Adapting the stages of implementation completion to an evidence-based implementation strategy: The development of the NIATx stages of implementation completion.

Access to integrated services for persons with co-occurring substance use and mental health disorders is a long-standing behavioral health problem. Evidence-based practices (EBPs) that focus on patient needs are effective in improving care for persons with co-occurring disorders. The stages of implementation completion (SIC) is a measure that assesses the process that organizations go through when implementing a new EBP and can be used to compare differences between organizations in their fidelity to recommended processes. To implement, organizations use specified strategies to integrate EBP into the care process. These strategies require a significant investment of staff resources. When organizations struggle to achieve competency with a set of implementation strategies, resources are wasted impacting the ability to use the strategies in future change efforts. As such, it is critical to measure organizational efforts to achieve competency, but instruments to do so are lacking. The SIC was adapted for a proven implementation strategy, NIATx, to address this gap. The NIATx strategy provides outside support and coaching to facilitate the implementation of a new EBP. Results from this study indicated that the NIATx-SIC could distinguish between addiction treatment agencies that applied NIATx implementation strategies with competency, versus those that did not, in the context of a multilevel randomized control trial. Study results provide evidence for the utility of adapting the SIC to specific implementation strategies and the benefit that the NIATx-SIC could provide for similar studies involving the use of NIATx to implement EBPs.