Nudges and Incentives to Enhance the Opioid Treatment Workforce

This study is designed to assess how to effectively recruit and enroll primary care providers into participation into an ECHO MAT learning collaborative. For study participants that enroll in the learning collaborative, the study team will track participation over 6 months. The study is designed to be implemented in two phases. Phase 1 is the recruitment phase. Providers will be randomized to receive recruitment letters and emails from 1 of 4 conditions. Randomization for this phase will occur at the practice level, as determined by provider address. Participants that contact the study team and enroll in the study will begin Phase 2 of the study. In Phase 2 of the study participants will be randomly assigned to rewards for participation in ECHO MAT learning collaborative. Their participation in the learning collaborative will be tracked. Phase 2 of the study is a pilot. Recruitment: Primary care providers will receive recruitment letters, and may receive emails and phone calls based on the recruitment condition they are assigned to. Informed Consent: Since it is not possible to consent before recruitment, participants will complete the informed consent process at the beginning of Phase 2 of the study. The consent form will be shared with eligible participants when they contact the study team to enroll. Before enrolling in the ECHO MAT learning collaborative, participants will be asked to provide consent in order to enroll in the study. Randomization: Phase 1: Primary care providers will be randomized by practice to 1 of 4 study arms. Computerized randomization will assign practices to study arms, practices and primary care providers will have an equal chance of being randomized to each study arm . Phase 2: Eligible participants will be randomized to the Phase 2 study arm upon enrollment in the study. Randomization will be assigned using a predetermined randomly ordered list of study condition assignments. Upon enrolling in the study, the participants will be assigned to the condition that is next on the list. Participants will have an equal chance of being randomized to each study arm. Assessment: Assessment for Phase 1 will occur when participants contact study staff with interest in the study or to enroll. Any primary care providers that are sent letters but do not contact study staff will be included in study analyses as 'No' for outcomes for Phase 1. Assessment for Phase 2 will occur throughout the 6 months after participants enroll in the study. Outcomes for this study phase are related to participation in ECHO MAT learning collaboratives, which is tracked for each training by study staff. Detailed Description of the Intervention: Phase 1 recruitment letters are designed in a 2 (prosocial mention of need for primary care providers trained in opioid use disorder treatment vs. none) x 2 (mention of additional practice supports available for participation in training vs. none). This yields 4 study conditions for recruitment letters: 1) Letter including prosocial messages and additional mention of practice supports available for participation, 2) Letter including prosocial messages but no additional mention of practice support available for participation, 3) Letter including an additional mention of practice support available for participation but no prosocial messages, and 4) Recruitment as usual letter that does not include prosocial messages or an additional mention of practice support available for participation. Phase 2 examines participation in the learning community by group. Participants will be randomly assigned to 1 of 3 groups. At this time the investigators are not disclosing the Phase 2 conditions, and will disclose these at the end of the study, as approved by UNC's institutional review board (IRB).