Organizational-level predictors of adoption across time: naltrexone in private substance-use disorders treatment centers.
OBJECTIVE
Prominent on the nation's research agenda on substance-use disorders treatment is the dissemination of effective pharmacotherapies. Thus, the purpose of this article is to use a "diffusion of innovations" theoretical framework to examine the organizationallevel predictors of the adoption of a pharmacotherapy, naltrexone (Revia), in private substance use-disorders treatment centers (N = 165).


METHODS
Data for these analyses were derived from the National Treatment Center Study, which contains four waves of data collected between 1994 and 2003. An event history model examined the impact of culture, leadership characteristics, internal structure, and external characteristics on the likelihood of adopting naltrexone between 1994 and 2003.


RESULTS
The results suggest that organizations embracing a 12-step model and those employing more experienced administrators were significantly less likely to adopt naltrexone. Moreover, treatment centers that used prescription drugs, possessed an employee handbook, were accredited, and operated on a for-profit basis were significantly more likely to adopt naltrexone over time.


CONCLUSIONS
Structural characteristics do affect the innovation adoption behaviors of private substanceuse disorders treatment centers. Organizational-level "research to practice" implications to further the adoption of innovative evidence-based treatments are discussed.
Oser
Carrie B
CB
Department of Sociology, Center on Drug and Alcohol Research, University of Kentucky, 1531 Patterson Office Tower, Lexington, Kentucky 40506-0350, USA. cboser0@uky.edu
Roman
Paul M
PM
D003469:Culture; D004363:Drug Utilization; D006801:Humans; D007857:Leadership; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D017149:Private Sector; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000188:drug therapy*
D009292:Narcotic Antagonists; D009271:Naltrexone