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Table 1 Emergent themes: barriers and facilitators categorized within EPIS framework

From: The prospects for sustaining evidence-based responses to the US opioid epidemic: state leadership perspectives

 

Theme responses by leader type

Current (n = 8)

Former (n = 8)

n (%)

n (%)

SUSTAINMENT BARRIERS

Outer Context

  Service-Environment

   Medicaid coverage & reimbursement

4 (50.0)

4 (50.0)

   Rely on continued funding

3 (37.5)

X

   Infrastructure

2 (25.0)

3 (37.5)

  Inter-organizational

   Reduced timeframes

4 (50.0)

X

   Opioid-specific funding cliff

3 (37.5)

X

   Opioid-specific data collection

2 (25.0)

X

Inner Context

  Intra-organizational

   Costs to integrate services

3 (37.5)

4 (50.0)

   Lack of adequate workforce

2 (25.0)

3 (37.5)

  Individual Adopter Characteristics

   Competing priorities

3 (37.5)

5 (62.5)

   Shifting priorities

X

2 (25.0)

SUSTAINMENT FACILITIATORS

Outer Context

  Inter-organizational

   Positioning within the state

8 (100.0)

4 (50.0)

    Access to governor office

3 (37.5)

X

    Access to Medicaid office

6 (75.0)

X

   Professional networks

X

3 (37.5)

  Consumer Support/Advocacy

   External pressure/public support

2 (25.0)

3 (37.5)

  Service-Environment

   Flexibility in spending

2 (25.0)

2 (25.0)

   Technical assistance

3 (37.5)

1 (12.5)

Inner Context

  Intra-organizational

   Strategic planning

6 (75.0)

4 (50.0)

   Demonstration of outcomes

1 (12.5)

X

  1. X: Not identified as a theme among interviewees in this group
  2. Note. This table only reflects responses to the barrier and facilitators prompt, in-text citation may differ when referencing separate prompt
  3. “Individual” within the inner context of the EPIS framework is interpreted as unit-level factors influencing adoption of a practice within a system. For our analysis, the inner context unit is at the organizational-level