Rural programs were significantly less likely to have nurses, traditional healing consultants, or ceremonial providers on staff.

Rural programs were less likely to consult outside evaluators, use strategic planning to improve program quality, offer pharmacotherapies, pipe ceremonies, and cultural activities among their services, or to participate in research or program evaluation studies.

Rural programs were significantly more likely to employ elders among their traditional healers, offer AA-open group recovery services, and collect data on treatment outcomes.

Greater openness toward EBTs was related to a larger clinical staff, having addiction providers, being led by directors who perceived a gap in access to EBTs, and working with key stakeholders to improve access to services.

Programs that provided early intervention services (American Society of Addiction Medicine level 0.5) reported less openness.