Parent study overview
EMERGENCY
The parent study employed a modified stepped wedge design which included an Implementation Facilitation Phase. The first cluster of three OTPs were randomly assigned at the end of February 2020 to begin the implementation facilitation intervention to improve accessibility to treatment in programs unable to admit patients within 14 days. The second cluster of three OTPs began the intervention at the end of November and beginning of December 2020. All OTPs finished the intervention by June 2021. The entire Implementation Phase occurred during the federal COVID-19 Public Health Emergency declaration, which began on March 20, 2020.The intervention was focused on implementing interim methadone treatment and other changes to admission procedures. Interim methadone treatment, methadone without routine counseling, is permitted under the extant OTP regulations for OTPs with admission delays due to inadequate amount of counseling staff. Randomized trials have shown it to be an effective alternative to waiting lists [The External Facilitator invited all the SOTAs and OTP staff who were directly involved in the implementation intervention to participate in one individual qualitative interview. He emailed them a copy of the IRB-approved information sheet for the interviews and invited them to schedule an appointment with an experienced interviewer (SGM). All agreed to participate. During appointments, the interviewer reviewed the information sheet with staff and obtained verbal informed consent prior to conducting the interview via Zoom. Participants were not financially compensated for completing the interview. Human Subjects oversight was provided by the Western Institutional Review Board (WIRB).