Including grantee and participant voice in the evaluation of a complex state block grant

Abstract Information: Oregon’s State Opioid Response (SOR) grant, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), intended to increase access to FDA-approved medications for treating opioid use disorder (OUD) and to strengthen the continuum of prevention, harm reduction, treatment, and recovery support services for OUD and other substance use disorders (SUD). To achieve these goals, Oregon’s SOR strategic plan, which included nine initiatives and funded 58 grantees over two years, focused on expanding access to and utilization of SUD services and supports. To promote equitable access, the strategic plan identified priority communities (e.g. rural, African American, Latine/Hispanic, youth, LGBTQ+) and partnered with several federally recognized Tribal health organizations. To address the scope of the SOR strategic plan, we used a complex systems principle, embeddedness, to organize the evaluation into five nested levels (overall impact, initiative, grantee/organization, service provider/workforce, and client). Within that structure, we selected methods to manage complexity – an evidence rubric to assess overall impact, and sub-studies to allow for in-depth evaluation with a smaller set of grantees. Moreover, we endeavored to align the evaluation with our commitment to promoting social justice through equity-centered evaluation strategies embedded in each method, which included amplifying grantee and participant voices. The purpose of this panel is to describe how we expanded the evaluation to include grantee and participant voices while also managing the complexity of the SOR grant. To do this, we’ll use examples from three components of the evaluation: medication-assisted treatment (MAT) implementation, SUD workforce training, and impact on expanding access to SUD services and supports. The MAT sub-study focused on funded activities at the initiative level and included the voices of grantees through interviews. The SUD workforce training sub-study focused on funded activities at the grantee/organization level and included voices of service providers with a follow-up survey. The impact evaluation focused on the overall impact of SOR funding as well as impact at the initiative level, and elevated the voices of culturally-specific grantees. The discussant will conclude with a visualization of the SOR evaluation and its interacting components. They will also engage panelists in a discussion of the strengths and challenges of their respective approaches, including how the funder’s priorities impacted their ability to include voices that are often marginalized in the health system.