ArticleSubstance abuse : research and treatment2021
Barriers for Implementing the Hub and Spoke Model to Expand Medication for Opioid Use Disorder: A Case Study of Montana.
Article in Substance abuse : research and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 20 citations in OpenAlex.
- Effects of Online Naloxone Training for Laypersons: An Extended-Baseline Assessment.Substance use & misuse · 2024Trial
- A mixed methods analysis of clinics' perspectives on community factors influencing access to medications for opioid use disorder.Addiction science & clinical practice · 2026Article
- Implementation challenges and opportunities in decentralized methadone service delivery.BMC health services research · 2025Article
- A Hybrid Type II Hub-and-Spoke Model Evaluation Framework in the Commonwealth Partnerships for Antimicrobial Stewardship Programme-A Study Protocol.Antibiotics (Basel, Switzerland) · 2025Article
- Implementation Challenges and Opportunities in Decentralized Methadone Service Delivery.Research square · 2025Article
- Effectiveness of Washington State's hub and spoke model to improve opioid use disorder outcomes.Health affairs scholar · 2025Article
- Evaluating spoke facilitation costs of implementing TelePain in the Veterans Health Administration.Implementation science communications · 2025Article
- Concerns About Medications for Opioid Use Disorder Among American Indian Community Members: A Qualitative Secondary Analysis.Public opinion quarterly · 2025Article
- An Approach to Enhancing Medication Treatment for Opioid Use Disorder in the HEALing Communities Study.Psychiatric services (Washington, D.C.) · 2024Article
- Stakeholder perspectives on a telemedicine referral and coordination model to expand medication treatment for opioid use disorder in rural primary care clinics.Journal of substance use and addiction treatment · 2024Article
- Rural and frontier access to mental health prescribers and nonprescribers: A geospatial analysis in Oregon Medicaid.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry.Journal of technology in behavioral science · 2022Article
- 'It's the same thing as giving them CPR training': rural first responders' perspectives on naloxone.Harm reduction journal · 2022Article
- Expert Panel Consensus on State-Level Policies to Improve Engagement and Retention in Treatment for Opioid Use Disorder.JAMA health forum · 2022Article
- Association Between Interorganizational Collaboration in Opioid Response and Treatment Capacity for Opioid Use Disorder in Counties of Five States: A Cross-Sectional Study.Substance abuse : research and treatment · 2022Article
- Cancer in rural America: Improving access to clinical trials and quality of oncologic care.CA: a cancer journal for cliniciansReview
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAccess to medication for opioid use disorder (MOUD) varies across the rural-urban continuum. The Hub & Spoke Model (H&S) emerged to address these gaps in service whereby hubs with staff expertise in MOUD support delivery of specialized care to a network of spoke locations, often located in rural communities with workforce shortages. This paper presents a case study of efforts to implement the hub and spoke model in a frontier and rural (FAR) state: Montana.
methodsThe primary data are structured interviews with 65 MOUD program staff in hub and spoke locations within Montana. Both inductive and deductive coding were used to analyze the transcripts.
findingsUsing the H&S structure to expand access to MOUD in Montana led to mixed results. There were consistent themes identified in the interviews about the reasons why hubs struggled to successfully recruit spokes, including (1) geographic barriers, (2) a lack of interest among medical providers, (3) fears about excessive demand, (4) concerns about the financial viability of the model, and (5) a preference for informal technical assistance rather than a formal H&S relationship. In addition to these 5 themes, efforts to implement H&S across different medical systems were unsuccessful, whereas the H&S model worked more effectively when H&S locations were within the same organization.
conclusionThis case study identified limits to the H&S model utility in supporting states' abilities to expand access to MOUD treatment and offers suggestions for adapting it to accommodate variation across divergent rural contexts. We conclude with recommendations for strategies that may assist in expansion of MOUD in rural communities that are like those found in Montana.
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