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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