Evidence-based multimedia 12-step facilitation toolkit improves counselor adherence in group counseling with minimal training: Preliminary results

s / Drug and Alcohol Dependence 140 (2014) e2–e85 e21 Evidence-based multimedia 12-step facilitation toolkit improves counselor adherence in group counseling with minimal training: Preliminary results Adam C. Brooks1, Alexandre B. Laudet2, T. Case1, C.M. Carpenedo1, D. Knoblach1, L. Benishek1, D. Carise3, K.C. Kirby1,3 1 Treatment Research Institute, Philadelphia, PA, United States 2 National Development and Research Institute, New York, NY, United States 3 Psychiatry, University of Pennsylvania, Philadelphia, PA, United States Aims: Numerous psychosocial interventions effectively improve client outcomes in clinical trials, but adapting evidencebased protocols into formats suitable for dissemination to community treatment programs is challenging. We translated 12-Step Facilitation (12SF) into a multimedia curriculum toolkit to help counselors deliver clinically useful group sessions that convey core elements of 12SF; we tested the toolkit’s conceptual fidelity and clinical utility. Methods: Toolkit material development was informed by consultation with content experts, counselors and clients, to develop simple, engaging presentations of core 12SF concepts. In a pre-post design, we coded 2 treatment groups on preselected 12-Step topics runby10 counselors. Counselorswere randomly assigned to attend a 3-h training to familiarize themwith the 12SF toolkit and accompanying self-teaching strategies (TK), or to an attention control training including relevant 12-Step content (AC). Post-training 12Step groups were audiotaped and coded for adherence to 12-Step content and skillfulness. 12-Step engagement and self-reported substanceusewas assessed among clients (N=44) for threemonths following toolkit exposure. Results: TK counselors demonstrated very large and statistically significant Preto Post-Training adherence improvements in 12SF techniques (mean d=1.74) and in 12-Step content (mean d=1.49) relative to counselors in the AC condition. TK counselors also demonstratedmoderate improvement in skill when delivering 12-Step content (mean d=0.58). TK exposed clients self-reported significantly fewer drinking days (d= .59) and fewer drug use days (d= .49) relative to AC clients. Conclusions: Preliminary results show thatmultimedia toolkits may be a costeffective, easily disseminated approach to improve group counseling in community treatment with minimal training. Financial support: NIAAA R01 AA017867. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.078 Implementation of an electronic information system to enhance practice at an opioid treatment program L.S. Brown, Steven A. Kritz, Melissa Lin Addiction Research and Treatment Corporation, Brooklyn, NY, United States Aims: The Addiction Research and Treatment Corporation is a medication-assisted opioid treatment program, also providing primary care (including HIV care) to approximately 2800 predominantly minority adults in New York City. We received National Institute on Drug Abuse R01 funding to study implementation of an electronic health information system. Methods: The domains of Quality, Risks, Productivity, Satisfaction, and Finances were evaluated utilizing a pre-post implementation study design. Subsequent to the research, we exploited systemcapabilities tomeasureOutcomes forHIVdisease, diabetesmellitus, and hypertension for 100% of patients under care for these conditions. Results: For the Quality domain, annual medical assessments and annual, 30-day, and 90-day multidiscipline assessments were timely for 83%, 70%, 72%, and 42% of cases, respectively, pre-implementation; and 97%, 96%, 87%, and 70% respectively, post-implementation. All results were highly significant. Hepatitis C viral load was appropriately performed in 85% of cases pre-implementation and 81% post-implementation; a nonsignificant difference. For Risks, the number of events was too low to detect a statistically meaningful change. For Satisfaction, there was no change for patients and a non-significant upward trend post-implementation for staff. Productivity declined postimplementation; reaching statistical significance for counselors. Finances did not change significantly. Outcomes for HIV disease (suppressed viral load), diabetes mellitus (HgbA1C<7), and hypertension (BP<140/90) showed improvement over the course of a 1-year timeframe. Conclusions: Despite onlymodest research results, we can now demonstrate system capabilities that improve patient outcomes, the key measure of patient status. Financial support: Researchsupportedby theNational Institute on Drug Abuse (R01 DA022030). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.079 Association of objective and perceived neighborhood characteristics with tobacco use among young adults Qiana L. Brown1, A.J. Milam1, M.J. Smart1, R.M. Johnson2, Sabriya L. Linton1, C.D. Furr-Holden1 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States 2 Boston University School of Public Health, Boston,