Source: UTAH STATE UNIVERSITY submitted to NRP
TRICOUNTY OVERDOSE PREVENTION PROGRAM (TOPP)
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
OTHER GRANTS
Reporting Frequency
Annual
Accession No.
1032941
Grant No.
2024-46100-43182
Cumulative Award Amt.
$442,636.00
Proposal No.
2024-04486
Multistate No.
(N/A)
Project Start Date
Sep 1, 2024
Project End Date
Aug 31, 2027
Grant Year
2025
Program Code
[LX]- Rural Health & Safety Education
Recipient Organization
UTAH STATE UNIVERSITY
(N/A)
LOGAN,UT 84322
Performing Department
Kinesiology & Health Science
Non Technical Summary
Drug poisoning deaths remain the leading cause of injury death in Utah, with about 11 deaths per week of which 8 were due to opioids and potentially preventable through the use of Naloxone, the overdose prevention medication. To address this issue and reduce overdose deaths, we are proposing to develop, implement and evaluate the TriCounty Overdose Prevention Program (TOPP) which is designed to address the high rates of opioid overdose deaths observed in our three rural target counties including Duchesne, Uintah and Daggett. Within these counties, we will develop overdose prevention and harm reduction trainings designed for high-risk populations including high-risk occupational groups (construction, mining, manufacturing and service industry employees), and high-risk minority groups including Native American and Hispanic. The trainings will be culturally and linguistically appropriate for our Native American and Hispanic populations and designed to provide participants with the skills to respond to opioid overdoses using Naloxone and save lives. Furthermore, our trainings will provide businesses and participants with overdose prevention kits, which include Naloxone, increasing ability to respond to overdoses at work and home. In addition, our trainings will increase awareness of available prevention, treatment, and recovery services available in the region with the goal to increase the number of people accessing these life-saving services. The overall program goal will be to decrease overdose deaths by 10% by the end of the three year program. We will evaluate several outcomes through use of pre, post, and 3-month follow up surveys and widely disseminate our findings.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
100%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
90360993020100%
Knowledge Area
903 - Communication, Education, and Information Delivery;

Subject Of Investigation
6099 - People and communities, general/other;

Field Of Science
3020 - Education;
Goals / Objectives
Objectives, Activities, Outcomes and TimelineAlignment of Objectives with Federal Goals: Our objectives address Goal 5 of USDA's Strategic Plan for FY 2022-2026 "Expand Opportunities for Economic Development and Improve Quality of Life in Rural and Tribal Communities". Our proposed program will focus on improving quality of life among our selected rural and Tribal populations through the implementation of an innovative overdose prevention program designed specifically for high-risk populations including Native Americans, Hispanics and high-risk occupations. We will follow USDA's priorities for improving the quality of life in rural and Tribal Communities by ensuring that we (1) Build Trust by working with underserved Tribal and Hispanic Communities, and (2) Reduce Barriers to Access by designing our program to be culturally and linguistically appropriate and available in in-person and online formats (USDA, 2022).In addition, our program aligns with Congressional guidance that Rural Health and Safety Education programs may focus on the prevention and/or reduction of opioid and other substance misuse. This aligns with the recommendation to focus programming on individual and family health education that implement programs to prevent or reduce opioid and substance misuse and abuse. Specifically, our program aligns with the US Department of Health & Human Services Overdose Prevention Strategy, specifically by widening access to opioid overdose reversal treatments such as naloxone/Narcan (Haffajee, RL, Sherry, TB, Dubenitz, JM, White, JO, Schwartz, D, et al., 2021).Objectives, Activities, and EvaluationObjective 1: Develop and disseminate the TOPP curriculum among high-risk occupation employees by the end of Year One, with a minimum of 10 trainings offered and 100 employees trained per year.Activity 1: The Co-Program Directors will develop the TOPP curriculum and assessment surveys designed specifically for our high-risk occupation groups.Activity 2: Program Coordinators will recruit local high-risk occupation businesses to enroll in the training, with a goal of hosting at least 10 trainings with total of 100 employees per year. Evaluation: We will track the number of high-risk employees that are trained in each county. During the trainings we will collect a pre-and-post survey to assess knowledge, attitude, and self-efficacy related to administering Naloxone to prevent an overdose. Then we will collect a follow-up survey at 3-months to assess changes in attitude, self-efficacy, and use of Naloxone.Objective 2: Increase access to Naloxone among high-risk occupation employees by distributing naloxone to over 100 employees and overdose prevention kits to over 25 businesses by the end of Year 2.Activity 1: Program Coordinators will distribute a naloxone kit to all Employees completing our training and an overdose prevention kit to all businesses. This will increase the ability to respond to opioid overdose at work and in personal lives.Evaluation: We will track the number of overdose prevention kits distributed to businesses and employees that completed training.Objective 3: Update and finalize our culturally centered overdose prevention and harm reduction training designed specifically for our Native American population to ensure it is culturally and linguistically appropriate and meeting current needs by the End of Year 2.Activity 1: The Program Directors and Tribal Program Coordinator will collaborate with key Tribal partners, including the Ute Tribe Health Board, to review training materials and provide feedback which will be used to modify all materials to be culturally and appropriate since the Ute Tribe does not have a written language.Activity 2: The Tribal Program Coordinator will conduct outreach to enroll Native American groups in the training program. Once enrolled, we will conduct on-site and online trainings with a goal of training at least 5 groups and 50 people per year, starting in Year 2.Activity 3: Tribal Program Coordinator will distribute a naloxone kit to all people completing the culturally centered training the increasing ability to respond to opioid overdose.Evaluation: The finalized culturally centered Native American focused training curriculum will be the key outcome for this objective. We will also track the number of Native Americans that complete the training in each county. Due to respect for data sovereignty and limitations to obtain Tribal IRB approval, we will not collect any surveys among trainings completed on Tribal lands.Objective 4: Develop and disseminate a culturally and linguistically appropriate overdose prevention and harm reduction training for the Hispanic Population in our target counties with a goal of training 25 people by the End of Year 3.Activity 1: The Program Directors and Hispanic Program Coordinator will collaborate with key community partners to modify existing training materials to be culturally and linguistically appropriate for our target population.Activity 2: The Hispanic Program Coordinator will work with professional translation services to have all curriculum materials translated in Spanish. Once translated, we will pilot test the Spanish curriculum with community partners to identify any other areas needing modification.Activity 3: The Hispanic Program Coordinator will conduct outreach to enroll high-risk Hispanic groups in the training program. Once enrolled, we will conduct on-site and online trainings with a goal of training at least 3 groups and 25 people by the end of year 3.Activity 4: The Hispanic Program Coordinator will distribute a naloxone kit to all people completing the Hispanic focused training increasing ability to respond to opioid overdose.Evaluation: The finalized Hispanic Focused training curriculum will be the key outcome for this objective. We will track the number of Hispanic people that complete the training in each county. We will also collect a pre-post survey to assess knowledge, attitude, and self-efficacy related to administering Naloxone to prevent an overdose.Objective 5: Host an annual substance use prevention, treatment, and recovery conference for the general population to improve knowledge, attitude, skills and abilities to address substance use and reduce stigma in the community.Activity 1: The Program Directors and Program Coordinators will plan and host an annual conference in the target counties. Each year will have a focus on one of our target populations. Year 1 will focus on high-risk occupational groups, Year 2- Native Americans, and Year 3-Hispanics. We will recruit experts to provide the educational sessions and have time for community input and cultural activities.Evaluation: We will track the number of participants and basic demographics. In addition, we will collect conference evaluation surveys to assess knowledge, attitude, skills and abilities to address substance use and levels of stigma in the community.
Project Methods
Approach DescriptionOur review has identified a key need to develop and implement opioid overdose prevention and harm reduction trainings among high-risk occupation groups including goods production and service industry. This will include trainings that are culturally centered to meet the needs of Native American and Hispanic workers in these industries as well. To expand access and use of Naloxone, we are proposing to develop and implement the TOPP designed specifically for high-risk occupation groups in the region.TOPP will provide in-person and online trainings specifically designed for these occupational groups. The curriculum will educate the participants on key overdose prevention and harm reduction information including: biology of opioids, occupational risks for substance use, signs and symptoms of opioid overdose, administration of naloxone, steps to responding to overdose at home or work, good Samaritan laws, harm reduction, effective treatment options, self-care, insurance options and referral information to key services related to substance use. Participants who complete the training will have the option to receive a naloxone kit (depending on availability) to take home, which will improve their ability to effectively respond to opioid overdose emergencies. In addition, all participating businesses will be provided with an overdose prevention kit to keep at the workplace as part of their first-aid kit, increasing the ability to respond to overdoses at the workplace.To ensure that we are providing an effective training to our underserved high-risk minority groups, we will also modify the trainings to be culturally and linguistically appropriate for the Native American and Hispanic populations. This will include delivery of educational programming facilitated by Native American and Hispanic Program Coordinators with input from the local Indigenous and Hispanic communities. We will use materials developed through the USU TROI and the Mountain Plains ATTC and will modify materials to address cultural norms related to substance use, treatment, recovery and other key aspects. In addition, we will provide materials in Spanish for non-English speaking participants. Lastly, we will utilize the expertise and pervious experience from the USU Tribal and Rural Opioid Initiative (TROI) Resource Center which has developed several training programs for the rural and indigenous communities throughout Utah, including culturally centered naloxone trainings.

Progress 09/01/24 to 08/31/25

Outputs
Target Audience:Target audiences reached during this reporting period Timeframe: September 1, 2024 to August31, 2025 Geography: Utah's Uintah Basin (primarily Roosevelt, Duchesne, Vernal, Ballard, and Ft. Duchesne) Scale: 17 sessions, 1,219 participants; 16 in-person and 1 virtual We targeted rural populations and workforce segments associated with elevated overdose risk and longer EMS response times. Audiences below are grouped by who was reached and why they mattered during this period; examples in parentheses are venues from the attached tracking sheet. Rural families and general community members Who: Parents, youth, and adult residents attending high-traffic community events and open houses (Family Night Out, UBIC USU Extension Family Fun Day, Irene Hansen Building Open House). Why: Large family-oriented events in the Basin reach broad cross-sections of residents in a single setting, including households with limited access to health education. These are the most efficient points for first-contact prevention messages and normalizing bystander overdose response in rural communities. Blue-collar and trades workers Who: Field and manual-labor workers and supervisors reachable through hands-on classes or employer touchpoints (Gardening Class & Naloxone Training; Duartes Electrical Services; Shell Gas Station/Fast Stop). Why: Injury, pain management, shift work, and remote sites increase overdose risk in these occupations. Training them where they work raises the odds a trained bystander is present during or after shifts. Service-industry employees Who: Restaurant and retail staff (Felys Mexican Restaurant; gas station staff). Why: Service settings are frequent locations for public medical emergencies. Front-line workers have high public contact and benefit from clear, actionable overdose response training to protect patrons and coworkers. Justice-involved adults and court-adjacent personnel Who: Adults engaged through corrections and county courts (Corrections Dept.; Duchesne County Court; Uintah County Court). Why: Transitions associated with arrest, release, and court involvement are high-risk periods for overdose. Direct training at these touchpoints places skills and naloxone closest to people at immediate risk and those supervising them. Indigenous community members Who: Ute Indian Tribe community members participating in a tribal event (Ute Tribe, Ft. Duchesne). Why: American Indian communities in the region carry disproportionate overdose burden. Culturally responsive engagement in tribal settings improves trust, relevance, and uptake of lifesaving practices. Hispanic/Spanish-speaking adults Who: Spanish-speaking community participants (Introducción a la Prevención del Suicidio; mixed Hispanic attendance at multiple community events). Why: Language barriers and work schedules limit access to English-only programming. Spanish-language delivery increases comprehension, self-efficacy, and willingness to act in family and workplace emergencies. Older adults and caregivers Who: Seniors and community members engaged through a senior meeting (Crossroads Senior Community Meeting). Why: Older adults often serve as caregivers or frequent witnesses of health emergencies in households and community centers. Equipping them expands capable bystander coverage across multigenerational homes. Faith-based and civic connectors Who: Interfaith leaders and attendees (Interfaith Council's Emergency Preparedness Event). Why: Faith and civic groups are trusted messengers in rural areas, magnifying reach through established networks and recurring gatherings. Public-sector and social service staff Who: Caseworkers and staff (DCFS). Why: These personnel have routine contact with high-need families and can reinforce prevention messages, connect clients to resources, and act as trained bystanders across office and field settings. Small employers and storefronts Who: Owners/managers receiving workplace "business kits" for on-site overdose readiness (15 kits placed). Why: Employers control policies, supplies, and staff training time. Engaging them enables sustainable placement of naloxone and response guidance in locations with daily foot traffic. Why these audiences, collectively (this period): They represent the Basin's highest-yield points of contact for overdose risk and bystander intervention: rural households at scale, workers in high-risk or high-contact jobs, communities with language and cultural barriers, justice-involved adults at critical transition points, seniors and caregivers, and local institutions that can propagate skills and access. By meeting people where they already gather or work, the project concentrated limited training hours in locations and populations where overdose prevention knowledge is most likely to be used. Changes/Problems:Summary: Three constraints required adjustments this period: (1) recruiting and retaining a Tribal Program Coordinator dedicated to the Ute Indian Tribe; (2) securing employer buy-in for on-site trainings in blue-collar sectors (oil and gas extraction, construction); and (3) countering stigma and access barriers in service-industry settings, particularly for Spanish-speaking workers. We adapted staffing, engagement, delivery format, and evaluation procedures accordingly while maintaining cultural safety and legal compliance. 1) Tribal Program Coordinator recruitment and retention Problem and reason: We filled the Tribal Coordinator role twice; both hires departed for other opportunities. A small talent pool, highly competitive local offers, and the need for strong cultural credibility within the Ute community made retention difficult. Change in approach: Shifted near-term delivery to a partner-led model using Tribal agencies and trusted presenters while we re-recruit. Used short-term agreements and honoraria to secure culturally grounded facilitators for key events and small-group sessions. Anchored outreach around a two-day Tribal-focused symposium hosted with the Ute Indian Tribe, then scheduled follow-up small-group refreshers with partner staff. Maintained data sovereignty: no surveys on Tribal lands; relied on counts, debriefs with Tribal partners, and qualitative feedback to guide adjustments. Effect on scope/timeline: Training volume met or exceeded targets via the symposium and partner-led sessions, but sustained cadence on Tribal lands requires re-establishing the Coordinator position. Next steps: Re-post the position with revised duties, flexible scheduling, and competitive compensation; formalize an MOU for shared recruitment with Tribal leadership; cross-train two non-Tribal staff to ensure continuity if turnover recurs. 2) Employer buy-in for on-site trainings (oil and gas extraction; construction) Problem and reason: Some employers hesitated to host on-site sessions due to stigma, perceived liability, productivity loss, and shift logistics. Change in approach: Repackaged the curriculum into 15-30 minute "toolbox talk" segments slotted into safety meetings across shifts. Added concise legal content on Utah Good Samaritan protections and employer risk management; paired training with a standardized business kit and refresher prompts. Engaged sector convenings (e.g., Uintah Basin Energy Summit) to reach decision-makers at scale and normalize overdose readiness alongside first aid. Began outreach to insurers/TPAs and safety vendors to align training with loss-control incentives. Effect on scope/timeline: Worksite conversions are slower than community events but trending upward where shift-aligned micro-sessions are offered. Next steps: Book at least 10 additional worksite sessions next period; formalize a peer-champion model (crew leads trained to host refreshers); expand presence at industry forums to accelerate sign-ups. 3) Service-industry access and Spanish-language reach Problem and reason: High turnover, late hours, and language barriers reduced completion rates among restaurant/retail staff; stigma further limited owner buy-in. Change in approach: Launched Spanish-only sessions co-delivered with Hispanic-serving partners; simplified handouts and reinforced confidentiality and Good Samaritan messaging. Offered short, after-hours micro-trainings with take-home naloxone for staff who complete the session. Added manager briefings that emphasize customer/staff safety and minimal operational disruption. Effect on scope/timeline: Participation is improving in venues that accept micro-sessions and Spanish-only delivery. Next steps: Host at least three dedicated Spanish-only sessions; expand partner referrals via chambers, faith groups, and adult-education/ESL programs. 4) Evaluation procedures on Tribal lands (clarification) Constraint and rationale: In alignment with cultural safety and data sovereignty, we did not collect surveys on Tribal lands. Change in approach: We tracked participation counts, captured structured debriefs with Tribal partners, and used off-site sessions for paired pre-post evaluation. Effect on outcomes: Knowledge/confidence change is assessed primarily in non-Tribal settings; Tribal delivery emphasizes access, skills practice, and relationship-building. Next steps: Continue partner-approved, low-burden feedback methods; share de-identified summaries with Tribal leadership for joint interpretation. Budget and compliance implications Budget: Short-term honoraria and partner facilitation replaced planned coordinator salary periods; overall spend remains within category limits. Re-recruitment may require modest reallocation to HR/advertising. Compliance: No special or additional reporting requirements were specified beyond standard award terms. We complied with data sovereignty expectations and REEport requirements; any updated conditions will be incorporated promptly. In summary, we adapted the delivery model to protect cultural integrity, remove friction for employers, and increase Spanish-language access. The core objectives remain unchanged; the approach now emphasizes partner-led Tribal engagement, shift-aligned micro-sessions for high-risk worksites, and dedicated Spanish-only offerings to counter stigma and scheduling barriers. What opportunities for training and professional development has the project provided?Training and professional development this period focused on building field-ready overdose response capacity while strengthening culturally safe, bilingual delivery. Learning occurred through a two-day Tribal-focused symposium and repeated community/worksite sessions, with parallel development for facilitators and employers. Symposium-based professional learning: Partners, frontline staff, and community leaders participated in the two-day Tribal-focused symposium (220 attendees), receiving targeted content on harm reduction, stigma reduction, overdose trends in Utah, and practical Narcan skills. Facilitator development: Program coordinators and collaborators practiced bilingual delivery, culturally responsive facilitation, and scenario-based coaching during both the symposium and community sessions. Cultural competence: Coaching from Tribal leaders and presenters strengthened respectful engagement, appropriate language use, and adherence to data sovereignty practices. Evaluation practice: Staff executed pre/post instruments when appropriate and refined logistics for 3-month follow-ups in non-Tribal settings. Workplace implementation: Owners/managers trained on kit placement, policy integration, and low-burden refresh protocols aligned to first-aid procedures. How have the results been disseminated to communities of interest?Overall, our project results are still pending, but we have disseminated key information related to our project as indicated below. Ute Indian Tribe Opioid Symposium (Fort Duchesne): Two-day public event with 220 participants. Dissemination occurred through plenary and breakout sessions, live Narcan trainings, resource booths, evening community programming, and partner-led storytelling and healing activities. Direct delivery in priority settings: Community fairs, employer sites, courts/corrections, senior meetings, interfaith preparedness events, and Tribal community venues. Bilingual materials distribution: English/Spanish decks, quick-reference job aids, wallet cards, and on-site naloxone kits. Workplace placements: Business kits placed at 15 sites with simple on-site guidance and refresh prompts. Partner networks: Tribal government and programs, health systems, behavioral health providers, and community organizations amplified invitations and key messages through their channels. What do you plan to do during the next reporting period to accomplish the goals?Next period, we will convert symposium momentum into routine delivery at worksites, expand Spanish-only access, deepen Tribal collaboration, grow on-site naloxone readiness, and tighten evaluation--while planning the next annual conference. Actions are below. Employer outreach at scale: Add at least 10 additional worksite sessions across construction, extraction, and service sectors; continue shift-aligned scheduling. Spanish-language reach: Host at least three dedicated Spanish-only sessions; co-deliver with Hispanic-serving partners; iterate materials from participant feedback. Tribal collaboration: Build on the 2025 symposium by scheduling follow-up trainings and small-group refreshers with Ute Tribe partners; maintain cultural safety and data sovereignty. Kit expansion: Increase business-kit placements from 15 to at least 25; pilot QR-based micro-refreshers at kit locations. Evaluation: Launch 3-month follow-up data collection for eligible non-Tribal trainees; raise paired pre-post completion using streamlined consent and brief instruments. Next conference cycle: Begin planning for the next annual conference focus area while continuing Tribal partnership activities seeded at the 2025 symposium. Sustainability: Formalize train-the-trainer tracks with Extension educators and partner organizations to extend geographic coverage without fidelity loss.

Impacts
What was accomplished under these goals? Key Accomplishments Delivery scale:17 sessions (16 in-person, 1 virtual); 1,219 participants total. Geography:Roosevelt, Duchesne, Vernal, Ballard, and Fort Duchesne, UT. Objective 1 (curriculum + training reach): Finalized overdose response curriculum in English and Spanish with embedded speaker notes and scenarios. Delivered 17 sessions to 1,219 participants across community events, courts/corrections, employers, service venues, faith/civic partners, and a Tribal community site. Implemented pre/post evaluation where appropriate; 83 participants completed paired instruments this period. Objective 2 (naloxone access): Distributed 80 naloxone kits to trained participants. Placed 15 workplace overdose-response "business kits" with owners/managers. Objective 3 (Native American focus): Hosted theUte Indian Tribe Opioid Symposium: Education, Prevention, & HealingonMay 6-7, 2025at theNuchu Civic Center (Fort Duchesne, UT).Attendance: 220. Program highlights:opening welcome and invocation (Mylo Smith, Larry Cesspooch); breakouts on the Utah opioid epidemic (Dustin Gillespie) and stigma/harm reduction (Michelle Q. Chapoose, LSUDC); recovery journey keynote (Mylo Smith);All-Ages Narcan training (Dr. Aaron Hunt)offered during day and lunch sessions; youth resilience (Rocky Herron); coping-skills workshop (Flo Grant, Cara Murray); roundtable on "The Who, What, and Where of Hope" (Jonah Grant, Dr. Mickelson, Jason Law, Isaac Barraza; moderator Michelle Q. Chapoose); evening Family Night with community success stories, a comedy hour, and luminary lighting. Partners:Ute Indian Tribe; Indian Health Service; Addict to Athlete; Ute Indian Tribe Alcohol/Substance Use Abuse Prevention Program (ASAPP); Bureau of Indian Affairs Office of Justice Services; Be the Light Recovery Foundation; Indigenous Health and Wellness Connections; Ashley Regional Medical Center; NAT-Su Behavioral Health; Northeastern Counseling Center; Red Pin Treatment Center. Cultural safety:respected data sovereignty; no surveys administered on Tribal lands; delivery emphasized oral communication and community norms. Conducted additional Tribal community training activities in Fort Duchesne within the broader session count above. Objective 4 (Hispanic/Spanish-speaking focus): Finalized all core training, participant handouts, and evaluation materials in Spanish. Delivered a Spanish-language session and reached Hispanic workers/families via mixed-audience events; refined plain-language Spanish materials based on field feedback. Objective 5 (annual conference): Completedthe annual conference requirement this period via the Tribal-focused symposium described above (220 participants). Conference design prioritized practical skills (hands-on Narcan training), lived-experience storytelling, and culturally grounded healing activities. Operational notes: Justice-involved adults reached at county courts/corrections during high-risk transitions. Faith/civic connectors and senior groups engaged to expand trained-bystander coverage. High-traffic community events (e.g., UBIC Family Fun Day) used to normalize bystander response at scale.

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