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Background and Aims: We wanted to test whether introducing an additional Naloxone component into overdose education would affect the willingness and confidence of a potential overdose witness to intervene effectively. A further aim was to test the potential of education to reduce barriers to administering Naloxone and barriers to calling 999 (UK Emergency services).
Methods: We used quantitative methods to gather and analyze data from both control (overdose education, n=15) and experimental (overdose and Naloxone education, n=57) participants, facilitated by educators in the North West of England and London, for opioid users (n=5), former users (n=19), carers/support workers (n=29), family members (n=31) or friends (n=12) (multiple response item). We measured self-reported confidence and willingness of participants using evaluation forms with Likert scales, and knowledge using open-ended questions. We ran a focus group with educators about delivery, teaching and/or working with this study population as learners
Results: Both the controlled and the experimental sessions increased participants’ confidence to use first aid skills, specific confidence in an overdose situation and willingness to act. The educators reported low levels of learner literacy, which may have affected the reliability of the data gathered. The sessions the benefits of a flexible, workshop-style session, peer-to-peer support.
Conclusion: Introducing a Naloxone component to first aid education targeting potential witnesses of an opioid overdose situation does not seem to negatively impact on learners’ confidence or willingness to act, though the methodological challenges of this study limits the conclusiveness of this statement. Overdose or Naloxone education should employ a flexible format that is tailored to the needs of the learners and encourage peer-to-peer support.
Evidence for international first aid guidelines predominantly comes from studies conducted in western contexts during peacetime and/or healthcare settings. Yet, internationally the burden of trauma falls on low- and middle-income countries where lay responders might have to act in fragile contexts, where first aid and healthcare resources are limited or not available.
This study focuses on the principles and practices that govern first aid education (FAE), versus clinical evidence of first aid interventions. Accepting that application of first aid may vary according to context, we sought to understand educational principles according to contextual resources of fragile and non-fragile environments.
We interviewed educators, from six countries where conflict, geography or resources deemed them to be fragile, to explore which educational approaches were used and found effective in educating potential lay responders.
Through qualitative analysis, we identified educational approaches and themes including:
We connected a similar set of educational approaches in non-fragile contexts, as reflected in the International First Aid and Resuscitation Guidelines 2016. Recognizing common educational approaches provides educators with a common base on which to develop their educational approach and build future recommendations with global applicability. This also allows for mutual research and application between FAE in fragile and non-fragile environments.
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