Assessing Feasibility and Barriers to Implementing a Family-Based Intervention in Opioid Treatment Programs

Khary K. Rigg, Steven L. Proctor, Ethan S. Kusiak, Sharon A. Barber, Lara W. Asous, Tyler S. Bartholomew
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Abstract

Families Facing the Future (FFF) is an intervention designed specifically for families with a parent in methadone treatment. FFF is unique because it addresses prevention for children and recovery for parents in a single intervention. The primary goals of the program are to prevent parents’ relapse, help them cope with relapse if it occurs, and teach parenting skills in order to reduce the likelihood of substance use among their children. FFF has been implemented as an adjunct to treatment in several Opioid Treatment Programs, but has not been widely adopted due to various implementation barriers. The aims of this study, therefore, were to (1) assess the perceived feasibility of implementing FFF and (2) identify/describe barriers to implementing FFF. An online survey was used to assess implementation feasibility, while individual qualitative interviews were conducted to explore specific barriers to implementation. Data collection from a total of 40 participants (20 patients and 20 providers) was conducted from August 2022 to October 2022 at two Opioid Treatment Programs in Florida. Analyses revealed high feasibility scores, indicating that FFF was viewed by both patients and providers as a practical intervention to implement. Despite strong perceived feasibility of the intervention, qualitative findings identified several implementation barriers with respect to difficulty attending parent training sessions, aversion to in-home visits, and lack of funding (inability to provide patient incentives/bill insurance). This study provides evidence that while patients and providers view FFF as having high feasibility, significant implementation barriers exist. This paper fills a void in the literature by informing if and which modifications might be necessary to facilitate wider adoption of FFF in real-world Opioid Treatment Program settings.

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评估在阿片类药物治疗项目中实施基于家庭的干预措施的可行性和障碍
家庭面对未来 (FFF) 是专门为父母一方接受美沙酮治疗的家庭设计的干预措施。家庭面对未来 "的独特之处在于,它在一次干预中就解决了儿童的预防和父母的康复问题。该计划的主要目标是防止父母复吸,帮助他们应对复吸,并传授养育子女的技巧,以减少子女使用药物的可能性。FFF 已在多个阿片类药物治疗项目中作为辅助治疗手段实施,但由于各种实施障碍,尚未被广泛采用。因此,本研究的目的是:(1)评估实施 "家庭固定疗法 "的可行性;(2)识别/描述实施 "家庭固定疗法 "的障碍。在线调查用于评估实施的可行性,而个人定性访谈则用于探讨实施的具体障碍。从 2022 年 8 月到 2022 年 10 月,在佛罗里达州的两个阿片类药物治疗项目中,共对 40 名参与者(20 名患者和 20 名医疗服务提供者)进行了数据收集。分析表明,可行性得分很高,表明患者和医疗服务提供者都认为 "FFF "是一种切实可行的干预措施。尽管干预措施的可行性很高,但定性研究结果发现了一些实施障碍,如参加家长培训课程有困难、不喜欢上门探访以及缺乏资金(无法为患者提供激励措施/支付保险费用)。本研究提供的证据表明,虽然患者和医疗服务提供者认为 "家庭治疗 "具有很高的可行性,但在实施过程中仍存在重大障碍。本文填补了文献空白,说明了在现实世界的阿片类药物治疗计划环境中,是否有必要以及哪些修改可能有助于更广泛地采用 "家庭化治疗"。
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