Bridging health care gaps: UIC Institute for Research on Addictions hosts implementation science expert
Bridging health care gaps: UIC Institute for Research on Addictions hosts implementation science expert
The United States is a leader in spending for mental and physical healthcare, but not a leader in healthcare outcomes. While researchers understand many of the root causes of health conditions, the impact of that knowledge isn’t reaching patients.
UIC’s Institute for Research on Addictions (IRA) represents a cohesive, multidisciplinary collaboration among investigators to address the major public health and societal concern of substance misuse and addictions. This week, the IRA hosted Dr. Sara Becker, inaugural director of the Center for Dissemination and Implementation Science and the Alice Hamilton professor of psychiatry at Northwestern University. Using implementation science, Becker hopes to find solutions to the U.S.’s health care accessibility issues.
“We need to be increasing the speed and impact of our behavioral health research, both for addiction and mental health,” said Becker. “There’s this enormous gap between what we know in terms of our public health and medical knowledge, and what we actually do in terms of our public health and medical practice.”
Implementation science is the study of methods to increase the uptake of evidence-based interventions to improve individual and population health. Becker’s team argues that there are at least four specific gaps—the public health supply gap, the public health demand gap, the expertise gap and the scientific gap—that can be bridged using implementation science.
Becker shared that on the supply side, there is a gap between the care that could be available with the knowledge we have and the care that exists. On the demand side, the treatments that do exist aren’t reaching the people who need them. Only 20% of people diagnosed with a substance use disorder typically receive health services. Only half of those with a mental health disorder and only 70% of those with physical disabilities receive any care.
“We need to do a better job, not only making the treatment readily available, but removing structural and systemic barriers that allow people to access it,” said Becker.
Part 2
In discussing the expertise and scientific gaps, Becker noted that between 2015 and 2019, only 1.5% of National Institute on Drug Abuse (NIDA) funded research on opioids and stimulants was for implementation research; most funding still went to scientific discovery. So, while the tools to curb the addiction epidemic were being built, there was no solution for accessibility.
Implementation science offers a solution: instead of only thinking about the effect a new intervention or health service would have on a patient, researchers should consider the context the patient lives in. When developing treatments, questions regarding setting, patient and provider buy-in, training and treatment reimbursement options, efficiency and more should be answerable.
“Can it be done equitably and in a patient-centered way?” asked Becker. “That is the core of implementation research.”
Contingency management is a treatment model where individuals are rewarded for evidence of positive behavioral change through incentives like vouchers and rewards. It is the most effective behavioral treatment for opioid addiction but is one of the least available treatment options. Becker’s research in implementation science was applied to contingency management through several case studies and trials, including her team’s Project MIMIC. Project MIMIC worked with 30 opioid treatment programs across New England to strategize and implement contingency management in their clinics.
“You really need to understand the barriers to the intervention so that you can select your strategies to address them,” said Becker.
In addition to the Seminar Series, the IRA also offers research support infrastructure and membership for interested faculty, research trainees and academic professionals. Learn more on their website.