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Based at the University of Wisconsin–Madison, NIATx 200 is a randomized trial that will focus on the adoption of improvement strategies to increase admissions and continuation and reduce no-shows and wait time to treatment. Four states—Michigan, New York, Oregon, and Washington—will recruit 50 providers to take part in this study. As NIATx members they will work to create a culture of process improvement in which treatment center staff use existing resources to improve services, learn innovative strategies through peer networking, and model organizational improvements in addiction treatment.

The Need

According to the Substance Abuse and Mental Health Services Administration, every year more than 23 million Americans are in need of addiction treatment, but less than 10 percent of those individuals receive treatment (1). Some find barriers to treatment in financing or readiness, but often problems in service delivery prevent clients from accessing treatment (2). NIATx focuses on this last barrier—the delivery of treatment—to improve patients' access to, engagement in, and retention in treatment.


This study will aid in determining which combination of collaborative services produces the greatest improvement and is the most cost effective in achieving the four NIATx aims:

  1. To reduce the wait time between a client's first request for service and the first treatment session
  2. To reduce client no-shows
  3. To increase addiction treatment centers' admissions
  4. To increase the treatment continuation rate between the first and the fourth treatment sessions

Secondary analysis will explore the impact of the various study arms on treatment completion rates, levels of adoption and sustainability of required innovations, organizational readiness to adopt and sustain process innovations, voluntary employee turnover, and contributions to the margin. We will also examine the impact of study arms on the success of each innovation and the cost to deliver each combination of services being tested.

Each of the 200 providers will be randomly assigned to a group that uses at least one of the following NIATx services:

  • Learning Sessions: Twice-yearly meetings for provider and state Change Teams
  • Interest Circles: Monthly teleconferences for provider Change Leaders
  • Coaching: Process improvement experts assigned to work with providers
  • Web site: A repository for improvement resources

Principal Investigators:
David Gustafson Sr., Ph.D