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Current efforts to reduce sexual violence in college campuses underscore the role of engaging men in prosocial bystander behavior. The current study implemented an online survey to explore associations between engaging in heavy drinking and attitudes toward bystander intervention among a sample of college men (N = 242). Correlates of sexual aggression were also explored as mediators of the hypothesized relationship between engaging in heavy drinking and attitudes toward bystander intervention. Data indicated that men who engaged in two or more episodes of heavy drinking over the past month reported lower prosocial bystander attitudes compared with men who did not engage in such behavior. The association between engaging in heavy drinking and lower prosocial bystander attitudes was mediated by men's perception of their peers' approval for sexual aggression, their own comfort with sexism, and engagement in coercive sexual behavior. Implications for sexual assault prevention are discussed.

Access to the opioid antidote naloxone is a critical component of addressing the opioid crisis. Naloxone is a population-level prevention intervention associated with substantial reductions in overdose mortality and reduction of nonfatal overdose. Pharmacies’ pivotal role in dispensing medications like buprenorphine for the treatment of opioid use disorder and selling nonprescription syringes places them at the crossroads of opioid access and risk mitigation methods like naloxone provision. Testing ways to optimize pharmacy-based naloxone provision will be key as the country expands the implementation of naloxone through the medical system. In the Respond to Prevent Study, we conducted a large, practical study of a pharmacy-focused intervention in a sample of Washington, Oregon, Massachusetts and New Hampshire community chain pharmacies to increase naloxone dispensing and improve opioid safety. The intervention integrated two evidence-based educational toolkits and streamlined materials to enhance the focus on naloxone policy, stigma reduction, and patient communications around naloxone, nonprescription syringes and buprenorphine access. The real-world study implemented a stepped wedge, clustered randomized trial design across 175 community chain pharmacies to evaluate the effectiveness of the Respond to Prevent intervention in increasing: (a) pharmacy based naloxone distribution rates, naloxone-related patient engagement, and pharmacist and technicians’ attitudes, knowledge, perceived behavioral control and self-efficacy toward naloxone; and (b) pharmacy nonprescription syringe sales, and pharmacist and technicians’ attitudes, knowledge, perceived behavioral control and self-efficacy toward dispensing buprenorphine for opioid use disorder (secondary outcomes). This commentary provides a brief narrative about the study and presents insights on the design and adaptations to our study protocol, including those adopted during the unprecedented COVID-19 pandemic further compounded by Western wildfires in 2020.

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Background: The role pharmacies play in addressing the opioid crisis and drug-related risks such as injection drug use is evolving. Estimating the prevalence of injection drug use at the community level is challenging because of the stigma of drug use. Many community pharmacies sell nonprescription sterile syringes; thus, pharmacy-level sales of injection equipment may be an indicator of drug-related harms and unmet needs of high-risk populations. Objectives: To describe, compare, and assess the convergent validity of staff-reported nonprescription syringe (NPS) sales volume and NPS administrative sales data from community pharmacies in Massachusetts (MA) and Rhode Island (RI). Methods: This study employed both prospective cross-sectional survey data collection and utilization of administrative pharmacy sales data. Between November 2017 and January 2018, we administered a telephone-based survey to estimate average weekly NPS type and volume for 191 chain pharmacies (CVS Health) located in communities experiencing fatal opioid overdoses above the state's 2015 annual median rate. For the same time period, we obtained NPS sales data from surveyed pharmacies and all CVS Health pharmacies in the 2 states. We calculated Spearman correlations to assess convergence of average weekly volume between pharmacy staff reports and sales data. Results: All pharmacies responded to the survey. Most (98.4%) pharmacies surveyed sold NPS, but 42.0% reported running out of stock monthly or more frequently. Pharmacy staff tended to under-report syringe sales. Staff-reported weekly NPS sales volume was 67,922 versus 70,962 syringes from administrative pharmacy sales data. Spearman correlation between reported and actual NPS sales was 0.40 (95% CI 0.27e0.51). Conclusion:The counts of administrative pharmacy syringe sales data in MA and RI indicate high need, substantial volume, and notable access at community pharmacies. Future research should use NPS sales data rather than self-report data to track emerging trends and tailor local responses.

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BACKGROUND Technology-based interventions (TBIs) (i.e., web-based and mobile interventions) have the potential to promote health equity in substance use disorder treatment (SUTx) for underrepresented groups (i.e., African Americans/Blacks, Hispanics/Latinx, and American Indians/Alaskan Natives) by removing barriers and increasing access to culturally relevant, effective treatments. However, technologies (emergent and more long-standing) may have unintended consequences that could perpetuate healthcare disparities among underrepresented groups. Healthcare research, and SUTx research specifically, is infrequently conducted with these groups as a main focus. Therefore, an improved understanding of the literature at the intersection of SUTx, TBIs, and underrepresented groups is warranted to avoid exacerbating inequities and to promote health equity. OBJECTIVE To explore peer-reviewed literature (January 2000-March 2021) that includes underrepresented groups in SUTx research using TBIs. We further seek to explore whether this subset of research is race/ethnicity conscious (i.e., does the research consider underrepresented groups (beyond their inclusion as study participants) in introduction, methods, results, and/or discussion). METHODS Five electronic databases (MEDLINE, Scopus, Cochrane Library, CINAHL, and PsychInfo) will be searched to identify SUTx research using TBIs, and studies will be screened for eligibility at the title/abstract and full-text levels. Studies will be included if their sample includes underrepresented groups at 50% or more when combined. RESULTS This project is currently in the data extraction phase with an anticipated completion date of March 2022. CONCLUSIONS Research is needed to increase our understanding of the range and nature of TBIs being used in SUTx research studies with underrepresented groups. The planned scoping review will highlight research at this intersection to promote health equity.

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