After many hours, milestones reached

Screening, Assessment and Recvery Monitoring

Screening and assessment tools are important. They help service providers determine the appropriate level and intensity of care for clients who are entering the addiction treatment system. Monitoring the outcome of these clients is also a key part of the process. Dr. Brian Rush’s project team is pilot testing the Screening, Assessment and Recovery Monitoring (SARM) protocol at four pilot sites in Ontario. The fifth pilot site is scheduled to start study recruitment in early fall. As of August 8, 2012, 108 clients have been recruited into the study.

Two major milestones were reached leading up to pilot launch: development of the Ontario GAIN-Q3 and related certification and delivery of pilot site training.

Following selection of the GAIN-Q3 instrument as a Stage 1 assessment tool for the SARM protocol, the project Working Group provided recommendations for revisions to “Canadianize” the language of this tool, which was developed in the United States. The Working Group also made sure to cross-walk the tool with existing ADAT admission and discharge criteria, working to ensure that the information generated by the tool is relevant to the existing criteria. (ADAT stands for Admission and Discharge Criteria and Assessment Tools.) The Ontario version of the GAIN-Q3 reflects substantial input from key stakeholders in the Ontario addiction treatment system. The instrument itself, along with the accompanying administration and report software, was launched via Catalyst in July. Catalyst is the browser-based computer application which houses client-level clinical and administrative data for MOHLTC-funded addictions agencies in Ontario.

A train-the-trainer model is being used for the GAIN tools. To date, of the 14 pilot agency staff who attended the four-day training session in Illinois, 11 have achieved Administration Certification. Eight have also achieved Local Trainer Certification, an accomplishment that represents many, many hours of work – all done on a voluntary basis! As planned, these certified local trainers have also provided training to all staff in their pilot agency on the GAIN-Q3 instrument.

In terms of pilot site training, Dr. Rush’s team provided a day and a half of intensive training to all agency staff. The training included an overview of: the SARM protocol; SARM tool administration and interpretation; the relationship of the SARM protocol with the ADAT; and study logistics and next steps.

“We spent very valuable time at the Manitoulin Community Withdrawal Management Service,” said team member Nancy Chau, who visited the pilot site, one of five, in the spring. “We learned a lot about how they operate as an agency and some of the challenges they face as an addiction services provider due to their geographic location in Northern Ontario.”

Agency staff were also provided with a standardized and detailed study manual. Local study leads at each of the pilot sites were also engaged to act as a key liaison between the pilot agency staff and the study team. In addition, study leads are responsible for collecting and storing study recruitment materials, collecting staff feedback on the protocol, and providing assistance with study monitoring visits. During pilot testing, the study team also complete regular, on-site visits to provide support to agency staff to ensure that the protocol is implemented as designed.

Study recruitment will extend through September of this year (November for the fifth pilot site) with the 3- and 6-month recovery monitoring components wrapping up at the end of March 2013.

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