Prisoner Overdose Training and Naloxone Upon Release

描述（由申请人提供）：在全国范围内，药物中毒（过量）是成人意外死亡的第二大原因，也是罗得岛和其他15个州成人意外死亡的主要原因。离开监狱或监狱的人因吸毒过量而死亡的风险很高，特别是在释放后的头两周。本研究旨在通过针对监狱环境的预防干预措施直接解决这一问题。具体目标是：1）制作过量预防和纳洛酮给药培训数字视频光盘（DVD），供囚犯在从监禁中释放之前使用; 2）评估阿片类药物过量预防和纳洛酮给药教育DVD的可行性和可接受性，用于离开惩教设施的囚犯;以及3）评估参与者在接受干预后三个月对关键阿片剂过量预防/纳洛酮给药行为的知识、信心和示范的保持。目标人群是在罗得岛惩教部释放后四周内的囚犯，他们自己或认识参与吸毒的人。为了实现具体目标，将根据既定的培训协议和专门为监狱环境提供的教学培训，制定DVD干预措施。来自前囚犯、培训人员、监狱工作人员和国内预防过量用药专家的反馈将为DVD的制作提供信息。在为期12个月的实地测试中，125名参与者将参加利用DVD和教学内容的集体培训。成功完成培训的参与者将在从监禁中释放时接受纳洛酮。随访评估保留和干预的可接受性将在社区研究中心从监禁释放后3个月进行。这项研究的结果将为未来的随机对照试验研究提供初步数据。结果还将扩大其在监禁环境中的实施领域，并通过评估保留关键阿片类药物过量预防和纳洛酮管理知识，信心和尚未正式评估的技能展示。 公共卫生相关性：注射吸毒和其他阿片类药物的使用导致美国过量死亡率大幅增加，每年传统上难以接触的人口中有很大一部分通过教养设施，因此有很大的机会提供关于在监禁环境中预防过量的重要教育信息。本申请旨在评估罗得岛惩教署（RIDOC）监狱囚犯中的纳洛酮教育干预。通过这项试点研究产生的数据将有助于开发更大规模的干预试验，这将评估纳洛酮干预的有效性后，从监禁释放。

DESCRIPTION (provided by applicant): Nationally, drug poisonings (overdoses) are the second leading cause of accidental death among adults and the leading cause of adult accidental death in Rhode Island and in 15 other states. Individuals leaving prison or jail are at high risk for death from overdose, especially during the first two weeks after release. This study seeks to directly address this problem through a prevention intervention tailored to the prison setting. Specific aims are to: 1) create an overdose prevention and naloxone administration training Digital Video Disc (DVD) for use with prisoners prior to their release from incarceration; 2) assess the feasibility and acceptability of an opiate overdose prevention and naloxone administration educational DVD based intervention for inmates leaving a correctional facility; and 3)assess participants' retention of knowledge, confidence, and demonstration of critical opiate overdose prevention/naloxone administration behaviors three months after receiving the intervention. The targeted population is inmates who are within four weeks of release from the Rhode Island Department of Corrections who are themselves or know people who are involved in drug use. To accomplish the specific aims, a DVD intervention will be developed based on established training protocols and the didactic training tailored for delivery in a prison setting. Feedback from former prisoners, trainers, prison staff, and national experts in overdose prevention will inform the DVD development. In a field test conducted over a 12-month period, 125 participants will take part in a group format training that utilizes DVD and didactic components. Participants who successfully complete the training will receive naloxone when released from incarceration. Follow-up to assess retention and acceptability of the intervention will occur 3 months post release from incarceration at a community-located study site. Findings from this study will provide pilot data for a future randomized controlled trial study. Results will also expand the field both by its implementation in an incarcerated setting and by evaluating retention of key opiate overdose prevention and naloxone administration knowledge, confidence, and demonstration of skills that have not been formally assessed. PUBLIC HEALTH RELEVANCE: With injection drug use and other opiate use leading to a substantial increase in overdose mortality in the United States, and a substantial proportion of that traditionally hard-to-reach population passing through correctional facilities each year, there exists a tremendous opportunity to provide critical education information regarding overdose prevention in the incarcerated setting. This application aims to evaluate a naloxone education intervention among prison inmates at the Rhode Island Department of Corrections (RIDOC). Data generated through this pilot study will be instrumental for developing larger scale intervention trials which will assess effectiveness of a naloxone intervention upon release from incarceration.