PAC 799B Module 8 Final Manuscript and Presentation Example

From Manuscript to Practice: Abstract, Presentation and Dissemination of the Pine Hollow Naloxone Evaluation

Student Name

Psychology and Addiction Studies Program, Aspen University

PAC 799B: Addiction Studies Capstone

Instructor Name

Month Day, Year

From Manuscript to Practice: Abstract, Presentation and Dissemination of the Pine Hollow Naloxone Evaluation

Abstract

People leaving jail with opioid use histories face a sharply raised chance of dying from an overdose soon after they walk out, yet at the Pine Hollow County Detention Center, fewer than two in five eligible people accepted the naloxone kit offered at release. This mixed-methods program evaluation described uptake under the opt-in offer, explored reasons for accepting or declining through fourteen interviews with released people and nurses and assessed a switch to an opt-out offer in which kits were packed with each eligible person's belongings. Under opt-in, 157 of 412 eligible people (38.1%) left with a kit, with the weakest uptake for night and court releases. Four themes emerged from interviews: reluctance to accept in front of officers, rushed releases, kits taken for family and, under opt-out, kits simply being there. After the switch, 168 of 207 (81.2%) left with a kit; segmented regression estimated an immediate rise of 42.6 percentage points that persisted through the follow-up; the night gap nearly closed. About one in five still declined, often from fear of police. Packing naloxone by default for people leaving jail is a simple, low-cost change that substantially increased the share of people leaving with an antidote during their period of highest risk. Effects on overdose deaths were not measured.

Final Revisions

The final manuscript was checked chapter by chapter for consistency. The purpose statement and research questions were confirmed identical in Chapters 1, 3 and 4. Numbers in the text were checked against tables and against the cleaned data, which corrected one figure in Chapter 4 that had been calculated before the duplicate records were removed. The method chapter was revised into past tense. The limitations were moved to their own section, as the program's template requires. Appendices were added for the consent form, interview guides, release desk script and decisions log.

Presentation Plan

The plan leaves five minutes for questions within a twenty-minute slot. Each slide carries one message, usually one number or one quotation.

Getting the Findings to People Who Can Use Them

Brownson et al. (2009) argued that evidence-based public health depends not only on good evidence but on getting it to decision makers in forms that fit how they decide, and on adapting interventions to local conditions. Following that argument, Avery matched each audience to a format.

Why Other Jails Might Listen

Green et al. (2018) described how Rhode Island's unified correctional system adopted medications for opioid use disorder system-wide and saw deaths after release fall. Their example shows that correctional systems can change practice at scale when evidence and leadership align. Opt-out naloxone is a far smaller change, requiring no new staff or prescribers, which makes it easier to spread. The summary for other jails will lead with the idea from Johnson and Goldstein (2003) that changing the default changes the outcome, because it explains in one sentence why the procedure works.

Anticipated Questions at the Defense

Avery prepared answers to three likely questions. Asked whether the change might be explained by something else, Avery will point to the timing and shape of the change and to the events log. Asked whether the kits were used, Avery will say that use was not measured, describe the five interview accounts as illustrations only and point to the research recommendation. Asked what other jails should do first, Avery will say: map the handoffs between staff groups before the first kit is packed.

What Changed at Pine Hollow

By the time of the final manuscript, the jail administrator had signed a written policy making opt-out kits standard at release, the property checklist had been added to the property room's written procedures and the county health department had agreed to hold a one-month reserve of kits. The peer organization had begun offering kits to people who declined at the desk. These changes mean the project's main recommendation was already in place before the manuscript was submitted.

Final Checklist

Presenting to Different Audiences

The defense presentation is only one version of the story. For the staff meeting at the jail, Avery will cut the slides to five, lead with the quotations from nurses and released people and spend most of the time on what staff do differently now. For the sheriffs' association, the summary will lead with the before-and-after numbers and the low cost. Brownson and colleagues' point about fitting evidence to the decision maker applies to each version: the same findings, framed for what each audience can act on.

Closing Reflection

The project began with a number in a release log and ended with a change in how a jail sends people home. Its main lesson for practice is that small procedural details, where a kit sits and what a nurse says, can decide whether a good policy works at the counter where it meets people. Avery hopes to carry that lesson into a career in re-entry services.

References

Brownson, R. C., Fielding, J. E., & Maylahn, C. M. (2009). Evidence-based public health: A fundamental concept for public health practice. Annual Review of Public Health, 30, 175-201. https://doi.org/10.1146/annurev.publhealth.031308.100134

Green, T. C., Clarke, J., Brinkley-Rubinstein, L., Marshall, B. D. L., Alexander-Scott, N., Boss, R., & Rich, J. D. (2018). Postincarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system. JAMA Psychiatry, 75(4), 405-407. https://doi.org/10.1001/jamapsychiatry.2017.4614

Johnson, E. J., & Goldstein, D. (2003). Do defaults save lives? Science, 302(5649), 1338-1339. https://doi.org/10.1126/science.1091721