Using the Consolidated Framework for Implementation Research (CFIR) to understand student perceptions of reach, relevance, and fit of opioid overdose education and naloxone distribution programs on university campuses

Background Opioid overdose education and naloxone distribution (OEND) programs provide naloxone kits and training on recognizing and responding to opioid overdoses. While there are some early adopters of college campus OEND programs, this important setting remains underutilized. Purpose We conducted research on student-level perceptions of the reach, relevance, and fit of routine OEND implementation on a college campus in New York City. Methods Semi-structured, in-depth qualitative interviews (n = 40) were completed across three student groups: (i) those who were invited to and attended an OEND training, and opted to take a free naloxone kit (n = 24); (ii) those who were invited, but did not attend a training (n = 13); and (iii) those who were invited and attended a training, but did not take a kit (n = 3). We employed a framework-driven pragmatic qualitative approach using the Consolidated Framework for Implementation Research (CFIR). Results Our findings, synthesized across groups, were: (i) students were generally receptive to OEND program implementation on campuses broadly including their own, but perceived it as more relevant to the outer setting surrounding campus, which universities need to engage; (ii) beyond OEND programs, students expressed wanting better access to broader substance use and mental health services; and (iii) students described the need for improved university communications about its commitments to OEND program implementation to promote relevance and reach. Conclusions This study provides in-depth understanding of student-level perceptions around implementing campus OEND programs and identifies opportunities to improve future implementation and sustainability.