Assessing the comparative effectiveness of ECHO and coaching implementation strategies in a jail/provider MOUD implementation trial.

Background: For nearly two decades, it has been widely recognized that individuals in jail settings have a high prevalence of opioid use disorders (OUD) and are highly susceptible to fatal overdose upon their release. This setting provides a public health opportunity to address OUD with Medication for Opioid Use Disorders (MOUDs). Yet, 56% of jails do not provide MOUD, creating a pressing need for better implementation approaches in jail and the hand-off to the community.

Fostering MOUD use in justice populations: Assessing the comparative effectiveness of two favored implementation strategies to increase MOUD use.

Coaching is a favored strategy for the implementation of medications for opioid use disorder (MOUD), yet research has not adequately tested or assessed coaching dosages and mediums for overall effectiveness, nor have coaching doses been widely studied within criminal justice settings (CJS). Scaling up the use of MOUD, particularly in CJS, presents a challenge given the stigmatization of substance use disorder, funding for MOUD, availability and capacity of community-based treatment providers, leadership support, and the historical preference for behavioral therapy-based treatment practices. The University of Wisconsin's Center for Health Enhancement and Systems Studies (CHESS) and George Mason University's Center for Advancing Correctional Excellence! (ACE!) are conducting a randomized controlled trial to determine the optimal combination and dosages for two different coaching strategies to disseminate MOUD in justice-involved populations; those strategies are the NIATx model for process improvement and Extension for Community Healthcare Outcomes (ECHO) model.