D&I Projects
Stagewise Implementation to Target – Medications for Addiction Treatment (SITT-MAT)
SITT-MAT is a five-year, NIDA-funded R01 (1R01DA052975-01A1) designed to improve patient access to medications for opioid use disorder within specialty addiction programs and primary care clinics in Washington State. Led by Stanford University (PI: Mark McGovern) and the University of Wisconsin (PI: Jay Ford), SITT-MAT partners with the Washington State Health Care Authority to offer implementation support to 64 primary care clinics and specialty addiction treatment programs based on target implementation outcomes. This innovative project uses a stepped implementation model where implementation supports of increasing intensity and cost are delivered only if less intensive implementation support do not achieve target outcomes. Implementation support strategies are:
- Enhanced monitoring and feedback;
- Two-day workshop;
- Internal facilitation; and
- External facilitation.
Findings from SITT-MAT have the potential to inform implementation research and provide key decision-makers with practical information on how to address the opioid epidemic at a systems level. For more information about SITT-MAT, visit this page.
Mark McGovern
Stanford University School of Medicine
Director
Dr. Mark McGovern is a Professor of Psychiatry and of Medicine at Stanford University School of Medicine. In 2017, he founded the Center for Dissemination and Implementation (CDI). After 20 years as a practicing clinician, Dr. McGovern is now focused on scaling up equitable access to evidence-based health care, improving the science of implementation and sustainment of evidence-based care in public and private health care organizations and systems, and training and mentoring the next generation of implementation scientists. Within the hub of CDI, he is the Principal Investigator of two federally funded national centers for dissemination and implementation: the Center for Dissemination and Implementation At Stanford (C-DIAS)(P50DA05402) and Research Adoption Support Center (RASC)(U2CDA057717). He is also a Senior Advisor for the National Coordinating Office of the SAMHSA Mental Health Technology Transfer Center (H79SM081726).
Elena Rosenberg-Carlson
Stanford University School of Medicine
Research Scientist, Project Director
Elena Rosenberg-Carlson, MPH, is a Research Scientist and Project Director for the Stagewise Implementation to Target – Medications for Addiction Treatment (SITT-MAT) study at CDI. She has significant experience managing and supporting implementation research and capacity-building initiatives in collaboration with academic, public health, and community partners, most recently as part of the UCLA Center for HIV Identification, Prevention and Treatment Services (CHIPTS). Elena received her BA from Carleton College and her MPH from the University of Michigan. She is currently pursuing her doctorate degree in public health with a concentration in implementation science at Johns Hopkins University.
Hannah Cheng
Stanford University School of Medicine
Research Scientist
Hannah Cheng, MS, joined CDI in 2019 and transitioned into a research analyst role in 2022. Her work at CDI primarily focuses on implementing addiction treatments in primary care and specialty care settings. She is dedicated to understanding how to optimize implementation efforts and applying implementation science to improve equity and access to mental health services. Hannah received her BS in Psychology and Neuroscience from the University of Pittsburgh and her MS in Epidemiology and Clinical Research from Stanford University.
Jay Ford
University of Wisconsin-Madison
Principal Investigator
Kim Mount
Washington State Health Care Authority
Project Director
Tony Walton
Washington State Health Care Authority
Co-Investigator
Ryan Keith
Washington State Health Care Authority
Project Partner
Collaborators
C. Hendricks Brown, Co-Investigator, Northwestern University
Lisa Saldana, Co-Investigator, Oregon Social Learning Center
Todd Wagner, Co-Investigator, Stanford University School of Medicine
More Projects
Addiction Treatment Starts Here (ATSH)
Addiction Treatment Starts Here (ATSH) is a collaboration between CDI and the Center for Care Innovations to increase access to medications for addiction treatment (MAT) in safety-net primary care clinics across the State of California. Since its launch in 2019, ATSH has supported over 100 safety-net clinics in designing new or expanding existing MAT programs. The ATSH initiative is funded by the California Department of Health Care Services through the State of California’s State Opioid Response grant. For more information about ATSH, visit this page.
Addressing Methamphetamine Use Disorders in Primary Care
CDI, in collaboration with the University of California Los Angeles Integrated Substance Abuse Programs (ISAP), is evaluating the current practice and needs of primary care providers in addressing methamphetamine use problems among their patients. The project is funded by the State of California Department of Health Care Services, as a component of the federal State Opioid Response Grant. Both qualitative and quantitative approaches are being used to understand current practice patterns, barriers and facilitators to providing quality care, and perceived needs for enhancing existing services. Additionally, a pilot study of a multicomponent intervention, the Treatment and Recovery for Users of Stimulants (TRUST), is being implemented among patients receiving substance use disorder treatment in publicly-funded specialty addiction treatment settings. TRUST implementation was evaluated using mixed methods to understand the barriers and facilitators to protocol adherence and potential sustainability of the intervention. Both projects seek to improve care quality across healthcare settings to prevent overdose deaths and long-term complications associated with methamphetamine use.
Implementing Services and Treatment for Alcohol and other substance use in Reproductive health clinics (I-STAR)
Rates of risky alcohol and drug use and alcohol and substance use disorders (AUDs/SUDs) are highest among women during their reproductive years compared to other periods of the life course. Sexual and reproductive health (SRH) clinics are a trusted care source and primary point of access for women and serve as a safety net for structurally marginalized groups in the U.S. CDI’s Heather Gotham, in collaboration with MPIs at Emory University and Tulane University, are conducting a hybrid type 1 effectiveness-implementation study to examine the implementation of screening, brief intervention, and referral to treatment (SBIRT) in a regional affiliate (four clinics) of a national SRH organization. Our integrated study draws upon the evidence-based implementation approach, Implementation and Sustainment Facilitation (ISF), guided by the Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) models. Results will provide new, timely evidence to inform scale-up of alcohol and substance related services in SRH settings nationally. R01AA030529 – NIAAA; PIs: Welsh, Hall, and Gotham.
Completed Projects
Integrated Behavioral Health in Primary Care (IBHPC)
In collaboration with primary care leaders in the Stanford Health Care system, IBHPC is being implemented in Stanford Primary Care, Employer Based Clinics and affiliated primary care clinics. This integrated model is designed to increase the identification and treatment of behavioral health issues, including mental health and substance use issues. The goal is to support patients with behavioral health problems within their primary care experience and, when needed, coordinate care with specialty psychiatric services. Ongoing projects are evaluating staff perceptions and current state of behavioral health practices; installation of depression screening using technology platforms; developing electronic health record supports: and integrating consulting psychiatry and integrated social work personnel.
Mental Health Technology Transfer Center (MHTTC) National Coordinating Center
Funded by the Substance Abuse and Mental Health Services Administration (H79SM081726) from August 2018 to September 2024, the Mental Health Technology Transfer Center (MHTTC) Network consisted of 10 Regional Centers. The MHTTC Network’s purpose was to strengthen the mental health workforce’s capacity to deliver effective mental health prevention, treatment, and recovery services to individuals across the 58 US states and territories. Housed within CDI, the MHTTC National Coordinating Center provided leadership, infrastructure, and support nationwide, increasing its capacity to use dissemination and implementation (D&I) science to deploy effective implementation support strategies that lead to meaningful and sustainable changes in service delivery.
D&I Tools and Resources
Below are organizational measures we've developed and refined to aid in the implementation of mental health and substance use treatment services.
