Clinical trial NCT05008523: Opioids and Police Safety Study
Official title: Evaluation of an Experimental Educational Module on Opioid-related Occupational Safety to Minimize Barriers toOverdose Response Among Police Officers
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Opioid Overdose
Lead sponsor: New York University
Sponsor class: OTHER
Collaborators: name: Centers for Disease Control and Prevention
First posted: 2021-08-17
Enrollment: 333
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SINGLE_GROUP
Intervention model description: The Opioids and Police Safety Study employed a pragmatic trial design evaluated in a simultaneous embedded mixed-method approach.
Primary purpose: PREVENTION

Brief summary: Overdose deaths are currently the largest cause of accidental death in the US and opioid-related overdose deaths constitute the overwhelming majority of these deaths. Demands for a knowledge-base for effective law enforcement interventions is growing. This proposed study is designed to provide a knowledge base regarding key obstacles and facilitators of the willingness and preparedness of police to administer naloxone and related risk reduction practices and evaluate the efficacy of a web-based opioid-related occupational safety and risk reduction curriculum. Findings from this study will be applied to the development and implementation of effective interventions for police officers aimed at harmonizing law enforcement practices with public health goals.

Detailed description: This application proposes to contribute to the harmonization of law enforcement practices and public health goals to combat rising morbidity and mortality rates associated with opioid-related overdose (OD). Police departments around the U.S. are increasingly making the OD reversal drug, naloxone, available to their officers. This intervention has the potential to greatly improve emergency response after an OD. The proportion of precincts mandating that officers carry naloxone remains small, however, and barriers remain that make adoption of these first-responder programs problematic. Lawsuits from police unions contesting naloxone- related mandates and occupational safety concerns, including the potential for needle stick injuries (HIV/HCV risk) and incidental contact with fentanyl-class substances, constitute barriers, as do stigma and concerns about legal jeopardy. The study team proposes to equip police with best-practices for minimizing workplace harms related to encounters with PWUO/PWID and the legal and practical knowledge to respond confidently to an OD without fear of legal jeopardy as well as reduce health risks to PWUOs and PWIDs associated with law enforcement. More than 10,000 law enforcement officers in Pennsylvania (roughly one third of all PA officers) have already received naloxone and OD response training from GetNaloxoneNow.org (GNN), a web-based intervention. With the support of county departments of health, harm reduction agencies, law enforcement, and district attorneys, the team proposes to adapt extant interventions for police to create an online training module aimed at reducing barriers to police engagement in OD response. Using a mixed-method design, organized around a pragmatic trial design, the study will achieve the following objectives:1) Adapt an occupational risk reduction (ORR) curriculum to add to a web-based OD response and naloxone training platform (GNN); 2) Describe naloxone use patterns, OD response experiences, and attitudes related to illicit opioid use among a sample (N = 300) of police officers in PA trained via the GNN platform; 3) Evaluate the relative effectiveness of ORR + GNN, compared with GNN-only, with respect to the following outcomes: a) rates of carrying naloxone while on/off-duty; b) rates of OD response in which naloxone is/isn't administered; c) numbers of referrals to treatment; d) numbers of syringes confiscated; and e) rates of information sharing with OD survivors and others. Mediators and moderators of efficacy will also be analyzed. 4) Document the range of psychosocial mechanisms underlying participant OD response engagement post-intervention. This study aims to remove barriers to life-saving police engagement with PWUO/PWID by focusing both on the safety of law enforcement and evidence-based and best-practices for working with persons at risk of an opioid OD. The study also will provide empirical evaluation of the diffusion of naloxone-based response among law enforcement.

Eligibility criteria: Inclusion Criteria:

* Active duty Police Officer

Exclusion Criteria:

* Desk only- not active duty

Primary outcomes:
measure: Change in Naloxone Behavioral Outcomes in Policing Procedure
timeFrame: Time frame for all above items: the past 30 days at the time the survey is being administered; [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in Naloxone Behavioral Outcomes in Policing Procedure
timeFrame: Time frame for all above items: the past 30 days at the time the survey is being administered; [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in Naloxone Behavioral Outcomes in Policing Procedure
timeFrame: Time frame for all above items: the past 30 days at the time the survey is being administered; [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in Referral Behavioral Outcomes in Policing Procedure
timeFrame: Time frame: the past 30 days at the time the survey is being administered; [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in Confiscation Behavioral Outcomes in Policing Procedure
timeFrame: Time frame for all above items: the past 30 days at the time the survey is being administered; [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in Confiscation Behavioral Outcomes in Policing Procedure
timeFrame: Time frame for all above items: the past 30 days at the time the survey is being administered; [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
Secondary outcomes:
measure: Change in participant knowledge about needle stick injury and treatment
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in participant knowledge about needle stick injury and treatment
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in participant knowledge about needle stick injury and treatment
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in participant knowledge about needle stick injury and treatment
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in participant knowledge about needle stick injury and treatment
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in participant knowledge about needle stick injury and treatment
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Change in participant knowledge about needle stick injury and treatment
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Degree of participant familiarity with proper technique for dealing with contaminated injection equipment
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Degree of participant awareness of post-exposure prophylaxis (PEP) and its uses
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Degree of participant awareness of risk of fentanyl exposure and proper technique for dealing with synthetic opioids
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
Other outcomes:
measure: Degree of participant familiarity with fentanyl-class substances
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Degree of participant familiarity with best-practices related to policing PWUO and PWID who may be carrying heroin contaminated with fentanyl-class substances
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Opioid-Related OD knowledge
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Hypothesized Mediators of Intervention Efficacy: Stigma
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Potential Moderators: Demographic Variables
timeFrame: Baseline
measure: Potential Moderators: Perceived Attitudes/Expectations
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Prior instances of witnessing an opioid-related overdose
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Prior instances of working with syringes
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Prior instances responding to an overdose
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
measure: Experiences with other programs
timeFrame: [Data collected: Baseline, Post Intervention: 90 days, 180 days, 270 days, 360 days]
Locations:
city: New York
country: United States
facility: New York University
state: New York
Study officials:
References:
citation: Simmons J, Elliott L, Bennett AS, Beletsky L, Rajan S, Anders B, Dastparvardeh N. Evaluation of an Experimental Web-based Educational Module on Opioid-related Occupational Safety Among Police Officers: Protocol for a Randomized Pragmatic Trial to Minimize Barriers to Overdose Response. JMIR Res Protoc. 2022 Feb 25;11(2):e33451. doi: 10.2196/33451.