{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T17:17:21Z","timestamp":1772558241033,"version":"3.50.1"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260033-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Hospital-based opioid treatment (HBOT) can improve outcomes for patients with opioid use disorder, but little is known about specific attributes and supports needed for clinical champions to successfully implement HBOT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260033-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify characteristics and supports of effective clinical champions implementing HBOT in US hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260033-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>Qualitative study using postimplementation semistructured interviews conducted with individuals highly involved in HBOT implementation, including champions and hospital staff at 12 US community hospitals randomized to the high-intensity group of the Exemplar Hospital Initiation Trial to Enhance Treatment Engagement, a national implementation trial comparing low- and high-intensity HBOT implementation strategies. Interviews explored implementation experiences over 24 months from December 2021 to December 2023. Interviews were audio recorded, transcribed, and coded. The framework method and in-depth thematic analysis were used to explore the role of champions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260033-7\">\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>All hospitals received a best-practices manual, video webinar series, and hub team support for questions, while hospitals randomized to the high-intensity group also received monthly practice facilitation, telementoring, and 10% effort funding for a local champion. Champions led HBOT implementation with support from regional hubs with HBOT expertise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260033-8\">\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Effective champions were defined as those perceived by staff to successfully lead HBOT implementation. Open-ended questions and thematic analysis explored participants\u2019 perspectives on attributes of effective champions and how they overcame implementation barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260033-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 31 hospital staff (15 physicians, 5 executives, 5 pharmacists, 2 nurse practitioners, 2 social workers, 1 nurse, and 1 addiction counselor) were interviewed. Effective champions were perceived as respected hospital \u201cinsiders\u201d with institutional influence, persistence, and systems change skills. They built multidisciplinary teams, developed standard workflows, and used emotionally resonant strategies (eg, patient narratives) to overcome stigma and engage hospital leadership. Champions could be effective without addiction medicine expertise, particularly when provided with protected time, hospital leadership support, and external practice facilitation from addiction experts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260033-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This multisite qualitative study underscores the vital role of champions in expanding hospital-based opioid care. To ensure HBOT expansion, hospitals should invest in champions, protected time, leadership backing, and external supports that legitimize and routinize evidence-based addiction care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.0446","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:00:35Z","timestamp":1772553635000},"page":"e260446","source":"Crossref","is-referenced-by-count":0,"title":["Perspectives on Clinical Champions Implementing Hospital-Based Opioid Treatment in US Hospitals"],"prefix":"10.1001","volume":"9","author":[{"given":"Linda","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Medicine, Oregon Health and Science University, Portland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia","family":"Goff","sequence":"additional","affiliation":[{"name":"Department of Medicine, Oregon Health and Science University, 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