“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

Abstract

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.

Management and staff reception to overdose prevention in NYC nightlife venues

“…Nightlife management and staff are uniquely positioned for overdose response as they may be likely to encounter substance use in their venue’s on-premises toilets (Wolfson-Stofko et al, 2017). In line with previous research on the acceptability of overdose response and naloxone administration training among NYC service industry employees (Wolfson-Stofko et al, 2018), our findings confirmed venue management were receptive to integrating overdose prevention messaging and naloxone distribution into their venues’ operations.…”

It's what the community demands: Results of community‐based emergency opioid overdose trainings

“…These findings highlight the benefits of designing training tailored to restaurant and service industry workers, who are often in close proximity to the overdoses (Wolfson‐Stofko et al., 2017, 2018). The present study indicates individual‐level improvements in both knowledge and attitudes based on attending workplace training (Allen et al., 2020; LaSane et al., 2022; Wolfson‐Stofko et al., 2018). It also revealed aspects of the OEND training sessions that could be improved upon in the future.…”

“…Bar, music venue, and restaurant service industry workers are uniquely positioned to reduce preventable opioid overdose deaths. They are on the frontlines of overdose identification and response, yet there have been few efforts to train them (Allen et al., 2020; LaSane et al., 2022; Wolfson‐Stofko et al., 2018). To remedy this situation, Allen et al.…”

“…Bar, music venue, and restaurant service industry workers are uniquely positioned to reduce preventable opioid overdose deaths. They are on the frontlines of overdose identification and response, yet there have been few efforts to train them (Allen et al, 2020;LaSane et al, 2022;Wolfson-Stofko et al, 2018). To remedy this situation, Allen et al suggest training the community in and around nightclubs and bars in OEND, making them aware, amongst other things, that opioids could be present in the cocaine that is circulating in the area (Allen et al, 2020).…”

Nobody Wants to Be Narcan’d: A Pilot Qualitative Analysis of Drug Users’ Perspectives on Naloxone

“…Previous studies have indicated that non-opioid users hold overall positive opinions of naloxone. [12][13][14] A survey of lay persons found that while only 61% of respondents had heard of naloxone, most respondents (88%) felt naloxone was beneficial in preventing accidental opioid overdoses. 12 Both medical professionals and state government agencies support efforts to increase naloxone availability due to demonstrated benefits in reducing opioid overdose mortality.…”