Encouraging Better Treatments Through Macro Faultlines

Abstract

Drawing upon demography and intergroup relations theory, we introduce the novel construct of macro-faultlines that separate groups of interdependent organizations into distinct subgroups of organizations based on their similar demographic and intrapersonal profiles. We test these ideas in three multi-level, multi-source, and multi-wave studies spanning 10 years of research based on national samples of substance abuse disorder (SUD) treatment centers, organized into regionally selected groups of organizations intended as collaborative platforms for the execution of clinical trials. We found that faultlines based on employee life events (e.g., addiction) overpowered demographic faultlines in their effects on adoption of innovation. Divides within client populations (e.g., relapse status) encouraged innovation via information availability, whereas divides within employee populations discourage innovation. Finally, both employee and client-based faultlines were related to increased adoption of evidence-based treatments over a ten-year period. Implications for innovative responses to the opioid epidemic and substance abuse treatment in general are discussed.