Government funding requirements to promote implementation of evidence-based practices in community-based addiction treatment organizations: the association between funder requirements and treatment staff reports of barriers to implementation

A number of research studies have highlighted the importance of using empirically supported treatment (evidence-based practices (EBPs)) as the most effective means to reduce addiction. Even though significant federal funding has been committed to support implementation of EBPs in community-based treatment organizations (CBOs) (Glasner-Edwards & Rawson, 2010; NIDA, 2006; IOM, 2003) systematic study of the policy-components of EBP implementation is limited to date. This study examined whether the federal-funder-specific activities (measured as: recommending specific EBPs rather than promoting CBO selection of EBPs, activities associated with specific funding mechanisms, and providing training through ATTCs) were associated with staff perception of level of barriers to implementing federally-funded EBPs. Data sources included interviews with 510 clinical staff from CBOs nationwide who received SAMHSA funding (2003-2008) to implement EBPs. Bivariate analysis and regression modeling methods examined the relationship between federal-funder specific activities and three dependent variables: level of barriers experienced when implementing the EBP, level of modifications made to the EBP that was implemented, and a series of questions regarding attitudes about the usefulness of EBPs. In the regression models, the study controlled for staff, geographic and treatment unit characteristics. It also controlled for variables related to organizational capacity. Findings include: 1. whether or not federal-funders promoted the use of a specific EBP or whether the organization self-selected the EBP to implement was not significantly associated with the level of barriers experienced, the modifications made to the EBP or the attitudes about EBPs. 2. Staff receiving funding from different federal funding mechanisms was associated with reporting different levels of barriers, modifications and attitudes toward EBP implementation. 3. Finally, having received ATTC training was not significantly associated with having more positive attitudes about specific EBPs or the level of modifications or barriers to EBP implementation