title: Innovation attributes and adoption decisions: perspectives from leaders of a national sample of addiction treatment organizations.
abstract: Drawing on diffusion theory to further knowledge about evidence-based practices (EBPs) in the treatment of substance use disorders (SUDs), this study describes the perceived importance of innovation attributes in adoption decisions within a national sample of SUD treatment organizations. Face-to-face interviews were conducted with leaders of 307 organizations. A typology differentiated organizations reporting: (1) adoption of a treatment innovation in the past year ("recent adoption"), (2) plans to adopt an innovation in the upcoming year ("planned adoption"), or (3) no actual or planned adoption ("non-adoption"). About 30.7% of organizations reported recent adoption, 20.5% indicated planned adoption, and 48.8% were non-adopters. Leaders of organizations reporting recent adoption (n=93) or planned adoption (n=62) rated the importance of innovation attributes, including relative advantage, compatibility, complexity, and observability, on these adoption decisions using a Likert scale that ranged from 0 to 5. Innovation attributes most strongly endorsed were consistency with the program's treatment philosophy (mean=4.47, SD=1.03), improvement in the program's reputation with referral sources (mean=4.00, SD=1.33), reputational improvement with clients and their families (mean=3.98, SD=1.31), and reductions in treatment dropout (mean=3.75, SD=1.54). Innovation characteristics reflecting organizational growth and implementation costs were less strongly endorsed. Adopters and planners were generally similar in their importance ratings. There were modest differences in importance ratings when pharmacological innovations were compared to psychosocial interventions. These findings are consistent with diffusion theory and suggest that efforts to link EBPs with client satisfaction and potential reputational benefits may enhance the diffusion of EBPs. Attention to these attributes when developing and evaluating SUD treatment interventions may enhance efforts to increase subsequent adoption.
authors.affiliation: University of Kentucky, Department of Behavioral Science, 141 Medical Behavioral Science Building, Lexington, KY 40536-0086. Electronic address: hannah.knudsen@uky.edu.
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Knudsen
authors.affiliation: University of Georgia, Owens Institute for Behavioral Research and Department of Sociology, 106 Barrow Hall, Athens, GA, 30602-2401. Electronic address: paulroman67@gmail.com.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Roman
mesh_terms: D055317:Evidence-Based Practice / Q000458:organization & administration*; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D009936:Organizational Innovation; D019966:Substance-Related Disorders / Q000628:therapy*; D014481:United States; D014482:United States Substance Abuse and Mental Health Services Administration
keywords: Adoption of evidence-based practices; Diffusion theory; Innovation adoption; Substance use disorder treatment organizations