Collaborative Strategies in Safeguarding Children: A Community-Centric Approach to Overdose Response

Overdose deflection has become increasingly popular as the landscape shifts from a punitive response to understanding substance use and overdose as a public health problem requiring a community-based solution. First responder deflection (FRD) programs have emerged across the most affected states, such as Ohio. While FRDs, including Quick Response Teams (QRTs), have expanded nationally, research lags the implementation. A key gap is understanding the specifics of FRD program implementation, including how and when practice deviates from policy. In particular, family-specific overdose response programming is an overlooked area.

The proposed project employs a mixed-methods approach to (1) establish a foundational understanding of overdose response policy and procedure and how it relates to child placement outcomes, specifically overdose response with family programming (2) utilize expert consensus to understand promising practices for overdose response involving families and children; and (3) utilize a Pre-implementation Planning and Community Needs and Asset Assessment to understand how best practices for overdose response involving families and children can be embedded within different localities. 

For the first aim, we draw on a survey with deflection responders, including law enforcement, fire, EMS, child welfare social workers, peer supporters, and substance use outreach team members. We also include a secondary analysis employing Cordata Healthcare Innovations Database (individual overdose patient-level episodic overdose response data, including QRTs, LEAD, and Crisis Intervention Teams); The Ohio Statewide Automated Child Welfare System; and Ohio Department of Health Electronic Death Registration System mortality data. For the second aim, we implement a Modified Delphi Process consisting of in-depth interviews, surveys, and focus groups to reach expert consensus on the most helpful and most feasible strategies for overdose responses involving children and families. Finally, we engage in the rapid dissemination of results from the first and second aims by applying the Stages of Implementation Completion (SIC) framework to engage in a pre-implementation process with stakeholders consisting of engagement, consideration of feasibility, and readiness planning to provide a foundation for the implementation of promising practices.

Our proposed study advances research in methodologically innovative ways with important implications for policymakers, law enforcement, health and social services, and people with lived experience. Ohio is one of the pioneering states for overdose response making this an ideal location to carry out the project. Our robust dissemination plan includes rapid dissemination to stakeholders in Ohio via virtual workshops and briefs, a research report to NIJ, and broader dissemination in academic journals and conferences. CA/NCF