BUILD IT: An Implementation Tool to Increase Access to Evidence-based Preventive Interventions for Opioid Use Disorders

PROJECT SUMMARY/ABSTRACT This R61/R33 project, in response to RFA-DA-24-066 submitted to the National Institute on Drug Abuse (NIDA) as part of the Helping to End Addiction Long-term (HEAL) initiative, aims to develop and test a digital implementation tool to increase implementation of selected and indicated prevention programs (SIPPs) for opioid use disorder—the Building for Implementation Tool (BUILD IT). As communities struggle to adopt programs to address public health problems related to opioid use disorder, it is critical that advances in knowledge about successful implementation are made available in practical terms for rapid deployment to decision-makers who are positioned to make implementation of prevention efforts happen. BUILD IT will provide SIPP adopters, including those from low-resourced organizations, with an empirically derived alternative to expensive implementation technical assistance that is easily accessible and affordable. This phased award will allow an iterative development process, with sequenced interactions between data analysts, developmental architects, and users for input, followed by rigorous evaluation. BUILD IT will serve as an implementation support tool for organizations or systems adopting SIPPs to prevent initiation and escalation of opioid use, with a specific emphasis on HEAL initiative SIPPs. Procedures for the R61 phase include two parallel paths of activity to develop BUILD IT and prepare for its testing: (Aim 1) Secondary data analyses will be conducted using a large repository of implementation process data to identify activities or components to include as implementation recommendations. Recommendations and feedback will be based on type of program being implemented and the context in which it is being implemented, sequencing of items, value/weight of the items and the algorithmic structure over time in the implementation process. (Aim 2) Design, usability, and refinement sessions will be conducted with SIPP developers (n = 12) and community site implementers (n = 10) over a series of iterative sessions to inform the user interface and resources created. The staged architectural development of BUILD IT will run alongside both paths, interacting with them when new evidence is learned. In the R33 Phase, this project will test BUILD IT with a sample of former, current, and future HEAL-funded and other SIPP programs whose developers (n = 26) agree to include BUILD IT as an implementation tool in their scale-up efforts. Analyses will examine (Aim 1) implementation outcomes for sites exposed to BUILD IT including achievement of program start-up and competency for sustainment, as well as user feedback and (Aim 2) BUILT IT’s ability to improve implementation fidelity and subsequent program outcomes. Formal mediation analyses are proposed. BUILD IT is directly responsive to requests from program developers and implementing site communities. Having an easily accessible, informative, and evidence-based implementation tool available to newly adopting sites seeking to implement SIPPs has the potential for a substantial public health impact by increasing the availability of prevention for costly public health consequences related to the opioid epidemic.