A community engaged approach to opioid overdose prevention through health literacy and experiential learning

The opioid epidemic continues to devastate communities across the United States, largely driven by synthetic fentanyl-related overdoses. The purpose of this study was to evaluate the implementation and outcomes of a community-based Train-the-Trainer naloxone education initiative designed to expand overdose response capacity in Fort Worth, Texas. In response, UNT Health Fort Worth received a $310,339 grant to expand community training on recognizing and responding to opioid overdoses using Narcan in Fort Worth, Texas. Between 2024 and 2025, the program partnered with 43 organizations and trained 1347 participants, providing Narcan cartridges, drug deactivation pouches, flyers, an instructional PowerPoint, and a YouTube demonstration video. All materials incorporated plain language, QR links, and bilingual content to enhance accessibility. Pre- and post-tests from 678 matched participants were obtained and analyzed to assess changes in knowledge and confidence. Interactive components, practice on mannequin-based simulations, were identified as the most impactful. Participants demonstrated significant increases in confidence, rising from 58.9% before the training to 98.9% afterward. These results highlight the effectiveness of community-based, health-literate, experiential approaches in strengthening overdose response readiness and local harm-reduction capacity.