Rapid jail-based implementation of overdose education and naloxone distribution in response to the COVID-19 pandemic

Carrie B. Oser; Margaret McGladrey; Marisa Booty; Hilary Surratt; Hannah K. Knudsen; Patricia R. Freeman; Danelle Stevens-Watkins; Monica F. Roberts; Michele Staton; April Young; Emma Draper; Sharon L. Walsh

doi:10.1186/s40352-024-00283-8

Rapid jail-based implementation of overdose education and naloxone distribution in response to the COVID-19 pandemic

Carrie B. Oser, Margaret McGladrey, Marisa Booty, Hilary Surratt, Hannah K. Knudsen, Patricia R. Freeman, Danelle Stevens-Watkins, Monica F. Roberts, Michele Staton, April Young, Emma Draper, Sharon L. Walsh

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Background: People incarcerated in jails are highly impacted by the opioid epidemic, and overdose education and naloxone distribution (OEND) is an effective strategy to reduce opioid overdose deaths. This study examines barriers and facilitators of fast-track OEND implementation within the jails in the Wave 1 Kentucky counties of the HEALing Communities Study during the COVID-19 pandemic. Methods: Meeting minutes with jail stakeholders were qualitatively coded using the Practical, Robust Implementation and Sustainability Model (PRISM) as the coding framework. The analysis highlighted the top barriers and facilitators to fast-track OEND implementation within the PRISM framework. Results: Space and staffing shortages related to the COVID-19 pandemic, disruptions in interorganizational programming from pandemic-related service suspensions, and a lack of technological solutions (e.g., reliable Internet access) for socially distanced delivery were the top barriers to fast-track OEND implementation. In addition, there were limitations on non-jail staff access to jails during COVID-19. Top facilitators included jail leadership support, the option to prioritize high-risk groups, and the incorporation of OEND processes into existing communications and management software. While the COVID-19 pandemic strained jail infrastructure, jail and partner agency collaboration led to creative implementation strategies for the successful integration of OEND into jail operations. Urban jails were more likely than rural jails to be early adopters of OEND during the public health emergency. Conclusions: Understanding the barriers to and facilitators of OEND within jails will improve implementation efforts seeking to curb opioid overdose deaths. Jail leadership support and interorganizational efforts were key facilitators to implementation; therefore, it is recommended to increase buy-in with multiple agencies to promote success. Challenges brought on by COVID-19 have resulted in a need for innovative solutions for implementation. Clinical trial information: ClinicalTrials.gov, NCT04111939, Submitted 30 September 2019, https://clinicaltrials.gov/study/NCT04111939?titles=HEALing%20Communities%20Study&rank=1.

Original language	English
Article number	27
Journal	Health and Justice
Volume	12
Issue number	1
DOIs	https://doi.org/10.1186/s40352-024-00283-8
State	Published - Dec 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Funding

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) Initiative under award number UM1DA049406 (ClinicalTrials.gov Identifier: NCT04111939). The content of this manuscript 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. We wish to acknowledge the participation of the HEALing Communities Study communities, community coalitions, and jails who partnered with us on this study. In addition, we wish to express gratitude to the staff of the Naloxone Hub, which included Josie Watson (Naloxone Coordinator), Brent Watts (Naloxone Assistant), and the team of Implementation Facilitators who worked with Wave 1 OEND jails: Shaquita Andrews-Higgins, Sandi Back-Haddix, Michael Goetz, and Melissa Reedy-Johnson. We also acknowledge the contribution of Dr. Michelle Lofwall, the HCS-KY addiction psychiatrist who reviewed/signed the OEND standing order agreements with the partner organizations.

Funders	Funder number
Substance Abuse and Mental Health Services Administration
Melissa Reedy-Johnson
National Institutes of Health (NIH)	NCT04111939, UM1DA049406

Keywords

COVID-19 pandemic
Implementation science
Jails
Naloxone
Practical, robust implementation and sustainability model (PRISM)

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Law

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s40352-024-00283-8

Cite this

Oser, C. B., McGladrey, M., Booty, M., Surratt, H., Knudsen, H. K., Freeman, P. R., Stevens-Watkins, D., Roberts, M. F., Staton, M., Young, A., Draper, E., & Walsh, S. L. (2024). Rapid jail-based implementation of overdose education and naloxone distribution in response to the COVID-19 pandemic. Health and Justice, 12(1), Article 27. https://doi.org/10.1186/s40352-024-00283-8

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abstract = "Background: People incarcerated in jails are highly impacted by the opioid epidemic, and overdose education and naloxone distribution (OEND) is an effective strategy to reduce opioid overdose deaths. This study examines barriers and facilitators of fast-track OEND implementation within the jails in the Wave 1 Kentucky counties of the HEALing Communities Study during the COVID-19 pandemic. Methods: Meeting minutes with jail stakeholders were qualitatively coded using the Practical, Robust Implementation and Sustainability Model (PRISM) as the coding framework. The analysis highlighted the top barriers and facilitators to fast-track OEND implementation within the PRISM framework. Results: Space and staffing shortages related to the COVID-19 pandemic, disruptions in interorganizational programming from pandemic-related service suspensions, and a lack of technological solutions (e.g., reliable Internet access) for socially distanced delivery were the top barriers to fast-track OEND implementation. In addition, there were limitations on non-jail staff access to jails during COVID-19. Top facilitators included jail leadership support, the option to prioritize high-risk groups, and the incorporation of OEND processes into existing communications and management software. While the COVID-19 pandemic strained jail infrastructure, jail and partner agency collaboration led to creative implementation strategies for the successful integration of OEND into jail operations. Urban jails were more likely than rural jails to be early adopters of OEND during the public health emergency. Conclusions: Understanding the barriers to and facilitators of OEND within jails will improve implementation efforts seeking to curb opioid overdose deaths. Jail leadership support and interorganizational efforts were key facilitators to implementation; therefore, it is recommended to increase buy-in with multiple agencies to promote success. Challenges brought on by COVID-19 have resulted in a need for innovative solutions for implementation. Clinical trial information: ClinicalTrials.gov, NCT04111939, Submitted 30 September 2019, https://clinicaltrials.gov/study/NCT04111939?titles=HEALing\%20Communities\%20Study\&rank=1.",

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AU - Knudsen, Hannah K.

AU - Freeman, Patricia R.

AU - Stevens-Watkins, Danelle

AU - Roberts, Monica F.

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AU - Young, April

AU - Draper, Emma

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N2 - Background: People incarcerated in jails are highly impacted by the opioid epidemic, and overdose education and naloxone distribution (OEND) is an effective strategy to reduce opioid overdose deaths. This study examines barriers and facilitators of fast-track OEND implementation within the jails in the Wave 1 Kentucky counties of the HEALing Communities Study during the COVID-19 pandemic. Methods: Meeting minutes with jail stakeholders were qualitatively coded using the Practical, Robust Implementation and Sustainability Model (PRISM) as the coding framework. The analysis highlighted the top barriers and facilitators to fast-track OEND implementation within the PRISM framework. Results: Space and staffing shortages related to the COVID-19 pandemic, disruptions in interorganizational programming from pandemic-related service suspensions, and a lack of technological solutions (e.g., reliable Internet access) for socially distanced delivery were the top barriers to fast-track OEND implementation. In addition, there were limitations on non-jail staff access to jails during COVID-19. Top facilitators included jail leadership support, the option to prioritize high-risk groups, and the incorporation of OEND processes into existing communications and management software. While the COVID-19 pandemic strained jail infrastructure, jail and partner agency collaboration led to creative implementation strategies for the successful integration of OEND into jail operations. Urban jails were more likely than rural jails to be early adopters of OEND during the public health emergency. Conclusions: Understanding the barriers to and facilitators of OEND within jails will improve implementation efforts seeking to curb opioid overdose deaths. Jail leadership support and interorganizational efforts were key facilitators to implementation; therefore, it is recommended to increase buy-in with multiple agencies to promote success. Challenges brought on by COVID-19 have resulted in a need for innovative solutions for implementation. Clinical trial information: ClinicalTrials.gov, NCT04111939, Submitted 30 September 2019, https://clinicaltrials.gov/study/NCT04111939?titles=HEALing%20Communities%20Study&rank=1.

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KW - Practical, robust implementation and sustainability model (PRISM)

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Rapid jail-based implementation of overdose education and naloxone distribution in response to the COVID-19 pandemic

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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