Adolescent Substance Abuse Treatment Resource Allocation in Rural and Frontier Conditions: The Impact of Including Organizational Readiness to Change

ABSTRACT:  Context: Rural and frontier states are significantly affected by substance abuse and poverty. The high rate of substance abuse coupled with high levels of dependence on state-funded treatment systems places a burden on rural treatment systems and makes resource allocation a central planning issue. Purpose: The goal of this study was to combine substance abuse treatment need data with organizational readiness to change data to create a rank-ordered listing of residential treatment providers to answer the following questions: Do program priority rankings change when organizational readiness to change is included in a need-based resource allocation algorithm? Methods: Three methodological procedures were used to determine program priority rankings among 14 residential adolescent treatment programs in 8 Wyoming counties: (1) a social indicators analysis of crime data, (2) synthetic estimates of substance abuse treatment need, and (3) analysis of organizational change data from the directors and staff at adolescent residential treatment programs. Findings: Program need rankings based on crime data and synthetic estimates of substance abuse treatment need shifted when organizational readiness to change data was added to the algorithm. Conclusions: There is much to be gained from considering organizational readiness to change when selecting programs for funding. It plays a central role in the successful diffusion of evidence-based practices within and among programs. Including this measure in the resource allocation process can help planners identify programs that will be more apt to adopt a best practice. This is critical for making decisions about where to allocate scarce treatment resources.