Evaluation of an Experimental Educational Module on Opioid-related Occupational Safety to Minimize Barriers to Overdose Response among Police Officers

摘要 这项申请建议有助于协调执法做法和公共卫生。 目标是与阿片类药物相关过量(OD)相关的发病率和死亡率上升作斗争。警察 美国各地的部门正在越来越多地向他们的部门提供OD逆转药物纳洛酮 警官们。这种干预措施有可能极大地改善服药过量后的应急反应。这一比例 然而，强制警官携带纳洛酮的选区仍然很少，仍然存在阻碍 采用这些急救计划是有问题的。警察工会对纳洛酮的诉讼- 相关任务和职业安全问题，包括针刺伤人的可能性(艾滋病毒/丙型肝炎病毒 风险)和偶然接触芬太尼类物质构成障碍，耻辱和担忧也是如此 关于法律上的危险。研究小组建议让警察掌握最大限度地减少工作场所的最佳做法 与PWUO/PWID遭遇相关的危害以及自信应对的法律和实践知识 无需担心法律危险的吸毒过量，并减少与法律相关的残疾人士和残疾人士的健康风险 执法部门。宾夕法尼亚州超过1万名执法人员(约占宾夕法尼亚州所有执法人员的三分之一) 我已经接受了GetNaloxoneNow.org(GNN)的纳洛酮和服药反应培训，GetNaloxoneNow.org是一家基于网络的 干预。在县卫生部门、减少伤害机构、执法部门和 地区检察官，该小组建议对警察现有的干预措施进行调整，以创建一个在线培训模块 旨在减少警方参与应对吸毒问题的障碍。使用混合方法设计，有组织地 围绕务实的试验设计，本研究将实现以下目标：1)适应职业风险 减少(ORR)课程，以增加基于网络的服药反应和纳洛酮培训平台(GNN)；2) 描述以下人群的纳洛酮使用模式、服药反应经历和对非法阿片类药物使用的态度 通过GNN平台培训的PA警察样本(N=300)；3)评估 ORR+GNN与仅GNN相比，结果如下：a)纳洛酮的携带率 在值班/休班期间；b)使用/不使用纳洛酮的服药过量应答率；c)转诊至 治疗；d)没收的注射器数量；以及e)与吸毒幸存者分享信息的比率和 其他。还将分析功效的调解人和调解人。4)记录心理社会的范围 干预后参与者OD反应参与的潜在机制。这项研究的目的是删除 通过关注执法安全，阻止警察与PWUO/PWID进行救生接触 以及与有阿片类药物过量风险的人合作的循证和最佳做法。这项研究还将 提供基于纳洛酮的反应在执法部门中扩散的经验评估。

Abstract This application proposes to contribute to the harmonization of law enforcement practices and public health goals to combat rising morbidity and mortality rates associated with opioid-related overdose (OD). Police departments around the U.S. are increasingly making the OD reversal drug, naloxone, available to their officers. This intervention has the potential to greatly improve emergency response after an OD. The proportion of precincts mandating that officers carry naloxone remains small, however, and barriers remain that make adoption of these first-responder programs problematic. Lawsuits from police unions contesting naloxone- related mandates and occupational safety concerns, including the potential for needle stick injuries (HIV/HCV risk) and incidental contact with fentanyl-class substances, constitute barriers, as do stigma and concerns about legal jeopardy. The study team proposes to equip police with best-practices for minimizing workplace harms related to encounters with PWUO/PWID and the legal and practical knowledge to respond confidently to an OD without fear of legal jeopardy as well as reduce health risks to PWUOs and PWIDs associated with law enforcement. More than 10,000 law enforcement officers in Pennsylvania (roughly one third of all PA officers) have already received naloxone and OD response training from GetNaloxoneNow.org (GNN), a web-based intervention. With the support of county departments of health, harm reduction agencies, law enforcement, and district attorneys, the team proposes to adapt extant interventions for police to create an online training module aimed at reducing barriers to police engagement in OD response. Using a mixed-method design, organized around a pragmatic trial design, the study will achieve the following objectives:1) Adapt an occupational risk reduction (ORR) curriculum to add to a web-based OD response and naloxone training platform (GNN); 2) Describe naloxone use patterns, OD response experiences, and attitudes related to illicit opioid use among a sample (N = 300) of police officers in PA trained via the GNN platform; 3) Evaluate the relative effectiveness of ORR + GNN, compared with GNN-only, with respect to the following outcomes: a) rates of carrying naloxone while on/off-duty; b) rates of OD response in which naloxone is/isn't administered; c) numbers of referrals to treatment; d) numbers of syringes confiscated; and e) rates of information sharing with OD survivors and others. Mediators and moderators of efficacy will also be analyzed. 4) Document the range of psychosocial mechanisms underlying participant OD response engagement post-intervention. This study aims to remove barriers to life-saving police engagement with PWUO/PWID by focusing both on the safety of law enforcement and evidence-based and best-practices for working with persons at risk of an opioid OD. The study also will provide empirical evaluation of the diffusion of naloxone-based response among law enforcement.