175 - Adapting, Producing, and Testing a Youth Overdose Prevention Toolkit through Community-Based Participatory Research Methods

Publication Number: 1164.175

Danya Fast, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; Scott E. Hadland, Mass General Brigham for Children / Harvard Medical School, Boston, MA, United States

Background: In the US and Canada, overdose has become a leading cause of death for youth, yet effective prevention interventions remain poorly implemented and rarely tailored to youths’ needs. Clinicians in pediatric settings report uncertainty about how to address youth substance use and overdose risk. To address this gap, our 3-year 'Toolkit Project' uses qualitative and community-based participatory research methods to adapt, produce, and test a comprehensive, developmentally-appropriate ‘Youth Overdose Prevention Toolkit’ for use by clinicians in acute and ambulatory care settings.

Objective: The objective of the Toolkit Project is to co-design and integrate evidence-based core elements (i.e., naloxone, take-home drug testing strips, harm reduction education, and medications for opioid use disorder [MOUD]) into a single, practical resource. The Toolkit Project is being conducted in Boston, Massachusetts, and Vancouver, British Columbia—two regions heavily impacted by the overdose crisis but with differing healthcare systems and service infrastructures.

Design/Methods: Guided by the ADAPT-ITT implementation science framework, across the Adaptation, Production, and Testing phases we are collaborating with youth with lived experience of substance use and their caregivers through Community Advisory Boards (CABs). In the Adaptation phase (Aim 1), we are conducting semi-structured qualitative interviews with youth (ages 12-24), caregivers, and clinicians to identify adaptations that render toolkit elements developmentally appropriate, feasible, and stigma-reducing. In the Production phase (Aim 2), feedback from CABs and clinicians will inform the creation of a concise, user-friendly toolkit, including clinician scripts and local resource linkages. Finally, in the Testing phase (Aim 3), the toolkit will be pilot-tested with 40 youth across Boston and Vancouver.

Results: Aim 1 qualitative findings emphasize the importance of care that centers meaningful relationship and trust-building between youth, caregivers, and clinicians, considerations of overdose prevention information quantity and timing, and the need to prioritize immediate supports for youth experiencing poverty and unstable housing (e.g., food, bus tickets).

Conclusion(s): Our ultimate goal is to co-produce a rigorously developed, youth- and caregiver-centered overdose prevention toolkit ready for large-scale testing and broad dissemination across pediatric healthcare systems in the US and Canada.