Randomized Controlled Trial

. 2024 Aug:185:108034.

doi: 10.1016/j.ypmed.2024.108034. Epub 2024 Jun 8.

Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study

Hannah K Knudsen¹, Daniel M Walker², Nicole Mack³, Elizabeth N Kinnard⁴, Timothy R Huerta⁵, LaShawn Glasgow⁶, Louisa Gilbert⁷, Bryan R Garner⁸, Anindita Dasgupta⁹, Redonna Chandler¹⁰, Sharon L Walsh¹¹, Yjuliana Tin¹², Sylvia Tan¹³, Joel Sprunger¹⁴, Linda Sprague-Martinez¹⁵, Pamela Salsberry¹⁶, Merielle Saucier¹⁷, Maria Rudorf¹⁸, Sandra Rodriguez¹⁹, Carrie B Oser²⁰, Emmanuel Oga²¹, Julie Nakayima²², Beth S Linas²³, R Craig Lefebvre²⁴, Sarah Kosakowski²⁵, Rachel E Katz²⁶, Timothy Hunt²⁷, Ari Holman²⁸, JaNae Holloway²⁹, Dawn Goddard-Eckrich³⁰, Naleef Fareed³¹, Mia Christopher³², Alison Aldrich³³, Joella W Adams³⁴, Mari-Lynn Drainoni³⁵

Affiliations

¹ Department of Family and Community Medicine, Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: hkknud2@uky.edu.
² Department of Family and Community Medicine, Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: daniel.walker@osumc.edu.
³ Center for Official Statistics, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: nmack@rti.org.
⁴ Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: elizabeth.kinnard@bmc.org.
⁵ CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, Department of Family and Community Medicine, Department of Biomedical Informatics, The Ohio State University, 540 W. Spring St., Columbus, OH 43215, USA. Electronic address: timothy.huerta@osumc.edu.
⁶ Center for Program and Policy Evaluation to Advance Community Health, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: lglasgow@rti.org.
⁷ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: lg123@columbia.edu.
⁸ Department of Internal Medicine, The Ohio State University, 2050 Kenny Road Columbus, OH 43221, USA. Electronic address: bryan.garner@osumc.edu.
⁹ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: ad3341@columbia.edu.
¹⁰ National Institute on Drug Abuse, 301 North Stonestreet Ave, Bethesda, MD 20892, USA. Electronic address: redonna.chandler@nih.gov.
¹¹ Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 202, Lexington, KY 40508, USA. Electronic address: sharon.walsh@uky.edu.
¹² General Internal Medicine, University of Colorado School of Medicine, 12631 E 17th Ave Aurora, CO 80045, USA. Electronic address: yjuliana.tin@cuanschutz.edu.
¹³ Center for Clinical Research, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: stan@rti.org.
¹⁴ Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Ave, Suite 204, Cincinnati, OH 45229, USA. Electronic address: joel.sprunger@uc.edu.
¹⁵ School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215, USA. Electronic address: lsmarti@bu.edu.
¹⁶ College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA. Electronic address: salsberry.1@osu.edu.
¹⁷ Clinical Addiction Research and Evaluation Unit, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: MerielleSaucier@gmail.com.
¹⁸ General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: maria.rudorf@bmc.org.
¹⁹ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: sr3717@columbia.edu.
²⁰ Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506, USA. Electronic address: carrie.oser@uky.edu.
²¹ Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: eoga@rti.org.
²² Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA. Electronic address: julie.nakayima@uky.edu.
²³ Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: blinas@rti.org.
²⁴ Communication Practice Area, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: clefebvre@rti.org.
²⁵ General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: sarah.kosakowski@bmc.org.
²⁶ Addiction Services, Clinical & Support Options, 8 Atwood Dr Suite 201, Northampton, MA 01060, USA. Electronic address: rachelkatznp@gmail.com.
²⁷ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: th2258@columbia.edu.
²⁸ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: ah3735@columbia.edu.
²⁹ Center for Clinical Research, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: jlholloway@rti.org.
³⁰ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: dg2121@columbia.edu.
³¹ Biomedical Informatics, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA. Electronic address: Naleef.fareed@osumc.edu.
³² Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: mchristopher@rti.org.
³³ CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, The Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: alison.aldrich@osumc.edu.
³⁴ Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: jadams@rti.org.
³⁵ Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine/Boston Medical Center, and Department of Health Law, Policy and Management, Boston University School of Public Health, 801 Massachusetts Avenue, Room 2014, Boston, MA, 02118, USA. Electronic address: drainoni@bu.edu.

PMID: 38857770
PMCID: PMC11269010
DOI: 10.1016/j.ypmed.2024.108034

Randomized Controlled Trial

Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study

Hannah K Knudsen et al. Prev Med. 2024 Aug.

. 2024 Aug:185:108034.

doi: 10.1016/j.ypmed.2024.108034. Epub 2024 Jun 8.

Authors

Affiliations

¹ Department of Family and Community Medicine, Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: hkknud2@uky.edu.
² Department of Family and Community Medicine, Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: daniel.walker@osumc.edu.
³ Center for Official Statistics, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: nmack@rti.org.
⁴ Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: elizabeth.kinnard@bmc.org.
⁵ CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, Department of Family and Community Medicine, Department of Biomedical Informatics, The Ohio State University, 540 W. Spring St., Columbus, OH 43215, USA. Electronic address: timothy.huerta@osumc.edu.
⁶ Center for Program and Policy Evaluation to Advance Community Health, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: lglasgow@rti.org.
⁷ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: lg123@columbia.edu.
⁸ Department of Internal Medicine, The Ohio State University, 2050 Kenny Road Columbus, OH 43221, USA. Electronic address: bryan.garner@osumc.edu.
⁹ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: ad3341@columbia.edu.
¹⁰ National Institute on Drug Abuse, 301 North Stonestreet Ave, Bethesda, MD 20892, USA. Electronic address: redonna.chandler@nih.gov.
¹¹ Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 202, Lexington, KY 40508, USA. Electronic address: sharon.walsh@uky.edu.
¹² General Internal Medicine, University of Colorado School of Medicine, 12631 E 17th Ave Aurora, CO 80045, USA. Electronic address: yjuliana.tin@cuanschutz.edu.
¹³ Center for Clinical Research, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: stan@rti.org.
¹⁴ Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Ave, Suite 204, Cincinnati, OH 45229, USA. Electronic address: joel.sprunger@uc.edu.
¹⁵ School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215, USA. Electronic address: lsmarti@bu.edu.
¹⁶ College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA. Electronic address: salsberry.1@osu.edu.
¹⁷ Clinical Addiction Research and Evaluation Unit, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: MerielleSaucier@gmail.com.
¹⁸ General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: maria.rudorf@bmc.org.
¹⁹ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: sr3717@columbia.edu.
²⁰ Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506, USA. Electronic address: carrie.oser@uky.edu.
²¹ Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: eoga@rti.org.
²² Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA. Electronic address: julie.nakayima@uky.edu.
²³ Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: blinas@rti.org.
²⁴ Communication Practice Area, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: clefebvre@rti.org.
²⁵ General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA. Electronic address: sarah.kosakowski@bmc.org.
²⁶ Addiction Services, Clinical & Support Options, 8 Atwood Dr Suite 201, Northampton, MA 01060, USA. Electronic address: rachelkatznp@gmail.com.
²⁷ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: th2258@columbia.edu.
²⁸ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: ah3735@columbia.edu.
²⁹ Center for Clinical Research, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: jlholloway@rti.org.
³⁰ School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027, USA. Electronic address: dg2121@columbia.edu.
³¹ Biomedical Informatics, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA. Electronic address: Naleef.fareed@osumc.edu.
³² Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: mchristopher@rti.org.
³³ CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, The Ohio State University, Suite 5000, 700 Ackerman Rd, Columbus, OH 43202, USA. Electronic address: alison.aldrich@osumc.edu.
³⁴ Center for Public Health Surveillance and Technology, RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. Electronic address: jadams@rti.org.
³⁵ Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine/Boston Medical Center, and Department of Health Law, Policy and Management, Boston University School of Public Health, 801 Massachusetts Avenue, Room 2014, Boston, MA, 02118, USA. Electronic address: drainoni@bu.edu.

PMID: 38857770
PMCID: PMC11269010
DOI: 10.1016/j.ypmed.2024.108034

Erratum in

Corrigendum to "Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study" [Preventive Medicine Volume 185 (2024) 108034].
Knudsen HK, Walker DM, Mack N, Kinnard EN, Huerta TR, Glasgow L, Gilbert L, Garner BR, Dasgupta A, Chandler R, Walsh SL, Tin Y, Tan S, Sprunger J, Martinez LS, Salsberry P, Saucier M, Rudorf M, Rodriguez S, Oser CB, Oga E, Nakayima J, Linas BS, Lefebvre RC, Kosakowski S, Katz RE, Hunt T, Holman A, Holloway J, Goddard-Eckrich D, Fareed N, Christopher M, Aldrich A, Adams JW, Drainoni ML. Knudsen HK, et al. Prev Med. 2025 Oct;199:108383. doi: 10.1016/j.ypmed.2025.108383. Epub 2025 Aug 7. Prev Med. 2025. PMID: 40781038 No abstract available.

Abstract

Background: Scaling up overdose education and naloxone distribution (OEND) and medications for opioid use disorder (MOUD) is needed to reduce opioid overdose deaths, but barriers are pervasive. This study examines whether the Communities That HEAL (CTH) intervention reduced perceived barriers to expanding OEND and MOUD in healthcare/behavioral health, criminal-legal, and other/non-traditional venues.

Methods: The HEALing (Helping End Addiction Long-Term®) Communities Study is a parallel, wait-list, cluster randomized trial testing the CTH intervention in 67 communities in the United States. Surveys administered to coalition members and key stakeholders measured the magnitude of perceived barriers to scaling up OEND and MOUD in November 2019-January 2020, May-June 2021, and May-June 2022. Multilevel linear mixed models compared Wave 1 (intervention) and Wave 2 (wait-list control) respondents. Interactions by rural/urban status and research site were tested.

Results: Wave 1 respondents reported significantly greater reductions in mean scores for three outcomes: perceived barriers to scaling up OEND in Healthcare/Behavioral Health Venues (-0.26, 95% confidence interval, CI: -0.48, -0.05, p = 0.015), OEND in Other/Non-traditional Venues (-0.53, 95% CI: - 0.84, -0.22, p = 0.001) and MOUD in Other/Non-traditional Venues (-0.34, 95% CI: -0.62, -0.05, p = 0.020). There were significant interactions by research site for perceived barriers to scaling up OEND and MOUD in Criminal-Legal Venues. There were no significant interactions by rural/urban status.

Discussion: The CTH Intervention reduced perceived barriers to scaling up OEND and MOUD in certain venues, with no difference in effectiveness between rural and urban communities. More research is needed to understand facilitators and barriers in different venues.

Keywords: Community engagement; Implementation science; Medication for opioid use disorder; Naloxone; Opioid epidemic; Opioid overdose; Overdose prevention.

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Conflict of interest statement

Declaration of competing interest This research was supported by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration through the NIH HEAL (Helping to End Addiction Long-term(T)(M)) Initiative under award numbers UM1DA049394, UM1DA049406, UM1DA049412, UM1DA049415, UM1DA049417 (ClinicalTrials.gov Identifier: NCT04111939). Dr. Chandler was substantially involved in UM1DA049394, UM1DA049406, UM1DA049412, UM1DA049415, and UM1DA049417, consistent with her role as Scientific Officer. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration or the NIH HEAL Initiative®. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported int his paper.

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Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study

Affiliations

Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

References

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Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical