Gustafson D, Sr., Horst J, Boss D, et al. Implementation of Smartphone Systems to Improve Quality of Life for People With Substance Use Disorder: Interim Report on a Randomized Controlled Trial. JMIR Hum Factors. 2022;9(3):e35125. doi:10.2196/35125
This interim report provides the current lessons learned about the two implementation strategies being tested in an ongoing randomized trial. The randomized trial will assess two different implementation strategies for implementing ACHESS, re-named RISE Iowa for the trial. RISE Iowa is being used to target substance use disorder and promote services and adherence to treatment. RISE Iowa was implemented using a typical product training approach and a quality improvement method called the NIATx model. In the typical product training approach, a sales representative trains key players on using the product and provides access to a training manual or FAQ page. The NIATx model adds a layer where an external coach contacts the agency monthly to check in and provide support and guidance. In addition, tools for implementation are provided, such as checklists, workflow examples, and predictions for readiness to change. The first five months of the eighteen-month study are summarized in this article. Overall, the NIATx is significantly outperforming the product training approach. Not only are councilors and patients continuing to use RISE Iowa for longer (councilors: 38% v 4%, patients: 21% v 14% continued use at five months) and more frequently throughout the month (councilors 4 v 1.5 days per week: patients 6.5 v 5.5 days per month). Ten factors influencing implementation were identified. The most important were: the identification of pain points and targeted relief using RISE Iowa, integration into the current workflow, encouraging regular assistance from coaches, getting senior executives to promote use, and removing app bugs as they arise.