# Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)

> **NIH NIH R01** · STANFORD UNIVERSITY · 2021 · $716,104

## Abstract

PROJECT SUMMARY/ABSTRACT
To combat the US opioid epidemic, massive efforts have been focused on expanding access to medications
for opioid use disorder (MOUD). While there are indications of improved reach and adoption, an ironic gap
persists—only about one-third of specialty addiction treatment organizations offer MOUD. This proposal,
Stagewise Implementation-To-Target – Medications for Addiction Treatment (SITT-MAT), not only
advances the science of implementation, but advances our empirical understanding of how to best respond to
a substance-related epidemic. This is a revised application in response to PAR-19-274: Dissemination and
Implementation Research in Health” and aligned with the National Institute on Drug Abuse Strategic Plan
“ensuring the effective translation and implementation of scientific research findings to improve the prevention
and treatment of substance use disorders.” Within an adaptive implementation strategy trial design, using an
innovative stagewise implementation-to-target approach, 72 community addiction treatment programs will
participate. The stagewise implementation-to-target, stepped “care” type approach, deploys increasingly
intensive strategies only if needed. The sequence of implementation strategies are: 1) Enhanced Monitoring
and Feedback; 2) “NIATx/MAT Academy,” a 2-day workshop on MOUD and NIATx (Network for Improvement
of Addiction Treatment)—an evidence-based process improvement strategy; 3) Randomization to either NIATx
Internal Facilitation or NIATx External Facilitation; and, 4) If outcome targets are not achieved in the NIATx
Internal Facilitation arm, assignment to NIATx External Facilitation. We evaluate the relative impact of 5
possible paths of implementation strategies on RE-AIM target outcomes: reach, effectiveness, adoption, and
implementation quality. Maintenance of outcomes is evaluated for sustainment. Measures of multi-level
contextual determinants are rigorous and systematic. In opening the “black box” of implementation strategies,
we detail procedures, fidelity, participation and costs using standardized measures. The collective expertise of
the research team, the established partnership with a state system of care and addiction treatment
organizations, forecasts successful project execution. As we submit this application, the US is still coping with
the COVID19 pandemic. The global health situation may rebound to relative normalcy in the months from
December 2020. Meanwhile, the CDC, SAMHSA, CMS, and the State of Washington Health Care Authority
have all made accommodations to continue the initiation and management of MOUD for patients receiving
addiction treatment services. Therefore, even if the current quarantine restrictions persist, we do not anticipate
major modifications to the study protocol, except in-person implementation support activities would be
transitioned to videoconference formats. During this pandemic, it is even more critical for patients with opioid
use disorders to ...

## Key facts

- **NIH application ID:** 10313995
- **Project number:** 1R01DA052975-01A1
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** James H Ford
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $716,104
- **Award type:** 1
- **Project period:** 2021-09-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10313995

## Citation

> US National Institutes of Health, RePORTER application 10313995, Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT) (1R01DA052975-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10313995. Licensed CC0.

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