Translation of Opiate Overdose Prevention Strategies (The OPT-IN Project)


Prescription opioid overdose represents a public health crisis. A number of efforts have been implemented to address opioid prescribing and opioid risk mitigation strategies for prescribers, but relatively few efforts have sought to address this problem directly with individuals who use opioids.

In this study, we will use information gathered from potential interventionists at public health and healthcare settings to combine naloxone distribution practices with the BOS intervention and develop an online “toolkit” designed to facilitate translation into practice. Staff at partner organizations will then use the toolkit to deliver the combined interventions to their clients who are at risk of experiencing or witnessing an overdose. Our core partner is the Washtenaw County Health Initiative’s Opioid Project, which includes members across diverse settings (e.g., HIV outreach programs, shelters, addiction treatment, county health department, emergency departments). This project will use the translation framework of Enhanced Replicating Effective Programs (REP),12-14 which includes an online tool-kit package, the provision of training, and an external facilitator.

Aim 1: Adapt overdose prevention interventions (BOS + naloxone distribution) for delivery together by non-research staff; create a package of trainings, tools, and intervention materials; and develop an online “toolkit.” We will conduct qualitative interviews with clinicians, community outreach workers, and organizational leaders at potential adopting organizations identified through the Washtenaw County Health Initiative Opioid Project. The information obtained from these interviews will guide an iterative process to translate and package intervention materials and trainings into an online toolkit that is able to be tailored to many types of settings. Aim 2: Pilot test the BOS + naloxone distribution toolkit combined with external facilitation as a strategy to aid translation to delivery by staff. Staff at three sites (a HIV outreach organization, a homeless shelter, and an emergency department) will use the online “toolkit” developed in Aim 1 to deliver the interventions to their clients/patients, with the help of an external facilitator and training, including technical support. We will evaluate the translation strategy using the RE-AIM framework,15 which includes Reach (e.g., number of individuals receiving intervention), Effectiveness (e.g., patient/client outcomes), Adoption (e.g., numbers trained), Implementation (e.g., fidelity of intervention delivery) and Maintenance (e.g., sustained in routine practice over time) with mixed qualitative and quantitative methods with interventionists and intervention recipients. Findings from this study will set the stage for a future large-scale hybrid effectiveness-implementation trial. Ultimately, this work has high potential to have a meaningful effect on reducing the public health crisis of opioid overdose nationally by translating efficacious interventions to practice.