Changing Clinicians’ Attitudes Towards Medication-Assisted Treatments: An Online Training and Text-Messaging Intervention

Background: The opioid epidemic has levied substantial costs in the United States, requiring new approaches for prevention and treatment. Research has shown that medication-assisted treatments (MATs) are one of the most effective ways to treat opioid addiction; however, stigma among the public and among health professionals has contributed to their underutilization. Non- prescribing clinicians (NPCs) influence the implementation and utilization of MATs through their frequent interactions with patients, treatment recommendations, and referral practices. Compared to other types of health professionals’ less is known about NPCs attitudes towards MATs and other factors which affect their practice behaviors. Method: A national online survey of NPCs was conducted to assess their attitudes and practice related to MATs. The Theory of Planned Behavior was tested using structural equation modeling. Models were compared to determine whether antecedents to attitudes including knowledge, abstinence orientation, and exposure increased the overall predictive utility of the model. Survey respondents were recruited for a two-stage intervention trial. First, a one-hour online training regarding treatments for opioid addiction including MATs was implemented. Second, training participants were recruited to participate in a text-messaging intervention (TMI) designed to improve outcomes related to the training. Latent change score analyses and generalizing estimating equations were conducted to test the effects of the interventions. Results: Based on a sample of 620 NPCs, abstinence orientation, exposure, and knowledge were confirmed to be significantly related to attitudes towards MATs. The measurement model achieved excellent fit. TPB models predicted 68% of the variance in behavioral intentions. The online training was found to be effective in increasing attitudes and behavioral intentions related to MATs. Results supported the feasibility of implementing a TMI, however findings were inconclusive regarding its effectiveness. Conclusions: Results provided evidence that the TPB is a useful model to understand and predict NPCs’ practice behaviors related to MATs. Results provided evidence that online continuing education programs, even brief ones, may be an effective way to dispel misconceptions and change attitudes and behavioral intentions related to MATs. Further research is needed to determine the utility of offering a TMI following an online training.