University, 5201 Cass Avenue, Detroit, MI 48202, USA. Electronic address: julie.hanna@wayne.edu.
2
School of Social Work, Wayne State University, 5447 Woodward Avenue, Detroit, MI 48202, USA. Electronic address: spk@wayne.edu.
3
Center for Behavioral Health and Justice, Wayne State University, 5201 Cass Avenue, Detroit, MI 48202, USA. Electronic address: emily.pasman@wayne.edu.
4
Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA 01605, USA. Electronic address: ayorkor.gaba@umassmed.edu.
5
Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA 01605, USA. Electronic address: michael.andre@umassmed.edu.
6
Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA 01605, USA. Electronic address: david.smelson@umassmed.edu.
7
University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA; Michigan Department of Health and Human Services, USA. Electronic address: dpinals@med.umich.edu.

Abstract

Given the interrelated nature of opioid use, criminal justice interaction, and mental health issues, the current opioid crisis has created an urgent need for treatment, including medication assisted treatment, among justice-involved populations. Implementation research plays an important role in improving systems of care and integration of evidence-based practices within and outside of criminal justice institutions. The current study is a formative qualitative evaluation of the implementation of a cross-system (corrections and community-based) opioid use treatment initiative supported by Opioid State Targeted Response (STR) funding. The purpose of the study is to assess the fit of the Consolidated Framework for Implementation Research (CFIR) to a cross-system initiative, and to identify key barriers and facilitators to implementation. The process evaluation showed that adaptability of the clinical model and staff flexibility were critical to implementation. Cultural and procedural differences across correctional facilities and community-based treatment programs required frequent and structured forums for cross-system communication. Challenges related to recruitment and enrollment, staffing, MAT, and data collection were addressed through the collaborative development and continuous review of policies and procedures. This study found CFIR to be a useful framework for understanding implementation uptake and barriers. The framework was particularly valuable in reinforcing the use of implementation research as a means for continuous process improvement. CFIR is a comprehensive and flexible framework that may be adopted in future cross-system evaluations.

KEYWORDS:

Co-occurring disorders; Criminal justice; Implementation research; Medication assisted treatment; Opioids

PMID:
31285078
DOI:
10.1016/j.jsat.2019.06.012

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center