Reach | • Target intervention to patients that will be attending treatment at least twice per week for other treatment services. |
Effectiveness | • Share results of VA and non-VA trials |
Adoption | • Solicit explicit support from the highest levels of the organization through, for example, performance measures or treatment recommendations. |
• Identify or create measures of clinic effectiveness which can be utilized to identify gaps in performance and monitor the impact of implementation. | |
• Solicit agreement in advance for designated funding. | |
• Educate leadership about time commitment related to the intervention and potential strategies for integrating the intervention into current practices. | |
• Adopt incrementally. Start with a specific treatment track or clinic to reduce staff and funding burden until local evidence of effectiveness and feasibility is available to support spread | |
Implementation | • Disseminate information to educate staff about the process, goals, and value/effectiveness of the intervention and engage them in planning for the intervention from the start. |
• Provide expert consultation on how to adapt the intervention for specific clinic environments. | |
• Train staff on urine test cups and breathalyzer including sensitivity and specificity of the screen results. | |
• Make scripts available for communicating positive and negative test results to patients. | |
• Supply a tracking database to ensure consistency in awarding prize picks. | |
• Provide a step by step intervention appointment protocol. | |
• Facilitate documentation in the electronic health record. | |
Maintenance | • Ensure all staff is aware of their responsibilities related to incorporating information from the intervention into clinical interactions with patients to facilitate integration into the clinic. |
 | • Consider option of having case managers administer the intervention to their own patients rather than having one or two individuals responsible for the intervention. |