title: Hepatitis C testing in substance use disorder treatment: the role of program managers in adoption of testing services.
abstract: BACKGROUND
  Health care organizations do not adopt best practices as often or quickly as they merit. This gap in the integration of best practices into routine practice remains a significant public health concern. The role of program managers in the adoption of best practices has seldom been investigated.
  
  
  METHODS
  We investigated the association between characteristics of program managers and the adoption of hepatitis C virus (HCV) testing services in opioid treatment programs (OTPs). Data came from the 2005 (n = 187) and 2011 (n = 196) National Drug Abuse Treatment System Survey (NDATSS). We used multivariate regression models to examine correlates of the adoption of HCV testing. We included covariates describing program manager characteristics, such as their race/ethnicity, education, and their sources of information about developments in the field of substance use disorder treatment. We also controlled for characteristics of OTPs and the client populations they serve.
  
  
  RESULTS
  Program managers were predominantly white and female. A large proportion of program managers had post-graduate education. Program managers expressed strong support for preventive services, but they reported making limited use of available sources of information about developments in the field of substance use disorder (SUD) treatment. The provision of any HCV testing (either on-site or off-site) in OTPs was positively associated with the extent to which a program manager was supportive of preventive services. Among OTPs offering any HCV testing to their clients, on-site HCV testing was more common among programs with an African American manager. It was also more common when program managers relied on a variety of information sources about developments in SUD treatment.
  
  
  CONCLUSIONS
  Various characteristics of program managers are associated with the adoption of HCV testing in OTPs. Promoting diversity among program managers, and increasing managers' access to information about developments in SUD treatment, may help foster the adoption of best practices.
authors.affiliation: Department of Health Policy and Management, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA. jf2584@columbia.edu.
authors.forename: Jemima A
authors.initials: JA
authors.lastname: Frimpong
authors.affiliation: Robert F. Wagner Graduate School of Public Service, New York University, 295 Lafayette St., #3062, New York, NY, 10012, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: D'Aunno
mesh_terms: D001291:Attitude of Health Personnel; D006270:Health Facility Administrators / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D024382:Professional Role; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000150:complications* / Q000628:therapy* / Q000821:virology; D000078329:Workforce
keywords: Adoption; Best practices; Hepatitis C (HCV); Management; Opioid treatment programs; Program managers; Substance use disorder treatment