Organizational Strategy for Substance Abuse Care Improvement

(LOCI-SL Trial)

Overseen By Gregory Aarons, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Diego

Disqualifiers: Non-stakeholders, Non-executives, Non-managers, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

470 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve how clinics deliver care for substance use disorders by testing a new strategy called Leadership and Organizational Change for Implementation (LOCI-SL). The strategy uses AI technology to help clinics better implement Motivational Interviewing and other proven practices. The trial will compare this new strategy against the current method to determine which is more effective. It seeks leaders, managers, or counselors working in clinics that treat substance use or mental health issues. As an unphased trial, this study offers participants the chance to contribute to innovative research that could transform care delivery in their field.

Do I need to stop my current medications for this trial?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that the LOCI-SL strategy is safe for implementation?

Research has shown that the Leadership and Organizational Change for Implementation (LOCI) strategy has been successfully used in clinics treating substance use. Studies have found that this approach helps clinics better implement Motivational Interviewing (MI) and other proven methods. Notably, no reports of negative effects have emerged from using this strategy. Since LOCI is not a drug or medical procedure, it focuses on improving clinic operations. Participants in previous studies did not report negative experiences, indicating that LOCI is well-tolerated. In summary, this is a safe way to enhance treatment for substance use disorders by improving clinic leadership and organization. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Organizational Strategy for Substance Abuse Care Improvement because it focuses on enhancing leadership and organizational change within treatment facilities. Unlike traditional substance abuse treatments that primarily target the individual's behavior, this approach aims to improve the way care is delivered by transforming organizational practices and leadership strategies. By focusing on systemic change, it has the potential to create more sustainable and widespread improvements in care quality and patient outcomes. This innovative strategy could lead to more effective and efficient substance abuse treatment programs across various settings.

What evidence suggests that the LOCI-SL strategy is effective for improving substance use disorder care?

Research has shown that the Leadership and Organizational Change for Implementation (LOCI) strategy, which participants in this trial may receive, can enhance outcomes in organizations using proven methods to treat substance use disorders. Studies have found that LOCI helps leaders implement strategies more effectively, fostering a supportive environment for these methods. This approach improves the overall atmosphere and attitudes of providers, facilitating the use and maintenance of effective practices. By enhancing leadership and the organizational environment, LOCI supports the use of successful treatment methods, such as Motivational Interviewing, in behavioral health organizations. These positive changes aim to improve care for individuals dealing with substance use disorders. ^{1 2 3 4 5}

Are You a Good Fit for This Trial?

This trial is for staff at provider or payer advocacy organizations, executives and managers at substance use disorder/mental health treatment agencies, clinic supervisors, counselors providing such treatments in Oregon and Indiana. It includes stakeholders from relevant state authorities and managed care organizations.

Inclusion Criteria

Stakeholders from Oregon Alcohol and Drug Policy Commission (ADPC)

Indiana Department of Child Services (DCS)

Indiana Department of Mental Health and Addiction (DMHA)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Preparation

Engagement with state policy and funding stakeholders to align strategies for EBP implementation

4 weeks

Implementation

Implementation of the Lyssn AI platform and Motivational Interviewing using the LOCI-SL strategy

9 months

Sustainment

Ongoing support and evaluation of EBP implementation and sustainment

Ongoing

Follow-up

Participants are monitored for changes in implementation leadership and climate

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Leadership and Organizational Change for Implementation

Trial Overview The trial tests a strategy called LOCI-SL that aligns leadership across systems to implement the Lyssn AI platform for Motivational Interviewing (MI) and evidence-based practices in treating substance use disorders.

How Is the Trial Designed?

Group I: LOCI Experimental Treatment 1 Intervention

Leadership and Organizational Change for Implementation strategy

Group II: Control Active Control 1 Intervention

assessment only through online survey

Who Is Running the Clinical Trial?

University of California, San Diego

Lead Sponsor

Trials

1,215

Recruited

1,593,000+

Pacific Institute for Research and Evaluation

Collaborator

Trials

28

Recruited

34,200+

Oregon Social Learning Center

Collaborator

Trials

36

Recruited

8,900+

Indiana University

Collaborator

Trials

1,063

Recruited

1,182,000+

Chestnut Health Systems

Collaborator

Trials

27

Recruited

24,500+

University of Central Florida

Collaborator

Trials

101

Recruited

1,191,000+

Published Research Related to This Trial

The study involved 53 community-based substance abuse treatment programs in the Southwest, focusing on how organizational characteristics influence the adoption of new interventions.

Programs facing higher needs and pressures, along with limited resources and poorer staff ratings, were more likely to pursue structured organizational changes, suggesting that these factors drive the need for improvement in treatment practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using organizational assessment as a tool for program change. Courtney, KO., Joe, GW., Rowan-Szal, GA., et al.[2023]

The demonstration project involved 30 Change Teams from 12 treatment agencies in Los Angeles County, focusing on rapid-cycle changes to improve substance abuse treatment processes, such as reducing wait times and no-shows.

The project highlighted that a clear methodology, peer interaction, and ongoing technical support are crucial for successfully implementing evidence-based improvements in addiction treatment services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving client engagement and retention in treatment: the Los Angeles County experience. Rutkowski, BA., Gallon, S., Rawson, RA., et al.[2010]

The Leadership and Organizational Change for Implementation (LOCI) intervention was found to be feasible and acceptable among 12 mental health service team leaders and their staff, indicating its potential for improving leadership in evidence-based practice (EBP) implementation.

Preliminary results suggest that LOCI positively impacts staff-rated leadership outcomes, making it a promising strategy for organizations aiming to enhance their capacity for implementing and sustaining evidence-based practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation. Aarons, GA., Ehrhart, MG., Farahnak, LR., et al.[2022]

The LOCI intervention aims to improve the implementation of evidence-based treatments for PTSD in mental health clinics by enhancing leadership at multiple levels and fostering a supportive organizational climate, evaluated through a stepped-wedge cluster randomized trial involving various clinics in Norway.

Surveys will be conducted over 20 months to assess leadership effectiveness and implementation climate, with results used to create tailored plans for improving treatment delivery, ultimately aiming to enhance the quality of care for patients with PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Testing the leadership and organizational change for implementation (LOCI) intervention in Norwegian mental health clinics: a stepped-wedge cluster randomized design study protocol. Egeland, KM., Skar, AS., Endsjø, M., et al.[2023]

The study evaluated an Organizational Process Improvement Intervention aimed at enhancing assessment and case planning for drug-involved offenders transitioning from correctional settings to community treatment, indicating that such strategies can effectively improve service coordination.

Qualitative interviews revealed that collaboration between correctional and community agency staff helped identify barriers and facilitators in the implementation process, suggesting that teamwork is crucial for successful treatment outcomes for offenders with substance abuse issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Building Bridges in New Jersey. Abdel-Salam, S., Kilmer, A., Monico, L., et al.[2018]

Only 19% of the 458 substance use disorder treatment programs studied utilized the NIATx process improvements, indicating a need for better implementation strategies.

Factors such as larger organization size, higher administrative intensity, and membership in provider associations positively influenced the likelihood of adopting NIATx processes, suggesting that supportive policies may enhance the effectiveness of SUD treatment centers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation of Network for the Improvement of Addiction Treatment (NIATx) Processes in Substance Use Disorder Treatment Centers. Fields, D., Knudsen, HK., Roman, PM.[2018]

There is a critical need for better dissemination and implementation strategies for evidence-based practices to combat the opioid crisis, as current addiction journals often overlook practical quality improvement projects.

The special issue aims to showcase implementation and quality improvement projects that can provide real-world guidance on translating research into effective practices for treating opioid use disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Applying and advancing best practices in opioid use disorder and addiction treatment: Introduction to the special issue on implementation science and quality improvement scholarship. Gordon, AJ., Oliva, EM.[2019]

Citations

1. sciencedirect.com sciencedirect.com/science/article/pii/S2949875924001450

Utility of the Leadership and Organizational Change for ... This study investigated the utility of the Leadership and Organizational Change for Implementation-System Level (LOCI-SL) strategy for supporting statewide EBP ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S2949875924001498

Randomized trial of the leadership and organizational ... The LOCI strategy resulted in more positive organizational and implementation outcomes compared to the control condition. •. Organizational change strategies ...

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38866139/

Randomized trial of the leadership and organizational ... This study tested the effects of LOCI on transformational and implementation leadership, implementation climate, implementation citizenship behavior, and EBP ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT03042832

Study Details | NCT03042832 | Testing the Leadership and ... This study will test the effects of the Leadership and Organizational Change for Implementation (LOCI) intervention in facilitating evidence-based practice ...

5. implementationscience.biomedcentral.com implementationscience.biomedcentral.com/articles/10.1186/s13012-017-0562-3

Testing the leadership and organizational change for ... First, improving leadership and organizational climate for EBP will advance both implementation science and will provide an empirically tested ...