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Lead Institution: University of Wisconsin

Status: Active

Research type: Cluster Randomized Controlled Trial

Setting(s): Prison

PI: Todd Molfenter

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Testing MOUD Scale-Up Strategies in Criminal Legal Settings

This three-arm cluster randomized trial will assess how best to expand medications for opioid use disorder (MOUD) in 120 prisons across 12 states. It compares two scalable, cost-effective implementation strategies—policy levers and multisite learning collaboratives—both borrowed from successful approaches used in low-resourcesettings. The study is motivated by strong evidence for MOUD, persistently low access in prisons, major health inequities among incarcerated people, and the high risk of overdose during reentry to the community.

Study Aims

Engage the JCOIN stakeholder and dissemination board in the process of integrating the diverse lived-experience perspectives of people living and working in incarcerated settings into the research design and analysis of the non-control arms

Test the differences between use of the Substance Abuse and Mental Health Services Administration (SAMHSA) Policy Academy Bundle, provider Learning Collaborative, and control using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (RE-AIM)

Conduct a qualitative exploration to aid the interpretation of quantitative results and gain an in-depth understanding of the factors that promote or impede the scale-up of MOUD in prison settings

Estimate the implementation and sustainment costs associated with each intervention and assess their relative economic value from a state- policymaker perspective after accounting for downstream cost offsets

Principal Investigator

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Todd Molfenter, PhD

University of Wisconsin

MPI

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Rosemarie Martin, PhD

University of Massachusetts Chan Medical School

Co-Investigators

  • Faye S. Taxman, PhD, George Mason University
  • Ali Jalali, PhD, Cornell University

Justice Agency Partner

  • Kevin Kemp, Correctional Leaders Association