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评估一项基于网络的关于警官阿片类药物相关职业安全的实验性教育模块:一项随机实用试验的方案,以尽量减少过量用药应对的障碍。

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.

作者信息

Simmons Janie, Elliott Luther, Bennett Alex S, Beletsky Leo, Rajan Sonali, Anders Brad, Dastparvardeh Nicole

机构信息

Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States.

School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States.

出版信息

JMIR Res Protoc. 2022 Feb 25;11(2):e33451. doi: 10.2196/33451.

Abstract

BACKGROUND

As drug-related morbidity and mortality continue to surge, police officers are on the front lines of the North American overdose (OD) crisis. Drug law enforcement shapes health risks among people who use drugs (PWUD), while also impacting the occupational health and wellness of officers. Effective interventions to align law enforcement practices with public health and occupational safety goals remain underresearched.

OBJECTIVE

The Opioids and Police Safety Study (OPS) aims to shift police practices relating to PWUD. It adapts and evaluates the relative effectiveness of a curriculum that bundles content on public health promotion with occupational risk reduction (ORR) to supplement a web-based OD response and naloxone training platform (GetNaloxoneNow.org, or GNN). This novel approach has the potential to improve public health and occupational safety practices, including using naloxone to reverse ODs, referring PWUD to treatment and other supportive services, and avoiding syringe confiscation.

METHODS

This longitudinal study uses a randomized pragmatic trial design. A sample of 300 active-duty police officers from select counties in Pennsylvania, Vermont, and New Hampshire with high OD fatality rates will be randomized (n=150 each) to either the experimental arm (GNN + OPS) or the control arm (GNN + COVID-19 ORR). A pre- and posttraining survey will be administered to all 300 officers, after which they will be administered quarterly surveys for 12 months. A subsample of police officers will also be qualitatively followed in a simultaneous embedded mixed-methods approach. Research ethics approval was obtained from the New York University Institutional Review Board.

RESULTS

Results will provide an understanding of the experiences, knowledge, and perceptions of this sample of law enforcement personnel. Generalized linear models will be used to analyze differences in key behavioral outcomes between the participants in each of the 2 study arms and across multiple time points (anticipated minimum effect size to be detected, d=0.50). Findings will be disseminated widely, and the training products will be available nationally once the study is completed.

CONCLUSIONS

The OPS is the first study to longitudinally assess the impact of a web-based opioid-related ORR intervention for law enforcement in the U.S. Our randomized pragmatic clinical trial aims to remove barriers to life-saving police engagement with PWUD/people who inject drugs 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. Our simultaneous embedded mixed-methods approach will provide empirical evaluation of the diffusion of the naloxone-based response among law enforcement.

TRIAL REGISTRATION

ClinicalTrail.gov NCT05008523; https://clinicaltrials.gov/show/NCT05008523.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/33451.

摘要

背景

随着与药物相关的发病率和死亡率持续飙升,警察处于北美药物过量(OD)危机的前线。药物执法塑造了吸毒者(PWUD)的健康风险,同时也影响着警察的职业健康和福祉。使执法实践与公共卫生和职业安全目标保持一致的有效干预措施仍未得到充分研究。

目的

阿片类药物与警察安全研究(OPS)旨在改变与吸毒者相关的警察做法。它改编并评估了一门课程的相对有效性,该课程将公共卫生促进内容与职业风险降低(ORR)相结合,以补充基于网络的药物过量应对和纳洛酮培训平台(GetNaloxoneNow.org,或GNN)。这种新颖的方法有可能改善公共卫生和职业安全实践,包括使用纳洛酮逆转药物过量、将吸毒者转介至治疗和其他支持性服务,以及避免没收注射器。

方法

这项纵向研究采用随机实用试验设计。从宾夕法尼亚州、佛蒙特州和新罕布什尔州选定的药物过量死亡率高的县中抽取300名现役警察作为样本,将其随机分为两组(每组n = 150),分别进入试验组(GNN + OPS)或对照组(GNN + 新冠病毒职业风险降低)。将对所有300名警察进行培训前和培训后的调查,之后每季度进行一次为期12个月的调查。还将采用同步嵌入式混合方法对一部分警察进行定性跟踪。已获得纽约大学机构审查委员会的研究伦理批准。

结果

结果将有助于了解这一样本执法人员的经历、知识和看法。将使用广义线性模型分析两个研究组中参与者在多个时间点的关键行为结果差异(预期可检测到的最小效应量,d = 0.50)。研究结果将广泛传播,研究完成后培训产品将在全国范围内可用。

结论

OPS是第一项纵向评估基于网络的与阿片类药物相关的职业风险降低干预措施对美国执法部门影响的研究。我们的随机实用临床试验旨在消除警察与吸毒者/注射吸毒者进行救生接触的障碍,既关注执法安全,也关注与有阿片类药物过量风险者合作的循证最佳做法。我们的同步嵌入式混合方法将对基于纳洛酮的应对措施在执法部门中的传播进行实证评估。

试验注册

ClinicalTrail.gov NCT05008523;https://clinicaltrials.gov/show/NCT05008523。

国际注册报告识别码(IRRID):DERR1-10.2196/33451。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd1e/8917434/40ed45076040/resprot_v11i2e33451_fig1.jpg

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