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Drug- and alcohol-dependent individuals are at a much higher risk for hepatitis infections than the general population and are at higher risk of poor outcomes following infection.1–13 Because of these risk factors, substance use disorder treatment clinics represent an ideal venue for screening, education, prevention, and treatment referral services for patients with hepatitis infections.  The Liver Health Initiative (LHI) was a training program jointly sponsored by the Veterans Health Administration’s (VA) Substance Use Disorders Quality Enhancement Research Initiative (SUD QUERI) and the Minneapolis VA Hepatitis C Resource Center (HCRC), with the goal of implementing these services in VA SUD clinics. The program was based on a successful liver health program established in the Minneapolis VA Health Care System’s Addictive Disorders Service14 and a training model previously used by the HCRC to promote evidence-based evaluation and treatment of patients with hepatitis C.15 The program design was informed by empirically based literature on the education of medical providers and the dissemination of health care innovations.16–22  The purpose of this paper is to describe the LHI training model, which shows promise for promoting implementation of hepatitis services in SUD clinics and may also be generalizable to promoting implementation of other evidence-based health care practices. The evaluation of this initial cohort of LHI trainees builds on the previous evaluation by assessing the generalizability of the effectiveness of this training program to a new topic area and target audience, comparing the intervention teams to wait-list teams receiving informational materials only, and collecting qualitative data regarding barriers, facilitators and strategies utilized to provide information about team or organizational characteristics that affect change. We hypothesized that 1) the training program would be effective in promoting implementation of recommended practices, 2) teams attending the training program would demonstrate greater success with implementation compared to wait-listed teams, and 3) the degree of implementation success would vary among teams attending the training, with qualitative data providing exploratory information on potential team and organizational characteristics that promote successful implementation.

A Training Model for Implementing Hepatitis Prevention Services in Substance Use Disorder Clinics: A Qualitative Evaluation