# Examining vertical alignment in perceived implementation climate within a trial of motivational interviewing in substance use disorder treatment clinics

> **NIH NIH F31** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2024 · $16,422

## Abstract

PROJECT SUMMARY /ABSTRACT
Motivational interviewing (MI) is a leading evidence-based practice (EBP) for substance use disorder (SUD)
with potential to improve population health. Although disseminated widely, MI fidelity and sustained use remain
low among community providers. Strategies are needed to improve the reach and impact of EBPs in usual
care. Implementation strategies related to improving the organizational context of SUD treatment programs
may lead to improved MI implementation. Improving an organization’s EBP implementation climate, the shared
perception of the importance of EBP implementation within an organization, can promote provider
implementation outcomes. EBP implementation climate is cultivated by program leaders who exhibit behaviors
that support implementation; thus, interventions, such as the Leadership and Organizational Change for
Implementation (LOCI) intervention, are being evaluated for their impact on provider MI implementation
outcomes. A presumed mechanism of LOCI is organizational vertical alignment, which is the extent to which
leaders and staff share perceptions about EBP implementation climate. Vertical alignment between leaders
and providers regarding implementation climate can signal shared views about the importance of the EBP, and
shared views that the structures and processes set in place by leaders facilitate implementation on the front
lines. However, analyses have yet to quantitatively examine this mechanism, with research typically indexing
mean level perceptions of front-line providers, without considering the impact of variation or provider alignment
with leader perceptions. Additionally, it is yet unknown whether vertical alignment is sensitive to change over
time and with exposure to leadership intervention. These data are critical to establishing vertical alignment of
implementation climate perceptions as a potential mechanism of action of implementation strategies.
The objective of this NRSA application is to foster my development as an implementation scientist with a focus
on organizational behavior, leadership, and addiction health services. This proposal leverages data from a
NIDA funded cluster randomized trial that examined the effect of LOCI on implementation leadership and
climate and MI implementation outcomes. The proposed project will examine organizational vertical alignment
of perceived implementation climate as a potential mechanism of action of organizational implementation
strategies. Specifically, Aim #1 will measure vertical alignment in perceived implementation climate among
providers and leaders in SUD treatment clinics implementing MI. Aim #2 will identify clinic characteristics that
are correlated with vertical alignment at baseline. Lastly, Aim #3 will examine longitudinal trajectories of vertical
alignment in perceptions of implementation climate and their associations with MI implementation outcomes.
The present study represents an important step in further understanding mech...

## Key facts

- **NIH application ID:** 10833490
- **Project number:** 5F31DA058514-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Young Vivian Byeon
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $16,422
- **Award type:** 5
- **Project period:** 2023-04-20 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10833490

## Citation

> US National Institutes of Health, RePORTER application 10833490, Examining vertical alignment in perceived implementation climate within a trial of motivational interviewing in substance use disorder treatment clinics (5F31DA058514-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10833490. Licensed CC0.

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