Bridging the gap: An environmental scan of post-overdose program features and evaluation measures

Area of Science:

• Public Health
• Addiction Medicine
• Health Services Research

Background:

• Prior overdose is a significant predictor of future fatal and non-fatal overdoses.
• Individuals experiencing overdose often do not access services immediately after the event.
• Novel interventions like post-overdose outreach programs are crucial for engaging this high-risk population.

Purpose of the Study:

• To conduct an environmental scan of post-overdose programs.
• To identify key features and evaluation measures of these programs.
• To analyze evaluation measures based on the initiating stakeholder using the Donabedian quality framework.

Main Methods:

• Systematic literature review following PRISMA guidelines.
• Environmental scan of academic and gray literature.
• Analysis of 36 studies using the Donabedian quality framework to categorize evaluation measures.

Main Results:

• Six key features of post-overdose programs were identified: program theory, team composition, client identification/contact, service provision, public-private partnerships, and referrals.
• 223 operationalized measures were extracted, categorized into client experience (2), structural (12), process (69), and outcome (90).
• Initiating organizations (e.g., EDs, public health, CBOs, EMS) showed differing foci in their evaluation measures, with only two measures related to stigma.

Conclusions:

• Post-overdose programs share six common features, but evaluation measures vary by initiating organization.
• The identified features and measures can guide future program development and evaluation.
• This scan can inform funding agencies and evaluators about existing measures and identify gaps, particularly concerning stigma reduction.