Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study

Abstract Background Overdose education and naloxone distribution (OEND) to laypersons are key approaches to reduce the incidence of opioid-involved overdoses. While some research has examined attitudes toward OEND, especially among pharmacists and first responders, our understanding of what layperso...

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Main Authors: Jon Agley, Yunyu Xiao, Lori Eldridge, Beth Meyerson, Lilian Golzarri-Arroyo
Format: Article
Language:English
Published: BMC 2022-05-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-022-13298-3
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author Jon Agley
Yunyu Xiao
Lori Eldridge
Beth Meyerson
Lilian Golzarri-Arroyo
author_facet Jon Agley
Yunyu Xiao
Lori Eldridge
Beth Meyerson
Lilian Golzarri-Arroyo
author_sort Jon Agley
collection DOAJ
description Abstract Background Overdose education and naloxone distribution (OEND) to laypersons are key approaches to reduce the incidence of opioid-involved overdoses. While some research has examined attitudes toward OEND, especially among pharmacists and first responders, our understanding of what laypersons believe about overdose and naloxone is surprisingly limited. Further, some scholars have expressed concerns about the prevalence of non-evidence-based beliefs about overdose and naloxone. We designed this study to analyze the prevalence, nature, and context of beliefs about naloxone and overdose among U.S. laypersons. Methods We conducted a cross-sectional study (n = 702) using Prolific.co (representative of the U.S. population by age, gender, and race). Primary outcomes were the believability of six statements about overdose/naloxone on a seven-point Likert-type scale. Five statements were unsupported, and one was supported, by current scientific evidence. We used latent profile analysis to classify participants into belief groups, then used regression to study correlates of profile classification. Results Believability of the statements (7: extremely believable) ranged from m = 5.57 (SD = 1.38) for a scientifically supported idea (trained bystanders can reverse overdose with naloxone), to m = 3.33 (SD = 1.83) for a statement claiming opioid users can get high on naloxone. Participants were classified into three latent belief profiles: Profile 1 (most aligned with current evidence; n = 246), Profile 2 (moderately aligned; n = 351), and Profile 3 (least aligned, n = 105). Compared to Profile 1, several covariates were associated with categorization into Profiles 2 and 3, including lower trust in science (RRR = 0.36, 95%CI = 0.24–0.54; RRR = 0.21, 95%CI = 0.12–0.36, respectively), conservative political orientation (RRR = 1.41, 95%CI = 1.23–1.63; 3:RRR = 1.62, 95%CI = 1.35–1.95, respectively), and never being trained about naloxone (Profile 3: RRR = 3.37, 95%CI = 1.16–9.77). Conclusions Preliminary evidence suggests some U.S. laypersons simultaneously believe that bystander overdose prevention with naloxone can prevent overdose and one or more scientifically unsupported claims about naloxone/overdose. Categorization into clusters displaying such belief patterns was associated with low trust in science, conservative political orientation, and not having been trained about naloxone. Preregistration This cross-sectional study was preregistered prior to any data collection using the Open Science Framework: https://osf.io/c6ufv
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spelling doaj.art-fffce1d213344d69be0fbdc7647ba38b2022-12-22T02:11:18ZengBMCBMC Public Health1471-24582022-05-0122111310.1186/s12889-022-13298-3Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional studyJon Agley0Yunyu Xiao1Lori Eldridge2Beth Meyerson3Lilian Golzarri-Arroyo4Prevention Insights, Department of Applied Health Science, School of Public Health Bloomington, Indiana University BloomingtonDepartment of Population Health Sciences, Weill Cornell MedicineCollege of Health and Human Performance, East Carolina UniversitySouthwest Institute for Research On Women, College of Social & Behavioral Sciences, University of ArizonaBiostatistics Consulting Center, School of Public Health Bloomington, Indiana University BloomingtonAbstract Background Overdose education and naloxone distribution (OEND) to laypersons are key approaches to reduce the incidence of opioid-involved overdoses. While some research has examined attitudes toward OEND, especially among pharmacists and first responders, our understanding of what laypersons believe about overdose and naloxone is surprisingly limited. Further, some scholars have expressed concerns about the prevalence of non-evidence-based beliefs about overdose and naloxone. We designed this study to analyze the prevalence, nature, and context of beliefs about naloxone and overdose among U.S. laypersons. Methods We conducted a cross-sectional study (n = 702) using Prolific.co (representative of the U.S. population by age, gender, and race). Primary outcomes were the believability of six statements about overdose/naloxone on a seven-point Likert-type scale. Five statements were unsupported, and one was supported, by current scientific evidence. We used latent profile analysis to classify participants into belief groups, then used regression to study correlates of profile classification. Results Believability of the statements (7: extremely believable) ranged from m = 5.57 (SD = 1.38) for a scientifically supported idea (trained bystanders can reverse overdose with naloxone), to m = 3.33 (SD = 1.83) for a statement claiming opioid users can get high on naloxone. Participants were classified into three latent belief profiles: Profile 1 (most aligned with current evidence; n = 246), Profile 2 (moderately aligned; n = 351), and Profile 3 (least aligned, n = 105). Compared to Profile 1, several covariates were associated with categorization into Profiles 2 and 3, including lower trust in science (RRR = 0.36, 95%CI = 0.24–0.54; RRR = 0.21, 95%CI = 0.12–0.36, respectively), conservative political orientation (RRR = 1.41, 95%CI = 1.23–1.63; 3:RRR = 1.62, 95%CI = 1.35–1.95, respectively), and never being trained about naloxone (Profile 3: RRR = 3.37, 95%CI = 1.16–9.77). Conclusions Preliminary evidence suggests some U.S. laypersons simultaneously believe that bystander overdose prevention with naloxone can prevent overdose and one or more scientifically unsupported claims about naloxone/overdose. Categorization into clusters displaying such belief patterns was associated with low trust in science, conservative political orientation, and not having been trained about naloxone. Preregistration This cross-sectional study was preregistered prior to any data collection using the Open Science Framework: https://osf.io/c6ufvhttps://doi.org/10.1186/s12889-022-13298-3NaloxoneOverdoseMisinformationTrust in scienceOpioidsOpioid epidemic
spellingShingle Jon Agley
Yunyu Xiao
Lori Eldridge
Beth Meyerson
Lilian Golzarri-Arroyo
Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study
BMC Public Health
Naloxone
Overdose
Misinformation
Trust in science
Opioids
Opioid epidemic
title Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study
title_full Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study
title_fullStr Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study
title_full_unstemmed Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study
title_short Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study
title_sort beliefs and misperceptions about naloxone and overdose among u s laypersons a cross sectional study
topic Naloxone
Overdose
Misinformation
Trust in science
Opioids
Opioid epidemic
url https://doi.org/10.1186/s12889-022-13298-3
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AT bethmeyerson beliefsandmisperceptionsaboutnaloxoneandoverdoseamonguslaypersonsacrosssectionalstudy
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