American Journal of Public Health, volume 115, issue 1, pages e1-e12

Effect of the Communities That HEAL Intervention on Overdose Education and Naloxone Distribution: A Cluster-Randomized, Wait-List Controlled Trial

Patricia Freeman 1
Alexander Y. Walley 1
T. John Winhusen 1
Emmanuel A. Oga 1
Jennifer Villani 1
Timothy Hunt 1
Redonna K. Chandler 1
Douglas R Oyler 1
Brittni Reilly 1
K H Gelberg 1
Christian Douglas 1
Michael S. Lyons 1
JaNae Holloway 1
Nathan Vandergrift 1
Joella W Adams 1
Katherine Asman 1
Trevor J. Baker 1
Candace J. Brancato 1
Debbie M. Cheng 1
Janet E. Childerhose 1
James L. David 1
Daniel J. Feaster 1
Louisa Gilbert 1
LaShawn Glasgow 1
Dawn Goddard-Eckrich 1
Charles E Knott 1
Hannah K. Knudsen 1
Michelle R. Lofwall 1
Katherine R. Marks 1
Jason T Mcmullan 1
Carrie Oser 1
Monica F Roberts 1
Abigail B. Shoben 1
Michael Stein 1
Scott T. Walters 1
Josie Watson 1
Gary A. Zarkin 1
Rebecca D Jackson 1
Jeffrey H. Samet 1
Sharon L. Walsh 1
Nabila El Bassel 1
Show full list: 41 authors
Publication typeJournal Article
Publication date2025-01-01
scimago Q1
SJR2.139
CiteScore9.5
Impact factor9.6
ISSN00900036, 15410048
Abstract

Objectives. To determine whether the Communities That HEAL (CTH) intervention is effective in increasing naloxone distribution compared with usual care.

Methods. The HEALing (Helping to End Addiction Long-Term) Communities Study (HCS) is a cluster-randomized, parallel-arm, wait-list controlled implementation science trial testing the impact of the CTH intervention on increasing the use of evidence-based practices to lower opioid-related overdose deaths. Communities (n = 67) highly impacted by opioid overdose in Kentucky, Massachusetts, New York, and Ohio were allocated to CTH intervention (n = 34) or wait-list comparison (usual care; n = 33) arms. The primary outcome for this study was the number of naloxone units distributed in HCS communities during the comparison period (July 1, 2021‒June 30, 2022), examined using an intent-to-treat negative binomial regression model.

Results. Naloxone distribution was 79% higher in the CTH intervention versus usual care arm (adjusted relative rate = 1.79; 95% confidence interval = 1.28, 2.51; P = .001; adjusted rates of naloxone distribution 3378 vs 1884 naloxone units per 100 000 residents), when controlling for urban‒rural status, state, baseline opioid-related overdose death rate, and baseline naloxone distribution rate.

Conclusions. The CTH intervention increased naloxone distribution compared with usual care in communities highly impacted by the opioid crisis.

Trial Registration. ClinicalTrials.gov identifier: NCT04111939. ( Am J Public Health. Published online ahead of print October 10, 2024:e1–e12. https://doi.org/10.2105/AJPH.2024.307845 )

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