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. 2024 Oct 2;11:1450672. doi: 10.3389/fmed.2024.1450672

Table 2.

Outcome and explanatory conditions.

Condition Description of condition Calibration Rationale
Providing MAT Extent to which the practice has at least one medical provider providing MAT to patients at that clinic 1 = providing MAT fully with systems in place
0.8 = generally providing but is still bumpy, erratic
0.6 = quietly providing MAT but not much or not advertised
0.2 = did a few and stopped
0 = not providing MAT
Outcome of interest
Practice Size Small practice = 1–2 medical providers; Medium = 3–5; Large = 6 or more N/A. Practice size was used as a contextual condition with separate QCA analyses for small, medium, and large practices Size may have an effect on ability or interest in providing MAT
Private practice Practice is owned privately by the physician or medical provider or those in the practice 1 = private practice
0 = practice is owned by a hospital
This practice structure may operate differently than others
Clinician with MAT Experience (Clinician) At least one medical provider (with prescribing authority like a physician or APP) has had exposure to or themselves provided MAT before either at this practice or elsewhere 1 = had experience providing MAT themselves
0.8 = has experience with observing MAT being provided in own practice
0.6 = has had some exposure in their training but has not provided it themselves or in own practice
0 = has not experience or exposure to MAT
Those who have already provided MAT makes for 1) mental switch of being willing to do it and 2) hurdle of having done it already so easier on-ramp to doing again; exposure maybe more willing to consider doing it
Some practices might have a MAT prescriber with experience (or a waiver) who is choosing NOT to prescribe
MAT prescriber on staff (Prescriber) Practice has a clinician with a DEA waiver 1 = Clinician with DEA waiver to prescribe MAT at practice
0 = No clinician with DEA waiver to prescribe MAT at practice
Some practices might have a MAT prescriber with experience (or a waiver) who is choosing NOT to prescribe
Behavioral Health in the Practice Having at least a part-time person physically located in the practice that provides mental and behavioral health support 1 = BH in the practice at least part-time regardless of employment and has a least some capacity to take on MAT patients
0.6 = so occasional and already overbooked that no capacity to take on MAT or very occasional BH in the practice and not familiar with MAT
0 = no BH in the practice even if have referral source
Since many perceive BH support as a needed component to providing MAT, this may make a difference in willingness to do it
Leadership Buy-in for MAT The extent to which leadership at the practice and health system level (if applicable) is supportive of providing MAT 1 = strong leadership support across range of leaders with emphasis on major decision maker(s)
0.6–0.9 = range of generally having support
0.1–0.4 – range of generally not supportive
0 = no leadership support or blocking efforts to do MAT
When leadership is not in support, then the practice often cannot move ahead with providing MAT
Practice Champion or Key Person The presence of a person who was in charge and made things happen for the MAT efforts; usually person with passion, but does not have to be 1 = had champion
<0.5 = not strong champion—someone voluntold to do it/no passion/capacity
0 = no champion
If there is someone there whose job it is to get MAT going, this could influence progress on making it happen
MAT system in place Extent to which the practice has some way of having their patients get to MAT help. A formal MAT system included identification of patients suffering OUD along with referral or treatment, behavioral health support/referral, peer support or referral, and follow-up plans 1 = providing MAT directly or have strong and consistent referral partners that their patients get referred to (including follow-up)
0.1–0.45 = range of having some referrals but not consistent or strong or not MAT-specific
0 = neither in place
If they have a way to refer to or provide MAT, this affects the outcome of getting patients to MAT