Facilitating implementation of a substance use intervention for youth: Outcomes from a randomized trial of the SIC-coaching implementation strategy

Abstract

Background

The sustainable implementation of evidence-based practice continues to plague the field of substance use treatment. In particular, effective treatments for adolescents with substance use and associated behaviors, is lacking. Multidimensional Family Therapy (MDFT) is one treatment that has demonstrated consistent positive outcomes for youth, but like other evidence-based programs historically has far fewer programs that reach sustainment than those that set out to implement. The Stages of Implementation Completion ® (SIC) is a measure of implementation process fidelity and has been used by numerous evidence-based programs to track the completion of pre-determined implementation activities. It has shown consistent ability to accurately predict whether newly adopting sites will launch a program and reach competency in program delivery for sustainment. The SIC-Coaching approach was developed as an implementation strategy to facilitate implementation with the use of SIC data to provide feedback throughout the implementation process.

Methods

A web-based platform was developed to show real-time implementation performance data. Using a randomized design, sites interested in implementing MDFT were randomized to receive SIC-Coaching versus standard technical assistance and consultation. Partway through recruitment, COVID-19 disruptions occurred and were considered in analyses for all sites (n = 32). Historical MDFT implementation process data ((n = 108) was used as a comparison group.

Results

Results suggest that compared to historical performance of sites implementing MDFT, sites implementing with the support of a coach exposed to SIC-Coaching were less likely to discontinue. Moreover, sites that initiated implementation during COVID-19 restrictions did not experience reported disruptions to implementation and were just as likely to reach competency in program delivery as sites initiating implementation prior to pandemic restrictions.

Conclusions

Implementation strategies such as SIC-Coaching hold promise for increasing rates of successful implementation of adolescent substance use treatment programs.