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
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.
Hanna J. K. S. Pasman E. Gaba A. Andre M. Smelson D. Pinals D. A. 2020). 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. J Subst Abuse Treat108 104-114. doi:10.1016/j.jsat.2019.06.012