Evaluation of Prevention Point Philadelphia's overdose prevention program

Objectives: Accidental opioid overdose is a significant cause of death in Philadelphia and the U.S. as a whole. Programs such as Prevention Point Philadelphia (PPP) have created overdose prevention programs to train injection drug users (IDUs) to respond to overdoses using tactics such as rescue breathing and naloxone administration. Trained IDUs have saved hundreds of lives in Philadelphia alone, but most IDUs remain untrained. Using the Health Belief Model, this study compared the behaviors and health beliefs around accidental overdose of trained IDUs to untrained IDUs in order to make recommendations to PPP on how to design an effective outreach campaign to recruit more IDUs for the overdose prevention program. Methods: 20 injection drug users between the ages of 18 and 65 were recruited at PPP's six weekly syringe exchange sites, and interviewed using a quantitative/qualitative instrument. Interviews were recorded, transcribed, and analyzed in the qualitative analysis software program, ATLAS.ti. Participants trained in the overdose prevention program were compared to untrained participants in their behaviors and health beliefs about accidental overdose, and their responses were analyzed using the Health Belief Model. Results: Trained participants perceived fewer barriers and more benefits to receiving overdose prevention training, as well as a higher perceived susceptibility to accidental overdose. However, untrained participants were as likely to have helped someone who was overdosing within the past year as trained participants, and displayed similar levels of self-efficacy around helping an overdose victim as trained participants. Conclusions: Since most untrained participants are willing to assist someone who is overdosing and have high levels of self-efficacy related to responding to overdoses, eliminating the untrained participants' perceived barriers to participating in the overdose prevention training may effectively increase the participation rate at PPP's program. Some strategies include: prominently advertising the program at the syringe exchange sites, emphasizing the ability to save a loved one's life, offering a small cash or gift card incentive for participating, or providing tokens to cover the cost of public transportation to and from the training session.