{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:46:34Z","timestamp":1782233194775,"version":"3.54.5"},"reference-count":55,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,9,12]],"date-time":"2016-09-12T00:00:00Z","timestamp":1473638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute of Drug Abuse","doi-asserted-by":"crossref","award":["R34DA038530"],"award-info":[{"award-number":["R34DA038530"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000026","name":"National Institute of Drug Abuse","doi-asserted-by":"crossref","award":["R01DA030459"],"award-info":[{"award-number":["R01DA030459"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute on Drug Abuse of the National Institutes of Health","award":["R25DA035163"],"award-info":[{"award-number":["R25DA035163"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe changes in characteristics of directors of outpatient opioid agonist treatment (<jats:styled-content style=\"fixed-case\">OAT<\/jats:styled-content>) programs, and to examine the association between directors\u2019 characteristics and low methadone dosage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Source<\/jats:title><jats:p>Repeated cross\u2010sectional surveys of <jats:styled-content style=\"fixed-case\">OAT<\/jats:styled-content> programs in the United States from 1995 to 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>We used generalized linear regression models to examine associations between directors\u2019 characteristics and methadone dose, adjusting for program and patient factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection<\/jats:title><jats:p>Data were collected through telephone surveys of program directors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>The proportion of <jats:styled-content style=\"fixed-case\">OAT<\/jats:styled-content> programs with an African American director declined over time, from 29 percent in 1995 to 16 percent in 2011. The median percentage of patients in each program receiving &lt;60\u00a0mg\/day declined significantly, from 48.5 percent in 1995 to 29 percent in 2005 and 23 percent in 2011. Programs with an African American director were significantly more likely to provide low methadone doses than other programs. This association was even stronger in programs with an African American director who served populations with higher percentages of African American patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Demographic characteristics of <jats:styled-content style=\"fixed-case\">OAT<\/jats:styled-content> program directors (e.g., their race) may play a key role in explaining variations in methadone dosage across programs and patients. Further research should investigate the causal pathways through which directors\u2019 characteristics affect treatment practices. This may lead to new, multifaceted managerial interventions to improve patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.12558","type":"journal-article","created":{"date-parts":[[2016,9,12]],"date-time":"2016-09-12T23:27:07Z","timestamp":1473722827000},"page":"1881-1907","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Role of Program Directors in Treatment Practices: The Case of Methadone Dose Patterns in U.S. Outpatient Opioid Agonist Treatment Programs"],"prefix":"10.1111","volume":"52","author":[{"given":"Jemima A.","family":"Frimpong","sequence":"first","affiliation":[{"name":"The Johns Hopkins Carey Business School Johns Hopkins University Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Shiu\u2010Yee","sequence":"additional","affiliation":[{"name":"Department of Sociomedical Sciences Mailman School of Public Health Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"D'Aunno","sequence":"additional","affiliation":[{"name":"Robert F. 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