Court Navigators and Opportunities for Disseminating Overdose Prevention Strategies

Area of Science:

• Implementation Science
• Public Health
• Criminal Justice

Background:

• Court navigator programs aim to link individuals involved with the justice system to essential community-based treatment and services.
• Existing literature highlights a gap in overdose prevention strategies within court settings and the services they connect individuals to.

Purpose of the Study:

• To describe the functioning of court navigator programs in three New England states (Connecticut, Maine, Massachusetts).
• To analyze program functions using implementation science frameworks to inform replication and address gaps in overdose prevention.
• To examine the extent to which court navigators refer clients to overdose prevention resources, including naloxone (the opioid overdose antidote).

Main Methods:

• Exploratory mixed-methods analysis of court navigator programs using semi-structured interviews informed by the Template for Intervention Description and Replication (TIDieR) Implementation guide.
• Analysis included administrative data on client contacts (n = 436) and a subsample with background information (n = 249) to assess navigator recommendations.
• Interviews were analyzed based on TIDieR criteria, focusing on intervention characteristics, resources, and organizational contexts.

Main Results:

• Court navigator programs exhibited variations in resources and organizational contexts despite sharing basic intervention characteristics.
• Nearly half of clients were self-referred (46.5%), and over two-thirds (69.1%) consented to follow-up, with significant program-level variation.
• Clients with a history of overdose (35.7% of those allowing follow-up) were more likely to be referred to naloxone (the opioid overdose antidote) locations, though few programs had naloxone readily available.

Conclusions:

• Court navigators, employed by community organizations, effectively link individuals to treatment and services but face significant gaps in implementing overdose prevention strategies.
• Court navigator programs present a substantial opportunity to address the unmet need for overdose prevention within the criminal justice system.
• Further integration of overdose prevention resources, such as naloxone (the opioid overdose antidote), into court navigator programs is crucial for public health impact.