Effects of Online Naloxone Training for Laypersons: An Extended-Baseline Assessment

<i>Background:</i> While laypersons can play a crucial role in administering naloxone in opioid overdoses, they must be recruited and trained to effectively manage overdose events as good Samaritans. This study aimed to examine the effectiveness of a technology-based intervention that recruited and trained laypersons to administer naloxone. <i>Methods:</i> Opioid Rapid Response System (ORRS) was an online recruitment and training intervention which capitalized on social cognitive theory and a digital media engagement model to mobilize laypersons to administer intranasal naloxone. ORRS was developed based on a randomized waitlisted controlled trial (<i>N</i> = 220). This secondary analysis is a within-group, extended-baseline assessment of the waitlisted group (<i>n</i> = 106), considering that they served as their own control prior to receiving the training. ORRS was conducted in five counties of Indiana with adults who did not self-identify as a certified first responder. Five indices were generated from 23 variables: knowledge of overdose signs, knowledge of overdose management, self-efficacy in responding, concerns about responding, and intent to respond. Paired t-test compared changes between 3 timepoints. <i>Results:</i> Three indices had significantly greater increases associated with training compared to extended baseline: recognizing opioid overdose signs (difference = 0.08; 95%CI = 0.02, 0.15; <i>t</i> = 2.48; <i>p</i> = 0.01); knowledge of overdose management (difference = 0.27; 95%CI = 0.18, 0.35; <i>t</i> = 5.99; <i>p</i> < 0.01); and self-efficacy in overdose management (difference = 0.68; 95%CI = 0.45, 0.91; <i>t</i> = 5.78; <i>p</i> < 0.01). Concerns related to overdose management significantly decreased as expected (difference = -1.53; 95%CI = -1.86, -1.21; t = -9.27; <i>p</i> < 0.01). <i>Conclusions:</i> ORRS provided strong support for self-efficacy, concerns, and knowledge related to overdose management, and the digital modality accelerates largescale dissemination.