Implementing contingency management into rural recovery housing: recommendations of a professional advisory expert panel.

IF 2.7 3区 医学 Q2 PSYCHOLOGY, CLINICAL
David M Ledgerwood, Milena C Stott, Stacey Quesada, Marci Sontag, Rachel M Beck, Michael G McDonell, David Johnson, Dominick DePhilippis, Sherrie Donnelly, Bryan Hartzler, Tammera Nauts, Matthew D Novak, James A Peck, Carla J Rash
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Abstract

Background: Rural areas in the United States have been severely impacted by recent rises in substance use related mortality and psychosocial consequences. There is a dearth of treatment resources to address substance use disorder (SUD). Rural recovery houses (RRH) are important services that provide individuals with SUD with an environment where they can engage in recovery-oriented activities, but dropout rates are unacceptably high, and evidence-based interventions such as contingency management (CM) may reduce dropout and improve outcomes for RRH residents. In this paper, we describe the results of a national convening of experts that addressed important issues concerning the implementation of CM within the context of RRHs.Methods: Twelve experts (five female) in the areas of CM, RRH and rural health participated in a one-day facilitated meeting that used nominal group technique to identify expert consensus in three areas as they pertain to RRH: (a) facilitators and barriers to CM implementation, (b) elements necessary for successful program building based on group feedback, and (c) recommendations for future implementation of CM.Results: Several RRH- and system-level barriers and facilitators to implementing CM were identified by the panel, and these were categorized based on the level of importance for and ease of implementation. CM funding, staff and resident buy-in, set policies, education on CM, and consistent fidelity to CM procedures and tracking were identified as important requirements for implementing CM in RRH.Conclusions: We provide recommendations for the implementation of CM in RRH that may be useful in this context, as well as more broadly.

在农村恢复性住房中实施应急管理:专业咨询专家小组的建议。
背景:美国农村地区受到近期药物使用相关死亡率和社会心理后果上升的严重影响。解决药物使用障碍(SUD)的治疗资源十分匮乏。农村康复之家(RRH)是一项重要的服务,它为药物滥用障碍患者提供了一个可以参与以康复为导向的活动的环境,但辍学率却高得令人无法接受,而应急管理(CM)等循证干预措施可以减少辍学率并改善农村康复之家居民的治疗效果。在本文中,我们介绍了全国专家会议的成果,会议讨论了在 RRHs 环境下实施应急管理的重要问题:方法:社区医疗、 RRH 和农村健康领域的 12 名专家(5 名女性)参加了为期一天的促进会议,会议采用名义小组技术,在三个与 RRH 相关的领域达成了专家共识:(a)实施社区医疗的促进因素和障碍;(b)根据小组反馈成功建立项目的必要因素;以及(c)对未来实施社区医疗的建议:小组确定了在 RRH 和系统层面实施社区医疗的若干障碍和促进因素,并根据实施的重要程度和难易程度对这些因素进行了分类。在 RRH 中实施社区医疗的重要条件包括:社区医疗资金、员工和居民的认同、既定政策、社区医疗教育以及始终坚持社区医疗程序和跟踪:我们为在 RRH 中实施社区医疗提供了一些建议,这些建议可能在这种情况下以及更广泛的情况下有用。
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来源期刊
CiteScore
4.70
自引率
3.70%
发文量
68
期刊介绍: The American Journal of Drug and Alcohol Abuse (AJDAA) is an international journal published six times per year and provides an important and stimulating venue for the exchange of ideas between the researchers working in diverse areas, including public policy, epidemiology, neurobiology, and the treatment of addictive disorders. AJDAA includes a wide range of translational research, covering preclinical and clinical aspects of the field. AJDAA covers these topics with focused data presentations and authoritative reviews of timely developments in our field. Manuscripts exploring addictions other than substance use disorders are encouraged. Reviews and Perspectives of emerging fields are given priority consideration. Areas of particular interest include: public health policy; novel research methodologies; human and animal pharmacology; human translational studies, including neuroimaging; pharmacological and behavioral treatments; new modalities of care; molecular and family genetic studies; medicinal use of substances traditionally considered substances of abuse.
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