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MIMIC (Maximizing Implementation of Motivational Incentives in Clinics)

Implementing Contingency Management in Opioid Treatment Centers Across New England: A Hybrid Type 3 Trial

Contingency management (i.e., motivational incentives for achieving pre-defined treatment goals) is one of the most effective behavioral interventions for persons with opioid use disorder, but its uptake in community opioid treatment programs is extremely low. This type 3 hybrid effectiveness-implementation trial evaluates whether two multi-level strategies can promote contingency management implementation within opioid treatment programs. The control condition is the staff-training strategy used by the SAMHSA-funded network of Addiction Technology Transfer Centers (ATTC), i.e., didactic workshop plus performance feedback plus staff coaching. The experimental condition is the ATTC strategy enhanced by two theory-driven components designed to sustain and accelerate change: implementation sustainment facilitation (ISF) and pay-for-performance, which we refer to as E-ATTC. Using a cluster randomized design, 30 opioid treatment programs across New England will be randomized to one of the two implementation conditions (ATTC versus E-ATTC).

The project addresses three specific aims:

  • Compare the effect of the two implementation strategies on implementation outcomes (primary aim).
  • Compare the effect of the two implementation strategies on patient outcomes (secondary aim).
  • Test whether implementation climate and leadership engagement partially mediate the relationship between implementation strategy and the key study outcomes.

Achievement of the study aims will address a critical public health problem (the lack of effective strategies to improve the quality of opioid treatment), while advancing knowledge about why and how implementation strategies work.

Project Details

  • Dates: September 2018 – July 2023
  • Funding source: National Institute on Drug Abuse
  • Grant number: R01DA046941
  • identifier: NCT03931174


  • Principal investigators: Sara Becker, PhD, (contact PI); Bryan Garner, PhD
  • Project staff: Sarah Salino (lead coordinator), Fariha Hasan, Kira DiClemente, PhD