Impact of the take ACTION Train-the-Trainer model of opioid overdose education with naloxone distribution– who benefits?

Abstract

Background

Overdose education with naloxone distribution (OEND) is a key national strategy to reduce morbidity and mortality related to opioid overdoses. Train-the-trainer model has been one method to increase the pool of trainers to facilitate greater dissemination of OEND. This exploratory study seeks to (1) evaluate participant’s change in knowledge and confidence, (2) examine if pre- and post-training test outcomes differed by occupation and level of experience, and (3) determine if train-the-trainer participants trained others 6 months later. Methods: Fifteen train-the-trainer sessions were delivered to staff from community organizations who served high-risk clients in four counties whose overdose death rates ranged from 11.2 to 32.8 per 100,000. Participants were administered pre- and post-training tests from September 2017 to December 2018. A follow-up survey was conducted 6 months post-training to evaluate outcomes. Final paired pre-and post-training surveys of 109 participants were used for analysis. Paired sample t-tests were used to evaluate changes in the knowledge and confidence in teaching others. One-way ANOVA compared the change scores across groups with different demographic or experiential characteristics. Kruskal-Wallis Test was used for Likert scales. Results: The one and one-half hour train-the-trainer curriculum increased participants’ knowledge and confidence to teach others (p < .001). This was particularly true for participants who had no prior experience compared to those who had some experience with naloxone (p = .0003). Changes in confidence to teach others significantly improved among demographic subgroups of participants. At 6 months after completing the train-the-trainer curriculum, 14 participants had trained 243 new trainees. Conclusions: Implementing a train-the-trainer model for OEND increases knowledge and participants’ confidence to teach others. This demonstrates the important potential of the train-the-trainer model to respond to the growing opioid overdose epidemic.

Keywords:

• Opioid overdose education
• naloxone distribution
• Train-the-Trainer

Acknowledgements

Recognize people who contributed meaningfully to the article but did not qualify as coauthors.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

Dr. Dahlem contributed to research conception and design, collection of data, interpretation of the result, writing, and revisions. Ms. Scalera contributed to research conception design, collection of data, funding requisition, writing, and revision. Ms. Chen contributed to data analysis, interpretation of results, writing, and revision. Dr. McCabe contributed to interpretation of results, writing, and revisions. Dr. Boyd contributed to overall guidance of research design, interpretation of results, writing, and revisions.

Additional information

Funding

Michigan Department of Health and Human Services, Office of Recovery Oriented Systems of Care, State Targeted Response and Substance Abuse Prevention Treatment Block Grant, Substance Abuse Mental Health Services Administration and was not involved in the manuscript process and submission. The development of this manuscript was partially supported by research grant R01DA031160 from the National Institute on Drug Abuse, National Institutes of Health. The National Institute on Drug Abuse, National Institutes of Health had no role in the study design, collection, analysis, or interpretation of the data, writing of the manuscript, or the decision to submit the article for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The work of the fourth author on this manuscript was supported by this grant.