Trial Outcomes & Findings for Fostering MAT Use in Justice Populations (NCT NCT04363320)

Last Updated: 2025-05-28

Results Overview

The intervention reach will be measured using data gathered through organization monthly tracking sheets to track MOUD use. 'Involved persons' include those who are initiated onto any MOUD (buprenorphine, extended-release injectable naltrexone, or methadone) and engaged with MOUD use.

Recruitment status

COMPLETED

Study phase

Target enrollment

256 participants

Primary outcome timeframe

baseline to 12 months

Results posted on

2025-05-28

Participant Flow

48 sites were recruited, 38 (25 jails \& 13 Community based treatment provider (CBTP) sites completed the study (sites per intervention listed in the participant flow). Consenting Participants are staff at the sites who provided data, including counts of people prescribed medications for opioid use disorder (MOUD) at their sites (see outcome measures for this data).

Unit of analysis: Sites

Participant milestones

Participant milestones
Measure	High-Dose NIATx Coaching & ECHO * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls NIATx Coaching: NIATx framework provides each participating site with a NIATx Coach who is an expert in MOUD implementation and organizational change and will help the organization adopt, implement, and increase the use of MOUD. Coaches help the sites think through key issues, offer process improvement training, and suggest changes. ECHO: The ECHO model connects MOUD prescribers and experts with primary care providers and medical teams to promote high-quality MOUD practices. ECHO is provided monthly through videoconferences. Experienced MOUD prescribers address topics such as counseling strategies, urine test interpretation, and transitioning from buprenorphine, naltrexone and methadone.	Low-Dose NIATx Coaching & ECHO * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls NIATx Coaching: NIATx framework provides each participating site with a NIATx Coach who is an expert in MOUD implementation and organizational change and will help the organization adopt, implement, and increase the use of MOUD. Coaches help the sites think through key issues, offer process improvement training, and suggest changes. ECHO: The ECHO model connects MOUD prescribers and experts with primary care providers and medical teams to promote high-quality MOUD practices. ECHO is provided monthly through videoconferences. Experienced MOUD prescribers address topics such as counseling strategies, urine test interpretation, and transitioning from buprenorphine, naltrexone and methadone.	High-Dose NIATx Coaching & No ECHO * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team NIATx Coaching: NIATx framework provides each participating site with a NIATx Coach who is an expert in MOUD implementation and organizational change and will help the organization adopt, implement, and increase the use of MOUD. Coaches help the sites think through key issues, offer process improvement training, and suggest changes.	Low-Dose NIATx Coaching & No ECHO * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team NIATx Coaching: NIATx framework provides each participating site with a NIATx Coach who is an expert in MOUD implementation and organizational change and will help the organization adopt, implement, and increase the use of MOUD. Coaches help the sites think through key issues, offer process improvement training, and suggest changes.
Overall Study STARTED	78 14	65 11	60 10	53 13
Overall Study COMPLETED	35 9	23 10	35 9	24 10
Overall Study NOT COMPLETED	43 5	42 1	25 1	29 3

Reasons for withdrawal

Reasons for withdrawal
Measure	High-Dose NIATx Coaching & ECHO * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls NIATx Coaching: NIATx framework provides each participating site with a NIATx Coach who is an expert in MOUD implementation and organizational change and will help the organization adopt, implement, and increase the use of MOUD. Coaches help the sites think through key issues, offer process improvement training, and suggest changes. ECHO: The ECHO model connects MOUD prescribers and experts with primary care providers and medical teams to promote high-quality MOUD practices. ECHO is provided monthly through videoconferences. Experienced MOUD prescribers address topics such as counseling strategies, urine test interpretation, and transitioning from buprenorphine, naltrexone and methadone.	Low-Dose NIATx Coaching & ECHO * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls NIATx Coaching: NIATx framework provides each participating site with a NIATx Coach who is an expert in MOUD implementation and organizational change and will help the organization adopt, implement, and increase the use of MOUD. Coaches help the sites think through key issues, offer process improvement training, and suggest changes. ECHO: The ECHO model connects MOUD prescribers and experts with primary care providers and medical teams to promote high-quality MOUD practices. ECHO is provided monthly through videoconferences. Experienced MOUD prescribers address topics such as counseling strategies, urine test interpretation, and transitioning from buprenorphine, naltrexone and methadone.	High-Dose NIATx Coaching & No ECHO * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team NIATx Coaching: NIATx framework provides each participating site with a NIATx Coach who is an expert in MOUD implementation and organizational change and will help the organization adopt, implement, and increase the use of MOUD. Coaches help the sites think through key issues, offer process improvement training, and suggest changes.	Low-Dose NIATx Coaching & No ECHO * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team NIATx Coaching: NIATx framework provides each participating site with a NIATx Coach who is an expert in MOUD implementation and organizational change and will help the organization adopt, implement, and increase the use of MOUD. Coaches help the sites think through key issues, offer process improvement training, and suggest changes.
Overall Study Lost to Follow-up	43	42	24	29
Overall Study Death	0	0	1	0

Baseline Characteristics

Data applies to site characteristics.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	High-Dose NIATx Coaching & ECHO n=14 Sites Starting Study * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	Low-Dose NIATx Coaching & ECHO n=11 Sites Starting Study * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	High-Dose NIATx Coaching & No ECHO n=10 Sites Starting Study * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team	Low-Dose NIATx Coaching & No ECHO n=13 Sites Starting Study * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team	Total n=48 Sites Starting Study Total of all reporting groups
Age, Continuous	46 years n=78 Participants	42 years n=65 Participants	46 years n=60 Participants	46 years n=53 Participants	46 years n=256 Participants
Sex/Gender, Customized Female	45 Participants n=78 Participants	39 Participants n=65 Participants	32 Participants n=60 Participants	30 Participants n=53 Participants	146 Participants n=256 Participants
Sex/Gender, Customized Male	23 Participants n=78 Participants	22 Participants n=65 Participants	27 Participants n=60 Participants	20 Participants n=53 Participants	92 Participants n=256 Participants
Sex/Gender, Customized Unknown	10 Participants n=78 Participants	4 Participants n=65 Participants	1 Participants n=60 Participants	3 Participants n=53 Participants	18 Participants n=256 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	5 Participants n=78 Participants	9 Participants n=65 Participants	0 Participants n=60 Participants	1 Participants n=53 Participants	15 Participants n=256 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	64 Participants n=78 Participants	52 Participants n=65 Participants	59 Participants n=60 Participants	49 Participants n=53 Participants	224 Participants n=256 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	9 Participants n=78 Participants	4 Participants n=65 Participants	1 Participants n=60 Participants	3 Participants n=53 Participants	17 Participants n=256 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=78 Participants	0 Participants n=65 Participants	0 Participants n=60 Participants	0 Participants n=53 Participants	0 Participants n=256 Participants
Race (NIH/OMB) Asian	7 Participants n=78 Participants	0 Participants n=65 Participants	0 Participants n=60 Participants	3 Participants n=53 Participants	10 Participants n=256 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	2 Participants n=78 Participants	1 Participants n=65 Participants	0 Participants n=60 Participants	1 Participants n=53 Participants	4 Participants n=256 Participants
Race (NIH/OMB) Black or African American	17 Participants n=78 Participants	2 Participants n=65 Participants	10 Participants n=60 Participants	7 Participants n=53 Participants	36 Participants n=256 Participants
Race (NIH/OMB) White	37 Participants n=78 Participants	50 Participants n=65 Participants	44 Participants n=60 Participants	38 Participants n=53 Participants	169 Participants n=256 Participants
Race (NIH/OMB) More than one race	4 Participants n=78 Participants	5 Participants n=65 Participants	2 Participants n=60 Participants	0 Participants n=53 Participants	11 Participants n=256 Participants
Race (NIH/OMB) Unknown or Not Reported	11 Participants n=78 Participants	7 Participants n=65 Participants	4 Participants n=60 Participants	4 Participants n=53 Participants	26 Participants n=256 Participants
Region of Enrollment United States	78 participants n=78 Participants	65 participants n=65 Participants	60 participants n=60 Participants	53 participants n=53 Participants	256 participants n=256 Participants
Geographic Location of Sites Rural	3 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	5 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	4 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	3 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	15 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
Geographic Location of Sites Suburban	1 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	3 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	3 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	6 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	13 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
Geographic Location of Sites Urban	10 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	3 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	3 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	4 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	20 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
Gender Served Male only	0 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	1 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	1 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
Gender Served Female only	0 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
Gender Served Both	14 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	10 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	10 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	13 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	47 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
Average Daily Population (Jails only) less than 100	1 Sites Starting Study n=8 Sites Starting Study • Data applies to site characteristics for Jails only.	3 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	2 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	0 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	6 Sites Starting Study n=29 Sites Starting Study • Data applies to site characteristics for Jails only.
Average Daily Population (Jails only) 101-250	1 Sites Starting Study n=8 Sites Starting Study • Data applies to site characteristics for Jails only.	3 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	5 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	10 Sites Starting Study n=29 Sites Starting Study • Data applies to site characteristics for Jails only.
Average Daily Population (Jails only) 251-500	2 Sites Starting Study n=8 Sites Starting Study • Data applies to site characteristics for Jails only.	0 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	3 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	6 Sites Starting Study n=29 Sites Starting Study • Data applies to site characteristics for Jails only.
Average Daily Population (Jails only) greater than 500	4 Sites Starting Study n=8 Sites Starting Study • Data applies to site characteristics for Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics for Jails only.	7 Sites Starting Study n=29 Sites Starting Study • Data applies to site characteristics for Jails only.
Average Monthly OUD Intakes (CBTP) less than 50	3 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	0 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics for CBTP only.	1 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics for CBTP only.	3 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	7 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics for CBTP only.
Average Monthly OUD Intakes (CBTP) 51-200	0 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	2 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics for CBTP only.	1 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics for CBTP only.	0 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	3 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics for CBTP only.
Average Monthly OUD Intakes (CBTP) 201-500	0 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	0 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics for CBTP only.	1 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics for CBTP only.	0 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	1 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics for CBTP only.
Average Monthly OUD Intakes (CBTP) greater than 500	0 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	0 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics for CBTP only.	0 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics for CBTP only.	1 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	1 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics for CBTP only.
Average Monthly OUD Intakes (CBTP) unknown	3 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	2 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics for CBTP only.	0 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics for CBTP only.	2 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics for CBTP only.	7 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics for CBTP only.
Type of Healthcare Model at Jails Direct	3 Sites Starting Study n=8 Sites Starting Study • Data applies to site characteristics at Jails only.	2 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	7 Sites Starting Study n=29 Sites Starting Study • Data applies to site characteristics at Jails only.
Type of Healthcare Model at Jails Contracted	4 Sites Starting Study n=8 Sites Starting Study • Data applies to site characteristics at Jails only.	4 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	4 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	13 Sites Starting Study n=29 Sites Starting Study • Data applies to site characteristics at Jails only.
Type of Healthcare Model at Jails Hybrid	1 Sites Starting Study n=8 Sites Starting Study • Data applies to site characteristics at Jails only.	1 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	5 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	2 Sites Starting Study n=7 Sites Starting Study • Data applies to site characteristics at Jails only.	9 Sites Starting Study n=29 Sites Starting Study • Data applies to site characteristics at Jails only.
CBTP Arrangements with Jails Joint Staffings	3 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics CBTP only.	1 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics CBTP only.	1 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics CBTP only.	2 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics CBTP only.	7 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics CBTP only.
CBTP Arrangements with Jails Shared Written Agreements	3 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics CBTP only.	2 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics CBTP only.	3 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics CBTP only.	3 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics CBTP only.	11 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics CBTP only.
CBTP Arrangements with Jails Electronic Health Record Access	2 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics CBTP only.	0 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics CBTP only.	2 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics CBTP only.	0 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics CBTP only.	4 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics CBTP only.
CBTP Arrangements with Jails Referral Processes	3 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics CBTP only.	3 Sites Starting Study n=4 Sites Starting Study • Data applies to site characteristics CBTP only.	3 Sites Starting Study n=3 Sites Starting Study • Data applies to site characteristics CBTP only.	4 Sites Starting Study n=6 Sites Starting Study • Data applies to site characteristics CBTP only.	13 Sites Starting Study n=19 Sites Starting Study • Data applies to site characteristics CBTP only.
MOUD Offered at Baseline Buprenorphine/Naloxone	10 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	8 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	7 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	11 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	36 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
MOUD Offered at Baseline Naltrexone (injectable)	8 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	10 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	5 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	7 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	30 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
MOUD Offered at Baseline Naltrexone (oral)	6 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	4 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	6 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	6 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	22 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
MOUD Offered at Baseline Methadone	7 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	3 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	6 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	2 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	18 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
MOUD Offered at Baseline No MOUD	0 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	1 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	1 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
MOUD Offered at Baseline Unknown	1 Sites Starting Study n=14 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=11 Sites Starting Study • Data applies to site characteristics.	0 Sites Starting Study n=10 Sites Starting Study • Data applies to site characteristics.	1 Sites Starting Study n=13 Sites Starting Study • Data applies to site characteristics.	2 Sites Starting Study n=48 Sites Starting Study • Data applies to site characteristics.
Type of Study Site Jails	8 Sites Starting Study n=14 Sites Starting Study	7 Sites Starting Study n=11 Sites Starting Study	7 Sites Starting Study n=10 Sites Starting Study	7 Sites Starting Study n=13 Sites Starting Study	29 Sites Starting Study n=48 Sites Starting Study
Type of Study Site Community Based Treatment Providers	6 Sites Starting Study n=14 Sites Starting Study	4 Sites Starting Study n=11 Sites Starting Study	3 Sites Starting Study n=10 Sites Starting Study	6 Sites Starting Study n=13 Sites Starting Study	19 Sites Starting Study n=48 Sites Starting Study

PRIMARY outcome

Timeframe: baseline to 12 months

Population: The Overall Number of Participants Analyzed reported are justice involved individuals staff (who were not consented and enrolled). Staff (consented participants) collected counts of justice involved individuals with various MOUD from their sites. Not all sites provided all three forms of medication at all times. Due to lack of tracking systems in the jail, some sites were only able to provide one of the two monthly counts.

Outcome measures

Outcome measures
Measure	Low-Dose NIATx Coaching & No ECHO n=13 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team	High-Dose NIATx Coaching & ECHO n=14 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	Low-Dose NIATx Coaching & ECHO n=11 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	High-Dose NIATx Coaching & No ECHO n=10 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team
Mean Number of New Eligible Justice Involved Persons Initiated With MOUD Per Month: Intervention Phase Methadone	2.03 New Justice Involved Persons per month Standard Deviation 5.57	20.36 New Justice Involved Persons per month Standard Deviation 51.31	0.55 New Justice Involved Persons per month Standard Deviation 1.57	4.47 New Justice Involved Persons per month Standard Deviation 9.63
Mean Number of New Eligible Justice Involved Persons Initiated With MOUD Per Month: Intervention Phase Buprenorphine	17.43 New Justice Involved Persons per month Standard Deviation 25.56	21.79 New Justice Involved Persons per month Standard Deviation 28.5	3.00 New Justice Involved Persons per month Standard Deviation 4.05	5.01 New Justice Involved Persons per month Standard Deviation 2.98
Mean Number of New Eligible Justice Involved Persons Initiated With MOUD Per Month: Intervention Phase Naltrexone	1.37 New Justice Involved Persons per month Standard Deviation 2.05	0.19 New Justice Involved Persons per month Standard Deviation 0.28	0.33 New Justice Involved Persons per month Standard Deviation 0.42	0.44 New Justice Involved Persons per month Standard Deviation 0.86

PRIMARY outcome

Timeframe: 13 months, 24 months

Outcome measures

Outcome measures
Measure	Low-Dose NIATx Coaching & No ECHO n=13 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team	High-Dose NIATx Coaching & ECHO n=14 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	Low-Dose NIATx Coaching & ECHO n=11 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	High-Dose NIATx Coaching & No ECHO n=10 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team
Mean Number of New Eligible Justice Involved Persons Initiated With MOUD Per Month: Sustainability Phase Methadone	2.41 New Justice Involved Persons per month Standard Deviation 6.31	28.29 New Justice Involved Persons per month Standard Deviation 75.24	0.01 New Justice Involved Persons per month Standard Deviation 0.03	4.67 New Justice Involved Persons per month Standard Deviation 6.6
Mean Number of New Eligible Justice Involved Persons Initiated With MOUD Per Month: Sustainability Phase Buprenorphine	32.32 New Justice Involved Persons per month Standard Deviation 60.72	30.37 New Justice Involved Persons per month Standard Deviation 35.77	3.3 New Justice Involved Persons per month Standard Deviation 4.4	7.89 New Justice Involved Persons per month Standard Deviation 3.18
Mean Number of New Eligible Justice Involved Persons Initiated With MOUD Per Month: Sustainability Phase Naltrexone	0.79 New Justice Involved Persons per month Standard Deviation 1.01	0.09 New Justice Involved Persons per month Standard Deviation 0.13	1.32 New Justice Involved Persons per month Standard Deviation 1.59	0.71 New Justice Involved Persons per month Standard Deviation 0.79

PRIMARY outcome

Timeframe: baseline to 12 months

Outcome measures

Outcome measures
Measure	Low-Dose NIATx Coaching & No ECHO n=13 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team	High-Dose NIATx Coaching & ECHO n=14 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	Low-Dose NIATx Coaching & ECHO n=11 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	High-Dose NIATx Coaching & No ECHO n=10 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team
Mean Total Number of Eligible Justice Involved Persons on MOUD Per Month: Intervention Phase Methadone	0.94 Justice Involved Persons per month Standard Deviation 1.80	98.73 Justice Involved Persons per month Standard Deviation 216.36	0.08 Justice Involved Persons per month Standard Deviation 0.35	56.58 Justice Involved Persons per month Standard Deviation 158.40
Mean Total Number of Eligible Justice Involved Persons on MOUD Per Month: Intervention Phase Buprenorphine	60.57 Justice Involved Persons per month Standard Deviation 105.31	104.07 Justice Involved Persons per month Standard Deviation 145.32	117.62 Justice Involved Persons per month Standard Deviation 190.42	36.50 Justice Involved Persons per month Standard Deviation 45.29
Mean Total Number of Eligible Justice Involved Persons on MOUD Per Month: Intervention Phase Naltrexone	3.21 Justice Involved Persons per month Standard Deviation 6.16	0.24 Justice Involved Persons per month Standard Deviation 0.34	2.60 Justice Involved Persons per month Standard Deviation 5.29	5.81 Justice Involved Persons per month Standard Deviation 15.04

PRIMARY outcome

Timeframe: 13 months to 24 months

Outcome measures

Outcome measures
Measure	Low-Dose NIATx Coaching & No ECHO n=13 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team	High-Dose NIATx Coaching & ECHO n=14 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	Low-Dose NIATx Coaching & ECHO n=11 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	High-Dose NIATx Coaching & No ECHO n=10 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team
Mean Total Number of Eligible Justice Involved Persons on MOUD Per Month: Sustainability Phase Methadone	1.96 Justice Involved Persons per month Standard Deviation 3.71	110.19 Justice Involved Persons per month Standard Deviation 219.28	0.01 Justice Involved Persons per month Standard Deviation 0.03	77.22 Justice Involved Persons per month Standard Deviation 183.37
Mean Total Number of Eligible Justice Involved Persons on MOUD Per Month: Sustainability Phase Buprenorphine	78.24 Justice Involved Persons per month Standard Deviation 136.17	127.32 Justice Involved Persons per month Standard Deviation 177.17	154.78 Justice Involved Persons per month Standard Deviation 227.42	43.71 Justice Involved Persons per month Standard Deviation 43.31
Mean Total Number of Eligible Justice Involved Persons on MOUD Per Month: Sustainability Phase Naltrexone	3.7 Justice Involved Persons per month Standard Deviation 6.44	0.22 Justice Involved Persons per month Standard Deviation 0.31	1.67 Justice Involved Persons per month Standard Deviation 1.56	10.86 Justice Involved Persons per month Standard Deviation 18.72

PRIMARY outcome

Timeframe: baseline, 12 months, 24 months

Population: Data was not collected for this outcome. This outcome was determined to not be a key variable at study start and should have been removed from the protocol. It was apparent from listening to sites that increasing the number of prescribers was not a goal as they were already encountering high turnover rates and staffing.

The adoption of each intervention will be in part measured by tracking the number of prescribers using MOUD at each time point.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: baseline, 12 months, 24 months

Population: Number of participants and sites included in data analysis changed through study conduct.

The maintenance of the intervention (MOUD Sustainability) will be measured using the Program Sustainability Assessment Tool included in the Staff Survey at three points during the study (baseline, 12-months \& 24-months) to determine if likelihood of sustainability increases as study progresses. This tool has a total possible range of scores from 0-63 with higher scores indicating increased sustainability of the intervention.

Outcome measures

Outcome measures
Measure	Low-Dose NIATx Coaching & No ECHO n=13 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team	High-Dose NIATx Coaching & ECHO n=14 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	Low-Dose NIATx Coaching & ECHO n=11 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	High-Dose NIATx Coaching & No ECHO n=10 sites * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team
MOUD Sustainability Measured Using the Program Sustainability Assessment Tool baseline	43.96226 score on a scale Standard Deviation 12.7701	44.79487 score on a scale Standard Deviation 17.88808	43.75385 score on a scale Standard Deviation 15.68342	43.16667 score on a scale Standard Deviation 14.61386
MOUD Sustainability Measured Using the Program Sustainability Assessment Tool 12 months	51.61905 score on a scale Standard Deviation 10.70736	50.71429 score on a scale Standard Deviation 8.827025	50.78571 score on a scale Standard Deviation 8.252304	45.95556 score on a scale Standard Deviation 10.73642
MOUD Sustainability Measured Using the Program Sustainability Assessment Tool 24 months	53.70833 score on a scale Standard Deviation 14.0077	51.51429 score on a scale Standard Deviation 13.18504	49.30435 score on a scale Standard Deviation 8.704413	48.37143 score on a scale Standard Deviation 11.95847

OTHER_PRE_SPECIFIED outcome

Timeframe: 12 months, 24 months

Population: Number of participants included in data analysis changed through study conduct.

Assess fidelity to the NIATx implementation strategies at two points during the study using a 10-item measure with scores ranging from 0-40 with higher scores indicating stronger fidelity of the intervention.

Outcome measures

Outcome measures
Measure	Low-Dose NIATx Coaching & No ECHO n=53 Participants * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team	High-Dose NIATx Coaching & ECHO n=78 Participants * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	Low-Dose NIATx Coaching & ECHO n=65 Participants * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * Four (one-hour) coaching calls at months 1, 4, 8, and 12 with Change Leader/Team * Prescribers participate in 12 monthly (one-hour) scheduled video conference calls	High-Dose NIATx Coaching & No ECHO n=60 Participants * Four-hour, Virtual Kick-Off Meeting split into two days with Study Team \& Coaches * 12 monthly (one-hour) coaching calls with Change Leader/Team
NIATx Fidelity 12 months	24.71429 score on a scale Standard Deviation 5.917287	24.2381 score on a scale Standard Deviation 6.449842	25.39286 score on a scale Standard Deviation 4.474945	24.11111 score on a scale Standard Deviation 6.544332
NIATx Fidelity 24 months	27.16667 score on a scale Standard Deviation 6.112472	24.57143 score on a scale Standard Deviation 5.494841	23.13043 score on a scale Standard Deviation 4.07101	24.62857 score on a scale Standard Deviation 7.272372

Adverse Events

High-Dose NIATx Coaching & ECHO

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Low-Dose NIATx Coaching & ECHO

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

High-Dose NIATx Coaching & No ECHO

Serious events: 0 serious events

Other events: 0 other events

Deaths: 1 deaths

Low-Dose NIATx Coaching & No ECHO

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Todd Molfenter, PhD

University of Wisconsin - Madison

Phone: 608-262-1685

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place