Pilot randomized study of three digital models to train opioid use disorder counselors in community reinforcement and family training.

Abstract

Community Reinforcement and Family Training (CRAFT) is an evidence-based approach that promotes family skills to encourage people with substance use disorders to seek treatment. To enhance scalable CRAFT implementation, we assessed three digital counselor training models for fidelity, feasibility/acceptability, and implementation potential. Participants (47 counselors) were randomized to one of three digital training programs. Tutorial (T): two-week CRAFT modules. Tutorial + Self Study Materials (TM): two-week tutorial plus 13 modules of training materials (e.g., session videos/checklists) released over 10 weeks after the tutorial. Tutorial + Self Study Materials + Coaching (TMC): two-week tutorial, 10 weeks of additional materials, plus feedback and coaching on ≥one recorded CRAFT sessions. Participants completed assessments at baseline, two weeks, and 12-weeks. The primary outcome was CRAFT fidelity. Secondary outcomes included CRAFT knowledge, feasibility, acceptability, and implementation potential. TMC participants demonstrated the highest CRAFT fidelity and knowledge with 83% of counselors achieving proficiency (T:0%; TM:67%). Feasibility was highest for completing the tutorial (73-100% of participants), then the CRAFT session recording and coaching (79%), and the self-study materials (56-75%). 93% of participants were satisfied with their training program. Implementation potential scores were high across all training groups. The TMC training yielded the best balance of CRAFT fidelity, feasibility/acceptability and implementation potential. TM had the next highest fidelity, and its significantly lower cost/effort may aid implementation in resource-limited settings. T alone was not sufficient to facilitate CRAFT fidelity. Digital training has promise for expanding CRAFT implementation and potentially addressing clinical workforce gaps. gov:NCT05875142.