Resumen
Background Overdose education and naloxone distribution (OEND) is a vitally important evidence-based practice for addressing the ongoing opioid epidemic. During the HEALing Communities Study in Kentucky, OEND was dramatically scaled up in eight counties using a “hub with many spokes” model and multifaceted implementation strategies. This aim of this manuscript is to describe qualitative perspectives of partner organizations regarding the utility of the implementation strategies used to expand OEND. Method Twenty small-group and 24 individual qualitative interviews were conducted with staff from 44 agencies that implemented OEND through partnerships with the study team. Interviews were conducted 6–8 months after the study's Communities That HEAL intervention had ended, allowing participants the ability to reflect on their experiences. Inductive coding in NVivo 12 and thematic analysis were used to identify themes regarding agencies’ perspectives regarding the implementation strategies deployed during the study. Results In describing implementation strategies that supported their efforts to implement OEND, interview participants largely focused on strategies that provided resources, such as shipments of no-cost naloxone and overdose education tools. Flexibility in how the requisite overdose education was delivered allowed agencies to identify an educational approach that fit their workflow and addressed OEND recipients’ needs. Participants also viewed implementation facilitation and technical assistance provided by study staff as helpful in facilitating the implementation process. Conclusions These qualitative data highlight the importance of multifaceted implementation strategies in the process of scaling up EBPs in communities. Future efforts should continue to explore how implementation strategies can be optimized to meet the needs of diverse types of organizations seeking to implement OEND and other evidence-based practices that can mitigate the harms of the opioid epidemic.
| Idioma original | English |
|---|---|
| Publicación | Implementation Research and Practice |
| Volumen | 7 |
| DOI | |
| Estado | Published - ene 1 2026 |
Nota bibliográfica
Publisher Copyright:© The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Financiación
One dominant theme in these interviews was that the provision of no-cost naloxone by HCS-KY was critically important to OEND implementation. The purchase of naloxone was supported by grant funds as well as a financial contribution from the Kentucky Opioid Response Effort (KORE), which was established through the Substance Abuse and Mental Health Services Administration's State Targeted Response and State Opioid Response grants and is housed within the state's Department for Behavioral Health, Developmental and Intellectual Disabilities. To some degree, this finding about the importance of no-cost naloxone is not surprising given that prior research has pointed to funding challenges coupled with the cost of naloxone and, at times, supply chain issues as barriers to implementation in community distribution programs (; ; ). Qualitative work by found that the cost was a barrier to pharmacy-based naloxone dispensing by standing order, and similarly, qualitative interviews focused on first responder-based OEND programs also noted that funding was a key facilitator of implementation (). Nearly 88% of all partner organizations were interested in sustaining OEND by joining KORE's program that also offers no-cost naloxone through its federal funding (), pointing to the longer-term viability of this approach. The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: 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 organizations who partnered with us on this study. In addition, we wish to express our gratitude to the University of Kentucky staff who worked to support our OEND partner organizations, including Josie Watson (Naloxone Coordinator), Brent Watts (Naloxone Assistant), and the Implementation Science team who worked with partner agencies, conducted these interviews, and/or engaged in the coding process: Kathy Adams, Shaquita Andrews-Higgins, Sandi Back-Haddix, Michael Goetz, Hallie Mattingly, Jeanie Hartman, Rachel Hoover, Latasha Jones, Ryan Morris, Melissa Reedy-Johnson, and Courtney Rogers. The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: 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.
| Financiadores | Número del financiador |
|---|---|
| Kentucky Opioid Response Effort | |
| Substance Abuse and Mental Health Services Administration | |
| National Institutes of Health (NIH) | NCT04111939, UM1DA049406 |
| Department for Public Health, Department for Behavioral Health | |
| NIH | NCT04111939, UM1DA049406 |
ODS de las Naciones Unidas
Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible
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Good health and well being
ASJC Scopus subject areas
- Neurology
- Psychiatry and Mental health
- Biological Psychiatry
Huella
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