Testing MOUD Scale-Up Strategies in Criminal Legal Settings

Study Information

This three-arm comparative effectiveness cluster randomized controlled trial evaluates a systems change approach to scaling medications for opioid use disorder (MOUD) across 120 prisons in 12 states. The research team will test two promising cost-effective, scale-up implementation approaches for their effectiveness in implementing MOUD in prison settings, policy levers and multisite learning collaboratives. These approaches are used in developing countries in the fields of healthcare, education, and community development. This focus is driven by strong evidence supporting MOUD efficacy, poor MOUD penetration rates in prisons, health inequities within incarcerated populations, and the high risk of preventable overdose deaths for those transitioning from criminal legal settings to the community.

Grant number: 1UM1DA064515

Link to NIH Reporter record: https://reporter.nih.gov/search/f-hxp1dPVEO26i_7EjwIvg/project-details/11262469

Study Team

PI: Rosemarie Martin, PhD, Todd Molfenter, Ph.D.

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 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

Research Type

Cluster-Randomized