The Role of Family in Reducing Risk of Fatal Opioid Overdose - Drug overdose is the leading cause of accidental death in the United States (US), and reducing drug overdose deaths requires intervening across all levels of the Social-Ecological Model. Many studies have examined overdose risk factors at the individual, community, and policy levels, but fewer studies have examined overdose risk and protective factors at the household or family level. Prior research indicates that unmarried status and “living alone” are associated with overdose mortality, yet it is unclear which other household characteristics are associated with risk of overdose fatality, or how factors at community levels may moderate these associations. In addition to their influence on health, social support, and substance use behaviors, household and family members can play a key role in reducing overdose deaths by providing emergency response in case of an opioid overdose. Household/family members are often the first to witness an overdose that occurs at home, uniquely positioned to respond in time to prevent fatality. Participating in overdose education and naloxone distribution (OEND) programs is one critical way in which family and household members can develop knowledge and skills in overdose response. OEND programs are evidence-based interventions with well-documented effectiveness in reducing opioid-related mortality, yet studies suggest that Hispanics at risk of overdosing are less likely to report receiving take-home naloxone or training, and Hispanic family members are also underrepresented in OEND programs. Most OEND programs are not culturally adapted or targeted for family members, despite substantial evidence supporting the enhanced efficacy of culturally adapted interventions. Therefore, this mixed methods, community-engaged study proposes to fill gaps in the literature on the role of family/household members in reducing opioid overdose deaths, using the following aims: Aim 1. Identify family/household-level risk and protective factors for overdose-related outcomes and elucidate how these household characteristics interact with individual and community characteristics. Aim 2. (a) Culturally adapt an OEND program for adult family members of Hispanics at high risk for opioid overdose and (b) assess the adapted program's feasibility, acceptability, and preliminary effectiveness in improving adult family members' knowledge of, and attitudes toward, opioid overdose response. Consistent with these aims, the objective of this K01 proposal is to enable the candidate to gain expertise in, and fill gaps in the literature on, the role of family/household members in overdose prevention. The proposed mentoring from renowned scholars at Arizona State University, as well as coursework in data analysis, clinical trials, cultural adaptation, and intervention evaluation methodologies, will enable the candidate to develop an independent research career centered on reducing drug overdose deaths, especially in populations at disproportionate risk.
