title: An Initial evaluation of law enforcement overdose training in Rhode Island.
abstract: OBJECTIVE
  To assess initial change in knowledge, self-efficacy, and anticipated behaviors among Rhode Island law enforcement officers on drug overdose response and prevention.
  
  
  METHODS
  Law enforcement officers (N=316) voluntarily completed a pre-post evaluation immediately before and after taking part in overdose prevention and response trainings. Assessment items included measures of knowledge (Brief Overdose Recognition and Response Assessment (BORRA)), self-efficacy, attitudes toward drugs and overdose prevention, awareness of the Good Samaritan Law, and open-ended items pertaining to overdose knowledge and response behaviors. Non-parametric tests measured within-group and between-group differences. Wilcoxon Signed Rank tests and Kruskal-Wallis tests evaluated changes in BORRA scores and self-efficacy items. McNemar's tests assessed changes regarding the Good Samaritan law and open-ended items. Wilcoxon Signed Rank tests measured post-training change in attitudes.
  
  
  RESULTS
  Law enforcement officers demonstrated statistically significant improvements in self-efficacy (identifying signs of opioid overdose, naloxone indication, counseling witnesses in overdose prevention, and referring witnesses for more information), overdose identification knowledge (BORRA mean increased from 7.00 to 10.39), naloxone administration knowledge (BORRA mean increased from 10.15 to 12.59), Good Samaritan Law awareness (17.9% increase after training), and anticipated behaviors in response to future observed overdose (65.7% changed from passive to active response post training).
  
  
  CONCLUSIONS
  Harm reduction programs can provide law enforcement officers with the knowledge and skills necessary to intervene and reduce overdose mortality. Given the statistically significant improvements in self-efficacy, attitudinal changes, and Good Samaritan law awareness, law enforcement officers are more prepared to actively interact with drug users during a drug-involved emergency.
authors.affiliation: Department of Emergency Medicine, The Warren Alpert School of Medicine, Brown University, 55 Claverick St. 2nd Floor, Providence, RI 02903, United States; The School of Public Health, Brown University, 121 South Main Street, Providence, RI 02912, United States.
authors.forename: Cory D
authors.initials: CD
authors.lastname: Saucier
authors.affiliation: University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, 4301 West Markham, Little Rock, AR, United States.
authors.forename: Nickolas
authors.initials: N
authors.lastname: Zaller
authors.affiliation: The School of Public Health, Brown University, 121 South Main Street, Providence, RI 02912, United States.
authors.forename: Alexandria
authors.initials: A
authors.lastname: Macmadu
authors.affiliation: Department of Emergency Medicine, The Warren Alpert School of Medicine, Brown University, 55 Claverick St. 2nd Floor, Providence, RI 02903, United States; The School of Public Health, Brown University, 121 South Main Street, Providence, RI 02912, United States. Electronic address: Traci.c.green@gmail.com.
authors.forename: Traci C
authors.initials: TC
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D062787:Drug Overdose / Q000517:prevention & control / Q000523:psychology*; D055030:Drug Users; D004493:Education / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D016495:Police / Q000193:education* / Q000523:psychology; D015397:Program Evaluation; D012237:Rhode Island; D020377:Self Efficacy; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone
keywords: First responders; Law enforcement; Naloxone; Opioids; Overdose