Leveraging regulatory flexibility for methadone take-home dosing to improve retention in treatment for opioid use disorder: A stepped-wedge randomized trial to facilitate clinic level changes.

Charles Neighbors, MBA, PhD
NYU Grossman School of Medicine

Megan O’Grady, PhD
University of Connecticut

Ashly Jordan, PhD, MPH
New York State Office of Addiction Services and Supports

Yubua Bao, PhD
Weill Cornell Medicine

ABSTRACT:
Methadone is a highly effective medication for treating opioid use disorders (OUD) that is provided in opioid treatment programs (OTPs). Recent federal regulatory changes have relaxed criteria for take-home dosing of methadone, offering an opportunity to improve the OUD care experience for patients. Implementing more flexible take-home dosing policies and practices in OTPs may help improve treatment access and outcomes. However, implementation of more flexible take-home dosing in response to federal policy changes has been uneven in OTPs. This stems from multi-level barriers, such as staff concerns for patient safety, financial concerns due to changes (or lack thereof) in payment models, and rigid organizational policies and practices. This presentation will describe a multi-component intervention designed as part of an academic-government partnership to address implementation barriers at multiple levels. We will specifically highlight successes and challenges in using data-based feedback and a financial tool to support OTP implementation of more flexible methadone take-home dosing practices.

Evidence-Based Preventive Interventions – Are they Inclusive of Diverse Populations and Do they Build a More Equitable Future for ALL Youth, Families and Communities?

Pamela Buckley, PhD
University of Colorado Boulder

Velma McBride Murry, PhD
Vanderbilt University

ABSTRACT:
Historically marginalized groups face health and social disparities, highlighting the need for equitable preventive interventions. This presentation synthesizes findings from two systematic reviews on representation, cultural tailoring, and subgroup analyses in prevention research. The first review (Buckley et al., 2023) examined 885 preventive programs for youth with evaluations published from 2010-2021 and found incomplete reporting: 77% of studies reported race (with samples predominantly White and Black/African American), 64% reported ethnicity (in which roughly one-third of participants were Hispanic/Latino), and 31% of studies collapsed across race or categorized race with ethnicity. Fewer than one-third of studies (29%) reported participants’ income status; among those that did, most participants came from low-income backgrounds. Of the 73% of studies that reported geographic location, 31% included participants from rural areas. The second review (Buckley et al., 2025) analyzed 292 rigorous experimental evaluations of youth preventive programs published between 2010–2023 and identified few culturally tailored interventions (31%) and limited subgroup testing—25% by race, 15% by ethnicity, and even fewer by economic disadvantage, gender, sexual orientation, geographic location, or nativity. When tested, effects often favored racial and ethnic minoritized groups, and subgroup reporting increased over time. However, concerns about selective reporting emerged, as very few studies preregistered their subgroup analyses. Advancing equity in prevention science will require improved reporting, prospectively registered subgroup testing, and greater investment in culturally grounded interventions. The presentation concludes with a proposed research project addressing these needs.

Implementation Lessons Learned in Scaling Up a Network-Enhancement Suicide Prevention Model

Peter Wyman, PhD
University of Rochester

Bryan Yates, BA
University of Rochester

WIlliam Bevens, PhD
University of California San Diego

Gregory Aarons, PhD
University of California San Diego

Nicole Stadnick, PhD, MPH
University of California San Diego

ABSTRACT:
Suicide rates among US military members have steadily increased since 2010, and suicide is now the first- or second-leading manner of death across branches. The US Air Force and university-based prevention scientists launched a research-practice partnership (2014) to develop and test an ecologically-valid, unit-level program: Wingman-Guardian Connect (WGC). Prior to this partnership, no RCT-validated programs shown to reduce suicide risk across broad military populations were in wide use, and most training models were adapted from programs developed in other contexts.

This presentation will briefly review WGC’s interactive network enhancement training model and RCT results (N= 1500) showing WGC reduces suicide risk, depression symptoms and work problems. The primary focus will be on lessons being learned through ongoing force-wide expansion of WGC to 68 bases as the new Air Force Resilience Program. This presentation will summarize the design of an ongoing hybrid effectiveness-implementation trial (NIMH funded) testing WGC delivered by USAF personnel on 9 early-adopter bases (20,000 personnel exposed to WGC) along with findings from implementer feedback and performance assessments being used to refine the implementation package. We will also describe challenges and facilitators to implementation of this new program in the evolving USAF landscape impacting resources and personnel to deliver preventive interventions on installations.