This paper describes a model by which local colleges and universities can promote and bolster sustainable SOR-funded opioid response programs at the local level. We briefly describe the model by which the academic institutions involved in this project engaged with local and regional recipients of SOR-funds, and then detail the categories of support requested of the academic partner(s) in those collaborations. Our goal is to inform the development of similar academic-community collaborations to promote the sustainability of SOR-funded services and programs.
Setting and design
This qualitative study evaluated the process and outcomes of a collaborative statewide consortium of public universities working with SOR-grantees across Virginia. These grantees, called Community Services Boards (or CSBs), are the local points of entry into specialty mental health, substance use disorder, and developmental services. The Virginia Department of Behavioral Health and Developmental Services (DBHDS) distributes SOR grant funding to the 39 CSBs across five regions of the state; Northern, Northwestern, Southwestern, Central, and Eastern. CSBs implementing or considering SOR applications were given the opportunity to apply for assistance from academic partners which could provide comprehensive support around prevention, treatment and data collection and analysis.
The academic consortium formed after several institutions independently convened community-academic workshops on the opioid overdose crisis at which CSB representatives advocated for a coordinated academic response to bolster substance use prevention, treatment, and management in their regions. The authors convened a five-university consortium to support the CSBs in implementing sustainable evidence-based services with funding from DBHDS. The university-based collaborative would become known as the Virginia Higher Education Opioid Consortium (VHEOC), leveraged academic expertise at George Mason University, Old Dominion University, University of Virginia, Virginia State University, and Virginia Tech.
The VHEOC governance committee, composed of the authors, conducted active outreach to Virginia’s CSBs from August 2019 through September 2020. The objectives of the outreach were to announce the availability of academic assistance for SOR-funded local services, provide a list of sample capabilities offered across the academic institutions, and to invite requests for proposals to support their services. The capabilities listed included, for example, technical support for prevention, treatment, and recovery programs, as well as the collection and analysis of program evaluation data. The mode(s) of outreach included email, telephone, and in-person site visits. In addition, representatives of the VHEOC presented at statewide behavioral health conferences attended by CSB leaders and other behavioral health providers, distributed brochures, both print and electronic, and maintained a project website with frequently asked questions and contact information for all participating institutions.
The specific modes of communication employed between VHEOC institutions and CSBs varied, but most culminated in meetings or workshops in which staff and leadership from one or more CSBs described their existing SOR-funded services and the capabilities necessary to improve or sustain them. The CSB leaders then participated in unstructured discussions with the VHEOC investigators to develop a request for proposals (RFP) using a template which explicitly linked funding to sustainability strategies. This template organized each RFP into five sections: nature of the problem to be addressed, purpose of the request to address the problem, primary point of contact for questions, date of completion, and outcomes or deliverables required.
The RFPs were reviewed by DBHDS for suitability for SOR funding, and then distributed by the VHEOC governance committee to faculty with relevant subject matter expertise across their respective institutions. Interested investigators, which could include VHEOC investigators, submitted proposals in response to specific RFPs through a VHEOC website. Faculty proposals were screened by a VHEOC review committee comprised of representatives of each partner university not including any submitting institutions. Those deemed responsive to the RFP were forwarded to the CSB for final review and selection. A VHEOC fiscal agent at the University of Virginia established the funding mechanism to support the academic partner(s) selected, managed the project in partnership with the local Principal Investigator(s) and the CSB(s). The PIs also provided quarterly progress reports to the VHEOC leadership to ensure that the funded project was conducted on time and within budget. The RFPs were also analyzed by the consortium leadership to identify common themes or categories of assistance requested of the academic partners.
Data analysis
Six VHEOC investigators representing the five universities participated in an iterative, three-phase content analysis approach to examine the RFPs submitted by CSBs to identify nominal categories of support requested by CSBs [
15]. In accordance with grounded theory analytic techniques [
16,
17], the RFPs were initially coded a priori by at least one individual representative of each institution. This process resulted in an initial organizing framework of 18 prospective codes, which the team collectively applied to each RFP in a team-based deductive analytic process [
15]. This approach allowed the team to combine and integrate predetermined codes for categories of support requested, and in some cases to identify emergent codes not captured in the initial codebook. These codes were entered into a revised codebook, which investigators from each institution employed to recode the RFPs individually. These results were integrated, intercoder was reliability determined [
18], differences were discussed electronically, and the RFPs were recoded until the team achieved an acceptable intercoder reliability, resulting in six final codes.