Experiences of peer-trainers in a take-home naloxone program: Results from a qualitative study

Marshall, Carley; Perreault, Michel; Archambault, Léonie; Milton, Diana

doi:10.1016/j.drugpo.2016.11.015

Cited by 37 publications

(29 citation statements)

References 38 publications

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“…Many SIEs stated that this intervention made them feel “empowered” as similarly reported in previous studies (Marshall et al, 2017; Wagner et al, 2014). Participants also stated that being supplied with naloxone made them feel “equipped” so that they could act in the event of an overdose:

“ Feeling confident and equipped to be an agent in saving someone’s life and that to a person is just invaluable…to be at work and – or somewhere else and know that you can do something .”

[Sevn, male]

“ I learned a lot.

…”

Section: Resultssupporting

confidence: 73%

“…Two authors (BWS and LE) with qualitative expertise separately coded one transcript, using a preliminary list of a priori codes based on topical domains addressed in the interview protocol (e.g., willingness to intervene, empowerment, etc.) adapted from similar studies (Marshall et al, 2017; Wagner et al, 2014). The coders met regularly during this process to discuss emergent themes and the addition of new code categories (e.g., importance of staying calm, requesting emergency medical services (EMS) and not police, etc.).…”

Section: Methodsmentioning

confidence: 98%

“…Focus groups are ideal for obtaining community-wide perspectives and experiences (Stewart et al, 2006) and were utilized to further understand participants’ perspectives on the intervention and potential changes in attitudes towards responding to an opioid overdose in real-world encounters post-intervention. A semi-structured interview guide informed by similar studies (Marshall et al, 2017; Wagner et al, 2016, 2014) included questions such as, ‘How does being trained on how to recognize an overdose and administer naloxone make you feel?’; ‘What did you think about the information on the importance of remaining calm?’; ‘Do you think it would be worthwhile to train all of your staff and why?’; ‘What did you think of the hands-on naloxone training?’; “Do you believe that you could respond to an overdose and administer naloxone?”; and, ‘How can we improve this training?’…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

“Feeling confident and equipped”: Evaluating the acceptability and efficacy of an overdose response and naloxone administration intervention to service industry employees in New York City

Wolfson‐Stofko

Gwadz

Elliott

et al. 2018

Drug and Alcohol Dependence

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Background: The problem of injection drug use in public bathrooms has been documented from the perspectives of people who inject drugs and service industry employees (SIEs). Previous studies suggest that SIEs are unaware of how to respond to opioid overdoses, yet there are no behavioral interventions designed for SIEs to address their specific needs. In response to this gap in the field, we constructed, implemented, and evaluated a three-module behavioral intervention for SIEs grounded in the Information-Motivation-Behavioral skills model. This paper focuses on the evaluation of one module, namely, the intervention component addressing overdose response and naloxone administration (ORNA). Methods: Participants were SIEs (N = 18 from two separate business establishments) recruited using convenience sampling. The study utilized a pre-/post-test concurrent nested mixed method design and collected quantitative and qualitative data including an evaluation of the intervention module. The primary outcomes were opioid overdose-related knowledge and attitudes. Acceptability was also assessed. Results: SIEs demonstrated significant improvements (p < 0.01, Cohen’s d = 1.45) in opioid overdose-related knowledge as well as more positive opioid overdose-related attitudes (p < 0.01, Cohen’s d = 2.45) following the intervention. Participants also reported high levels of acceptability of the module and suggestions for improvement (i.e., more role-playing). Conclusions: This study highlights the acceptability and evidence of efficacy of the ORNA module, as well as the utility of training SIEs in ORNA. The expansion of this training to other SIEs and public employees (librarians, etc.) who manage public bathrooms warrants further investigation.

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“ Feeling confident and equipped to be an agent in saving someone’s life and that to a person is just invaluable…to be at work and – or somewhere else and know that you can do something .”

[Sevn, male]

“ I learned a lot.

…”

Section: Resultssupporting

confidence: 73%

Section: Methodsmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

“Feeling confident and equipped”: Evaluating the acceptability and efficacy of an overdose response and naloxone administration intervention to service industry employees in New York City

Wolfson‐Stofko

Gwadz

Elliott

et al. 2018

Drug and Alcohol Dependence

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show abstract

“…Identifying individuals who have ever used naloxone and training them to be peer-educators and promote naloxone possession to individuals in their social networks is an evidence-based approach to changing social norms and behaviors. 15,16 …”

Section: Discussionmentioning

confidence: 99%

Awareness and access to naloxone necessary but not sufficient: Examining gaps in the naloxone cascade

Tobin

Clyde

Davey‐Rothwell

et al. 2018

International Journal of Drug Policy

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“…In the UK, (former) service users can be employed or engaged in drug treatment services and supply naloxone to potential overdose witnesses as of October 2015 (PHE, 2015). A Canadian interview study with peer-trainers identified the wish to help others as key motivation and found psychological benefits associated with the peer-trainer role, including a sense of recovery and empowerment (Marshall et al, 2017).…”

Section: Peer-led Provisionmentioning

confidence: 99%

Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation

McDonald

Campbell

Strang

2017

Drug and Alcohol Dependence

113

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Highlights Deaths from opioid overdose can be prevented by prompt administration of naloxone  It has been 20 years since take-home naloxone provision was first proposed  Take-home naloxone programs have recently overcome legal barriers in many countries  Take-home naloxone provision remains low compared to evident growing clinical need  The 'opt-out' model of required pre-provision may achieve wider naloxone coverage Abstract Background: Opioid overdose is a major cause of mortality, but injury and fatal outcomes can be prevented by timely administration of the opioid antagonist naloxone. Pre-provision of naloxone to opioid users and family members (take-home naloxone, THN) was first proposed in 1996, and WHO Guidelines were issued in 2014. While widespread in some countries, THN is minimally available or absent elsewhere. This review traces the development of THN over twenty years, from speculative harm reduction proposal to public health strategy.Method: Medline and PsycINFO were searched for peer-reviewed literature using Boolean queries: 1) "naloxone OR Narcan"; 2) "(opioid OR opiate) AND overdose AND prevention". Grey literature and specialist websites were also searched. Data were extracted and synthesized as narrative review, with key events presented as chronological timeline. Results Conclusions:Framed as a public health tool for harm reduction, THN has overcome social, clinical, and legal barriers in many jurisdictions. Nonetheless, the rising death toll of opioid overdose illustrates that current THN coverage is insufficient, and greater public investment in overdose prevention will be required if THN is to achieve its full potential impact.

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Experiences of peer-trainers in a take-home naloxone program: Results from a qualitative study

Cited by 37 publications

References 38 publications

“Feeling confident and equipped”: Evaluating the acceptability and efficacy of an overdose response and naloxone administration intervention to service industry employees in New York City

“Feeling confident and equipped”: Evaluating the acceptability and efficacy of an overdose response and naloxone administration intervention to service industry employees in New York City

Awareness and access to naloxone necessary but not sufficient: Examining gaps in the naloxone cascade

Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation

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