Connected health and the opioid crisis: behavioral economic approaches to increase naloxone uptake

Our overarching goal is to develop and test novel evidence-based interventions to increase naloxone uptake, a keystone to prevention of opioid-related mortality. Our approach is informed by behavioral economics and the principles of community-engaged research. Proposed interventions will be conducted in concert with ongoing Overdose Awareness and Reversal trainings led by our team in partnership with the Philadelphia Department of Public Health and the Free Library of Philadelphia. We will employ behavioral mapping to identify bottlenecks to naloxone acquisition and carrying. Then, in two sequential pilot randomized trials, we will implement and test training enhancements that address those bottlenecks using strategies such as commitment pledges and plans, framing, and tailored text message nudges. This connected health proposal incorporates automated text messaging using Way to Health, as well as photographic documentation of the endpoint (naloxone acquisition/carrying).  The pilot will inform models for expanding the cadre of first responders who are prepared to reverse opioid overdoses in community settings.