# Evaluating the Implementation of the VA Stepped Care for Opioid Use Disorder Train-the-Trainer (SCOUTT) Program

> **NIH VA I50** · VA PUGET SOUND HEALTHCARE SYSTEM · 2020 · —

## Abstract

Project: Although rates of pharmacologic treatment of opioid use disorders (OUD) are increasing, less than
40% of patients with OUD receive such treatment, with substantial variation across VA facilities and patient
characteristics. One initiative to address timely access to OUD care and suicide prevention, two of the top five
VA national priorities, is the national implementation of the Stepped Care for Opioid Use Disorder Train-the-
Trainer (SCOUTT) program across primary care, pain management and mental health clinic settings. Given its
national scope, range of implementation settings, and train-the-trainer approach, the roll-out of the SCOUTT
program presents a unique opportunity to evaluate the implementation of this program in the VA, with the goal
of yielding actionable findings to inform not only the current effort but also future implementation efforts to
spread similar programs across the VA. This project proposes to evaluate the SCOUTT program
implementation at 18 VA facilities using quantitative and qualitative methods.
Project Objectives: Guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-
AIM) framework, the specific aims of this evaluation project include to: 1) estimate the number and describe
characteristics of patients receiving OUD care at participating sites (Reach); 2) among patients with OUD,
assess the trends in the proportion of patients receiving pharmacologic treatment for OUD, acute care
utilization, and all-cause mortality in the year before and after SCOUTT's launch, relative to control facilities
(Effectiveness); 3) report the number of providers obtaining buprenorphine waivers and providers prescribing
OUD medications at implementation clinics; survey and interview providers and clinic leadership regarding
their perspectives on providing OUD treatment, organizational climate and barriers and facilitators to delivering
OUD care (Adoption); 4) assess patient retention in and compliance with SCOUTT; interview providers/leaders
to identify barriers and facilitators to implementing OUD care (Implementation); and 5) assess changes in
number of waivered and prescribing providers, retention in and compliance with stepped care; identify barriers
and facilitators to maintaining OUD care in original clinics across Years 1 and 2 and spreading OUD care to
other clinics in Year 3 (Maintenance).
Project Methods: Data sources for this project include VA administrative data, electronic surveys, and semi-
structured interviews. The summative evaluation will consist of summarizing and examining involvement in
stepped care at the patient- and provider-level and change over time in pharmacy, utilization, and mortality
metrics for participating clinics from the year before and year following the SCOUTT rollout. For the formative
evaluation, we will recruit clinic leaders and providers to complete brief electronic surveys at baseline and one
year after the rollout to assess receptivity to delivering stepped O...

## Key facts

- **NIH application ID:** 9834752
- **Project number:** 1I50HX002784-01A1
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Eric Hawkins
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2019-05-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9834752

## Citation

> US National Institutes of Health, RePORTER application 9834752, Evaluating the Implementation of the VA Stepped Care for Opioid Use Disorder Train-the-Trainer (SCOUTT) Program (1I50HX002784-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9834752. Licensed CC0.

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