scholarly journals Multi-informant Implementation and Intervention Outcomes of Opioid Overdose Education and Naloxone Distribution in New York City

2021 ◽  
Vol 1 (3) ◽  
pp. 209-222
Author(s):  
Laura Brandt ◽  
Takuya Yanagida ◽  
Aimee N. C. Campbell ◽  
Jermaine D. Jones ◽  
Marie-Therese Schultes ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Public Health Intervention ◽  
Stepwise Multiple Regression ◽  
Opioid Overdose ◽  
Multiple Perspectives ◽  
Independent Observer ◽  
Implementation Outcomes ◽  
Knowledge And Attitude

AbstractOverdose Education and Naloxone Distribution (OEND) is an effective public health intervention to reduce opioid overdose fatalities (McDonald and Strang, Addiction 111:1177–1187, 2016). However, we know little about OEND implementation outcomes (i.e., indicators of implementation success), specifically the fidelity of training delivery, and how these may relate to intervention outcomes (i.e., indicators of the success or effectiveness of an intervention), such as overdose knowledge and attitudes. This study evaluated 16 OEND trainings conducted at different Opioid Overdose Prevention Programs in New York City. Trainees (N = 75) completed the Opioid Overdose Knowledge and Attitude Scales before and after training (intervention outcomes). Implementation outcomes were fidelity (competence and adherence of the trainer, N = 10; modified Fidelity Checklist) and acceptability of OEND (Acceptability of Intervention Measure), assessed from multiple perspectives (trainees, trainers, and an independent observer). Trainees’ overdose knowledge, t(71) = − 8.12, p < 0.001, 95% CI [− 6.54, − 3.96], and attitudes, t(65) = − 6.85, p < 0.001, 95% CI [− 0.59, − 0.33], improved significantly from pre- to post-training. Stepwise multiple regression models indicated that adherence of the trainer rated from the observer perspective added significantly to the prediction of changes in overdose knowledge, F(1, 67) = 9.81, p = 0.003, and explained 13% of the variance in outcome. However, fidelity measures from the perspective of trainees or trainers and acceptability of OEND were not associated with changes in trainees’ overdose knowledge or attitudes. OEND implementation outcomes and their relationship with intervention outcomes differed depending on the role of the fidelity rater in relation to the intervention. Specifically, our findings indicate that fidelity should be measured from an independent perspective (i.e., an individual who is experienced with fidelity rating but not directly involved in the intervention).

Unintentional opioid overdose deaths in New York City, 2005–2010: A place-based approach to reduce risk

2014 ◽  
Vol 25 (3) ◽  
pp. 569-574 ◽  
Author(s):  
Anne Siegler ◽  
Ellenie Tuazon ◽  
Daniella Bradley O’Brien ◽  
Denise Paone
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Opioid Overdose ◽  
Reduce Risk ◽  
Overdose Deaths

scholarly journals Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study

10.2196/22411 ◽  
2020 ◽  
Vol 4 (12) ◽  
pp. e22411
Author(s):  
Alex S Bennett ◽  
Robert Freeman ◽  
Don C Des Jarlais ◽  
Ian David Aronson
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
York City ◽  
Shared Responsibility ◽  
Opioid Antagonist ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Negative Consequences ◽  
Qualitative Interview Study

Background Many people use opioids and are at risk of overdose. Naloxone is an opioid antagonist used to counter the effects of opioid overdose. There is an increased availability of naloxone in New York City; however, many who use opioids decline no-cost naloxone even when offered. Others may have the medication but opt not to carry it and report that they would be reluctant to administer it if they were to witness an overdose. Objective We aim to better understand why people who use opioids may be reluctant to accept, carry, and administer naloxone, and to inform the development of messaging content that addresses barriers to its acceptance and use. Methods We conducted formative qualitative interviews with 20 people who use opioids who are 18 years and older in New York City. Participants were recruited via key informants and chain referral. Results Participants cited 4 main barriers that may impede rates of naloxone acceptance, possession, and use: (1) stigma related to substance use, (2) indifference toward overdose, (3) fear of negative consequences of carrying naloxone, and (4) fear of misrecognizing the need for naloxone. Participants also offered suggestions about messaging content to tackle the identified barriers, including messages designed to normalize naloxone possession and use, encourage shared responsibility for community health, and elicit empathy for people who use drugs. Taken together, participants’ narratives hold implications for the following potential messaging content: (1) naloxone is short-acting, and withdrawal sickness does not have to be long-lasting; (2) it is critical to accurately identify an opioid-involved overdose; (3) anyone can overdose; (4) naloxone cannot do harm; and (5) the prompt administration of the medication can help ensure that someone can enjoy another day. Finally, participants suggested that messaging should also debunk myths and stereotypes about people who use drugs more generally; people who use opioids who reverse overdoses should be framed as lay public health advocates and not just “others” to be managed with stigmatizing practices and language. Conclusions It must be made a public health priority to get naloxone to people who use opioids who are best positioned to reverse an overdose, and to increase the likelihood that they will carry naloxone and use it when needed. Developing, tailoring, and deploying messages to address stigma, indifference toward overdose, fear and trepidation about reversing an overdose, and fear of police involvement may help alleviate fears among some people who are reluctant to obtain naloxone and use the medication on someone in an overdose situation.

scholarly journals A behavioral typology of opioid overdose risk behaviors among recent veterans in New York City

PLoS ONE ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. e0179054 ◽  
Author(s):  
Alex S. Bennett ◽  
Andrew Golub ◽  
Luther Elliott
Keyword(s):  
New York ◽  
New York City ◽  
Risk Behaviors ◽  
York City ◽  
Opioid Overdose

scholarly journals Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study (Preprint)

2020 ◽  
Author(s):  
Alex S Bennett ◽  
Robert Freeman ◽  
Don C Des Jarlais ◽  
Ian David Aronson
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
York City ◽  
Shared Responsibility ◽  
Opioid Antagonist ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Negative Consequences ◽  
Qualitative Interview Study

BACKGROUND Many people use opioids and are at risk of overdose. Naloxone is an opioid antagonist used to counter the effects of opioid overdose. There is an increased availability of naloxone in New York City; however, many who use opioids decline no-cost naloxone even when offered. Others may have the medication but opt not to carry it and report that they would be reluctant to administer it if they were to witness an overdose. OBJECTIVE We aim to better understand why people who use opioids may be reluctant to accept, carry, and administer naloxone, and to inform the development of messaging content that addresses barriers to its acceptance and use. METHODS We conducted formative qualitative interviews with 20 people who use opioids who are 18 years and older in New York City. Participants were recruited via key informants and chain referral. RESULTS Participants cited 4 main barriers that may impede rates of naloxone acceptance, possession, and use: (1) stigma related to substance use, (2) indifference toward overdose, (3) fear of negative consequences of carrying naloxone, and (4) fear of misrecognizing the need for naloxone. Participants also offered suggestions about messaging content to tackle the identified barriers, including messages designed to normalize naloxone possession and use, encourage shared responsibility for community health, and elicit empathy for people who use drugs. Taken together, participants’ narratives hold implications for the following potential messaging content: (1) naloxone is short-acting, and withdrawal sickness does not have to be long-lasting; (2) it is critical to accurately identify an opioid-involved overdose; (3) anyone can overdose; (4) naloxone cannot do harm; and (5) the prompt administration of the medication can help ensure that someone can enjoy another day. Finally, participants suggested that messaging should also debunk myths and stereotypes about people who use drugs more generally; people who use opioids who reverse overdoses should be framed as lay public health advocates and not just “others” to be managed with stigmatizing practices and language. CONCLUSIONS It must be made a public health priority to get naloxone to people who use opioids who are best positioned to reverse an overdose, and to increase the likelihood that they will carry naloxone and use it when needed. Developing, tailoring, and deploying messages to address stigma, indifference toward overdose, fear and trepidation about reversing an overdose, and fear of police involvement may help alleviate fears among some people who are reluctant to obtain naloxone and use the medication on someone in an overdose situation.

scholarly journals Human Papillomavirus Knowledge and Attitude among Homeless Women of New York City Shelters

2015 ◽  
Vol 25 (6) ◽  
pp. 727-731
Author(s):  
Ramin Asgary ◽  
Analena Alcabes ◽  
Rebecca Feldman ◽  
Victoria Garland ◽  
Ramesh Naderi ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Human Papillomavirus ◽  
York City ◽  
Homeless Women ◽  
Knowledge And Attitude

scholarly journals A qualitative study of repeat naloxone administrations during opioid overdose intervention by people who use opioids in New York City.

2021 ◽  
Vol 87 ◽  
pp. 102968
Author(s):  
Stephen Parkin ◽  
Joanne Neale ◽  
Caral Brown ◽  
Jermaine D. Jones ◽  
Laura Brandt ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Qualitative Study ◽  
York City ◽  
Opioid Overdose

Increasing Access to Buprenorphine in Safety-Net Primary Care Clinics: The New York City Buprenorphine Nurse Care Manager Initiative

2020 ◽  
pp. e1-e4
Author(s):  
Marissa Kaplan-Dobbs ◽  
Jessica A. Kattan ◽  
Ellenie Tuazon ◽  
Christian Jimenez ◽  
Sabina Saleh ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
New York City ◽  
York City ◽  
Underserved Populations ◽  
Safety Net ◽  
Opioid Overdose ◽  
Care Manager ◽  
Primary Care Clinics ◽  
Nurse Care

The Buprenorphine Nurse Care Manager Initiative (BNCMI) sought to increase access to opioid use disorder treatment in underserved New York City populations by expanding buprenorphine treatment capacity in safety-net primary care clinics. During 2016 to 2020, BNCMI added 116 new buprenorphine providers across 27 BNCMI clinics, and 1212 patients were enrolled; most patients identified as Latinx or Hispanic and were Medicaid beneficiaries. BNCMI increased access to buprenorphine, reached underserved populations, and is part of the New York City Health Department’s multipronged approach to reducing opioid overdose deaths. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e4. doi: https://doi.org/10.2105/AJPH.2020.306000 )

scholarly journals Racial Differences in Opioid Overdose Deaths in New York City, 2017

2019 ◽  
Vol 179 (4) ◽  
pp. 576 ◽  
Author(s):  
Bennett Allen ◽  
Michelle L. Nolan ◽  
Hillary V. Kunins ◽  
Denise Paone
Keyword(s):  
New York ◽  
New York City ◽  
Racial Differences ◽  
York City ◽  
Opioid Overdose ◽  
Overdose Deaths

scholarly journals Correlates of Hepatitis C Virus Infection in the Targeted Testing Program of the New York City Jail System

2016 ◽  
Vol 132 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Matthew J. Akiyama ◽  
Fatos Kaba ◽  
Zachary Rosner ◽  
Howard Alper ◽  
Aimee Kopolow ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
York City ◽  
Public Health Intervention ◽  
Hcv Infection ◽  
Antibody Positivity ◽  
Hcv Antibody ◽  
Hispanic White

Objective: The objective of this study was to understand predictors of hepatitis C virus (HCV) antibody positivity in a large urban jail system in New York City. Methods: We examined demographic characteristics, risk behaviors, and HCV antibody prevalence among 10 790 jail inmates aged 16 to 86 who were screened from June 13, 2013, to June 13, 2014, based on birth cohort or conventional high-risk criteria. We used logistic regression analysis to determine predictors of HCV antibody positivity. Results: Of the 10 790 inmates screened, 2221 (20.6%) were HCV antibody positive. In the multivariate analysis, HCV antibody positivity was associated most strongly with injection drug use (IDU; adjusted odds ratio [aOR] = 35.0; 95% confidence interval [CI], 28.5-43.0). Women were more likely than men to be infected with HCV (aOR = 1.3; 95% CI, 1.1-1.5). Compared with non-Hispanic black people, Hispanic (aOR = 2.1; 95% CI, 1.8-2.4) and non-Hispanic white (aOR = 1.7; 95% CI, 1.5-2.1) people were more likely to be infected with HCV. Non-IDU, recidivism, HIV infection, homelessness, mental illness, and lower education level were all significantly associated with HCV infection. The prevalence rate of HCV infection among a subset of inmates born after 1965 who denied IDU and were not infected with HIV was 5.6% (198 of 3529). Predictors of HCV infection among this group included non-IDU as well as being non-Hispanic white, Hispanic, recidivist, and homeless. Conclusion: These data reveal differences in HCV infection by sex, race/ethnicity, and socioeconomics in a large jail population, suggesting that a focused public health intervention is required and that universal screening may be warranted. Further sensitivity and cost-benefit analyses are needed to make this determination.

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