Community coalition and key stakeholder perceptions of the community opioid epidemic before an intensive community-level intervention

Mari Lynn Drainoni, Hannah K. Knudsen, Kathy Adams, Shaquita A. Andrews-Higgins, Vanessa Auritt, Sandi Back, Laura K. Barkowski, Evan J. Batty, Melika R. Behrooz, Sydney Bell, Sadie Chen, Mia Cara Christopher, Nicolette Coovert, Erika L. Crable, Anindita Dasgupta, Michael Goetz, Dawn Goddard-Eckrich, Jeanie L. Hartman, Holly Heffer, Pulwasha IftikharLatasha Jones, Samantha Lang, Karsten Lunze, Anna Martin, Tara McCrimmon, Melissa K. Reedy-Johnson, Carter Roeber, Ariel L. Scalise, Cynthia J. Sieck, Daniel M. Walker, Galya Walt, Jennifer D. Wood, Priscilla Zito, Ann Scheck McAlearney

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Introduction: Opioid overdoses are a major public health emergency in the United States. Despite effective treatments that can save lives, access to and utilization of such treatments are limited. Community context plays an important role in addressing treatment barriers and increasing access. The HEALing Communities Study (HCS) is a multisite community-level cluster-randomized trial that will study implementation and outcomes of a community coalition-based intervention (Communities that HEAL [CTH]) that implements evidence-based practices (EBPs) to reduce opioid overdose deaths in four states. To examine contextual factors critical to understanding implementation, we assessed the perspectives of community members about their communities, current substance use–related services, and other important issues that could impact intervention implementation. Methods: Researchers conducted 382 semi-structured qualitative interviews in the HCS communities. Interviews were audio-recorded and transcribed; researchers subsequently analyzed data using directed content analysis based on the constructs of the RE-AIM/PRISM implementation science framework to identify key themes within the external community context. Results: Despite the diversity in states and communities, four similar themes related to the external community context emerged across communities: These themes included the importance of understanding: 1) community risk perceptions, 2) levels of stigma, 3) the health services environment and the availability of substance use services, and 4) funding for substance use services. Conclusion: Understanding and addressing the external community context in which the CTH intervention and EBPs are implemented are crucial for successful health services-related and community engaged interventions. While implementing EBPs is a challenging undertaking, doing so will help us to understand if and how a community-based intervention can successfully reduce opioid overdose deaths and influence both community beliefs and the community treatment landscape.

Original languageEnglish
Article number108731
JournalJournal of Substance Abuse Treatment
StatePublished - Jul 2022

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Inc.


  • Community-engaged research
  • Evidence-based practices
  • Opioid use disorder
  • Qualitative research

ASJC Scopus subject areas

  • Psychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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