This project tests a training strategy to help rural jails start or increase their use of medications to treat opioid use disorder (MOUD - methadone, buprenorphine, naltrexone). Staff from participating jails will attend a series of training sessions, called Project ECHO, that include online learning sessions with skilled experts, case-based discussions (real-world examples), and peer-to-peer learning opportunities. Project ECHO is well-studied in healthcare settings but has rarely been used in correctional systems. Staff from 40 rural jails and local treatment programs will participate in 6 months of core sessions (all participants attend the same sessions), followed by 12 months of continuing sessions (where content is tailored to participants' needs). Staff will complete surveys about their knowledge and experience, and jails will provide data about their services. Researchers will measure changes in MOUD services offered by the jails over time, as well as the impact these changes have on staff's work environment. If Project ECHO helps expand MOUD services, it will offer a blueprint for expanding these life-saving services in other jails nationwide.
Administrative, security, or healthcare staff in participating jails
Employed at the facility a minimum of 3 months
Ongoing or recent participation in similar organizational improvement project
Inability to read or understand English or Spanish
Single group
Project ECHO
BehavioralVirtual learning sessions, case-based discussions, and peer-to-peer learning
Increase in MOUD prescriptions (administrative data)
Administrative data tracking the number of MOUD prescriptions will be used to assess whether the jail has increased its use of MOUD to treat opioid use disorder relative to baseline.
Organizational climate - Burnout (BAT-4)
Staff surveys measure Burnout via the 4-item Burnout Assessment Tool (BAT-4). Items are scored from 1 (never) to 5 (always), and the mean is calculated (higher scores = greater burnout). Change relative to baseline indicates impact of the intervention on this feature of organizational climate.
Organizational climate - Stress (TCU SOF subscale)
Staff surveys measure Stress via a validated 4-item subscale of the TCU Survey of Organizational Functioning. Items are scored from 1 (disagree) to 5 (agree), and the mean is calculated (higher scores = greater perceived stress). Change relative to baseline indicates impact of the intervention on this feature of organizational climate.
Organizational climate - Job Satisfaction (TCU SOF subscale)
Staff surveys measure job satisfaction using a 6-item validated subscale from the TCU Survey of Organizational Functioning. Items are scored from 1 (strongly disagree) to 5 (strongly agree), and the mean is calculated (higher scores = greater job satisfaction). Change relative to baseline indicates impact of the intervention on this feature of organizational climate.
Impact on Staff Knowledge: Opinions About MAT Questionnaire
Staff surveys include this 12-item scale, measuring familiarity, receipt of training, and perceived effectiveness of 4 formulations of medications for opioid use disorder. Each item is rated on a 1-5 scale, with higher scores reflecting stronger endorsement. Overall improvements in any of the 3 domains relative to baseline will indicate the intervention had a positive impact on staff knowledge about MOUD.
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University of Massachusetts, Worcester
Lead sponsor
National Institute on Drug Abuse (NIDA)
Collaborator
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