An implementation story: moving the GAIN from pilot project to statewide use.
Similar to implementing an evidence-based practice (EPB), implementing an evidence-based assessment (EBA) is a long, complex process that can take several years to complete. Between 2002 and 2007, the state of Missouri first piloted the Global Appraisal of Individual Needs-Initial (GAIN-I; Dennis et al. 2006) assessment at one state-contracted adolescent substance abuse treatment program and then implemented the GAIN statewide. This case study documents the implementation process through Fixsen and colleagues' (2005) six stages of implementation, from exploration and adoption through sustainability, and outlines challenges and solutions encountered at the external, organizational, and individual staff level. Strengths of this project included recognition that implementation is an ongoing multistep process, strong support by state-level staff, contracting with an external purveyor for ongoing technical assistance at the agency level as well as training of front-line clinicians, and an implementation team comprised of stakeholders at multiple levels.
Gotham
Heather J
HJ
Mid-America Addiction Technology Transfer Center, University of Missouri-Kansas City, Kansas City, MO 64110-2499, USA. gothamhj@umkc.edu
White
Michelle K
MK
Bergethon
Hannah S
HS
Feeney
Tim
T
Cho
Dong W
DW
Keehn
Barbara
B
D000293:Adolescent; D019317:Evidence-Based Medicine; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D020407:Internet; D008297:Male; D008923:Missouri; D020380:Needs Assessment / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D010865:Pilot Projects; D011050:Policy Making; D015397:Program Evaluation; D012984:Software; D013221:State Health Plans / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D014481:United States; D014482:United States Substance Abuse and Mental Health Services Administration