189 Implementing an opioid overdose education and naloxone distribution (OEND) Training-of-Trainers Program in rural pharmacies: Qualitative insights

Objectives/Goals: Opioid overdose education and naloxone distribution (OEND) programs improve knowledge, attitudes, and overdose response but face implementation and sustainment challenges in rural areas. This project will identify barriers, facilitators, and strategies for delivering an OEND Training-of-Trainers (ToT) program in rural community pharmacies. Methods/Study Population: We will conduct 60-minute qualitative interviews with 20 key informants (10 pharmacists, 10 staff) from 10 rural Arkansas community pharmacies. Interview questions are guided by the Consolidated Framework for Implementation Research (CFIR) constructs to identify factors influencing implementation. Recruitment will occur through the Rural Research Alliance of Community Pharmacies network. Interviews will be recorded and transcribed for analysis using a CFIR-informed coding process to identify overall themes. Results/Anticipated Results: Identification of CFIR-categorized facilitators and barriers to OEND ToT program implementation in rural community pharmacies is anticipated. Anticipated barriers identified in participant interviews include staffing availability, workflow integration, reimbursement, and space constraints. Barriers and facilitators identified will guide the collaborative co-design focus group sessions to select and adapt implementation strategies in phase two of the project. Discussion/Significance of Impact: Drug overdose remains a leading cause of death. OEND programs are effective but underused in rural areas. Identifying barriers and strategies to support implementation in the rural community pharmacy setting can expand access, improve knowledge and confidence, and advance scalable, evidence-based care.