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

对阿片类药物相关职业安全实验教育模块的评估，以最大限度地减少警官过量反应的障碍

基本信息

批准号：
9698712
负责人：
Janie Elizabeth Simmons
金额：
$ 58.79万
依托单位：
NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-30 至 2021-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9698712
关键词：
Evaluation Experimental Educational Module Opioid

项目摘要

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.

摘要这一应用建议有助于统一执法做法和公共卫生打击与阿片类药物过量（OD）相关的发病率和死亡率上升的目标。警察美国各地的部门越来越多地使OD逆转药物纳洛酮，可供他们军官这种干预有可能大大改善OD后的应急反应。比例然而，要求警察携带纳洛酮的选区仍然很小，采用这些第一反应程序的问题。警察工会对纳洛酮的诉讼- 相关的任务和职业安全问题，包括针头刺伤（HIV/HCV）的可能性风险）和偶然接触芬太尼类物质，构成障碍，耻辱和关注也是如此法律的危险研究小组建议为警察提供最佳做法，与遇到PWUO/PWID相关的伤害以及自信应对的法律的和实践知识无需担心法律的危害，并减少与法律相关的PWUO和PWID的健康风险执法宾夕法尼亚州有超过10，000名执法人员（约占所有PA官员的三分之一）已经从GetNaloxoneNow.org（GNN）接受了纳洛酮和OD响应培训，干预在县卫生部门、减少危害机构、执法部门和地区检察官，该小组建议调整现有的干预措施，为警察创造一个在线培训模块旨在减少警察参与OD响应的障碍。采用混合方法设计，围绕一个务实的试验设计，本研究将实现以下目标：1）适应职业风险减少（ORR）课程，以添加到基于网络的OD响应和纳洛酮培训平台（GNN）; 2）描述纳洛酮使用模式、OD反应经历和与非法阿片类药物使用相关的态度，通过GNN平台培训的巴勒斯坦权力机构警官样本（N = 300）; 3）评估 ORR + GNN与仅GNN相比，以下结果：a）纳洛酮携带率在上班/下班时; B）给药/不给药纳洛酮的OD反应率; c）转诊至治疗; d）没收的注射器数量;以及e）与吸毒过量幸存者分享信息的比率，他人还将分析功效的中介者和调节者。4)记录心理社会的范围参与者OD响应参与干预后的机制。这项研究旨在消除通过关注执法安全，以及与阿片类药物OD风险人群合作的循证和最佳实践。该研究还将提供执法部门对纳洛酮反应扩散的经验评估。