Abstract:

Session/Poster Description: Previous research has demonstrated that rural areas require different approaches to public health crises than urban areas, and the opioid crisis is no exception. Although naloxone has become increasingly available in urban areas, there has been a lack of diffusion in the utilization of this life saving drug among first responders in rural areas. In 2017, the Missouri Overdose Rescue and Education (MORE) project became the first overdose education and naloxone distribution (OEND) program specifically targeted towards first responders in rural areas in Missouri. The MORE project implemented a tiered Train-the-Trainer (ToT) model to disseminate OEND curriculum based on previous studies indicating its efficacy in rural areas (Bishan, Rajapaske, Neeman, & Dawson, 2013; Zisblatt et al., 2017), and developed an online training to improve training standardization and sustainability and disseminate overdose education more broadly and efficiently. The MORE project collaborated directly with Local Public Health Agencies (LPHAs) to assist with storage and distribution of naloxone to first responder agencies within their counties. To further diffuse naloxone throughout rural communities, the MORE project is developing a leave-behind naloxone training component in which EMS workers will train and distribute naloxone to survivors, friends, and family members at the scene after an overdose event. Early outcomes are promising. 3,926 first responders have been trained, and 5,259 naloxone kits have been distributed. Trainings have increased both knowledge and positive attitudes towards overdose response and naloxone administration. Future work will focus on documenting implementation best practices and evaluating the effectiveness of the leave-behind naloxone program.

Contributors: Alex Duello, MPH; Claire Wood, PhD; Lillie Jackson, MPH; Sandra Mayen, BS; Karen Wallace