Research of youth. Based on these gaps in the

      Research Methods inCriminal JusticeMark RuppKaplan University              Research Methods in Criminal JusticeIntroduction            Youthopiate addiction and overdose has become an increasingly prevalent problem overthe past decade (Nargiso, Ballard, & Skeer, 2015). With opiates more widelyavailable than ever through sources like social media and schools, youth areincreasingly exposed to the risk of overdose (Nargiso et al., 2015).

In somecases, opiate overdose can be fatal.             Although there isevidence of increased youth opiate usage over the past decade, there remains alack of understanding as to how to train police officers to most effectivelyrespond to such incidents (Miller, Griffin, & Gardner, 2016). Specifically,there is currently a lack of knowledge in the research or within lawenforcement as to how to identify signs of opiate overdose and to engage in themost optimal responses to protectthose involved in such cases and also to prevent the widespread distribution ofopiates throughout communities with high populations of youth.             Basedon these gaps in the research, the purpose of the proposed study is toimplement a police officer training and education intervention in order toincrease knowledge and response efficacy pertaining to youth opiate overdose.

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Based on a review of the literature and evidence of signs of opiate addictionand overdose, a systematic framework for responding to opiate usage will beimplemented in a sample of police officers. The following section includes areview of relevant literature related to youth opiate addiction and overdose.Variables of interest are then considered, and the hypothesis is outlined. Reviewof Literature            TheUnited States has experienced an epidemic in terms of opiate addiction over thepast 10 years (Degenhardt et al., 2014). Due to a massive increase inaccessibility to opiate based medications and a growing black market for thesedrugs, the nation’s youth population has become more exposed to opiates inlocations like schools and through social media (Nargiso et al., 2015). As aresult, the risk of opiate addiction has risen in the nation’s youth (Nargisoet al.

, 2015).            There is a fairly largeand growing body of evidence pertaining to risk factors for youth opiateaddiction (Frank et al., 2015; Miller et al., 2016). For example, research hasshown that previous history of drug use and socioeconomic status both predictopiate usage in youth populations and particularly in those who are involved instreet gangs (Mitra, Wood, Nguyen, Kerr, & DeBeck, 2015). Furthermore,there is an increasing body of evidence regarding treatments for opiateaddictions in both adult and youth populations (Saloner, Feder, & Krawczyk,2017). A combination of psychiatric and medical intervention is typicallyrequired to manage opiate addiction longitudinally because of its psychologicaland physical withdrawal symptoms (Miller et al., 2016).

            However, while evidencehas growth with regards to the prevalence of opiate addiction in youth and itstreatment, there is little research on officer training programs, knowledge, orexperiences with responding to opiate overdose in youth populations. In fact,no known studies have specifically explored the strategies and steps needed toengage in effective and time-efficient responses in the case of youth opiateoverdose from a law enforcement standpoint. In most cases, police officers arethe first to respond to substance overdoses and are responsible for engaging inimmediate strategies to protect the victim and also to subsequently proceedwith legal aspects of the case. Law enforcement officers play critical roles inidentifying signs and symptoms of an overdose and also understanding thechannels through which opiates are accessed by youth populations in order toprevent dissemination of these drugs and further risk of addictions andoverdose longitudinally.            Sufficiently controlledand peer-reviewed interventions of police officer training programs are neededin order to understand how to best respond to youth opiate overdose and also toprevent this problem in communities with high youth populations longitudinally.

Unpublished qualitative evidence has shown that police officer knowledge andunderstanding of youth opiate addiction is limited and that education andtraining is needed in order to provide these professionals with the skills andtraining needed to most effectively respond. In addition to training with respectto signs and symptoms of overdose, police officers require further education asto immediate medical response, appropriate referrals, and case follow upstrategies in order to proceed with legal aspects of the case if there arecriminal charges involved.             Evidence from anintervention designed to improve the knowledge and skills of police officerswith respect to youth opiate overdose may benefit researchers, practitioners,and policymakers alike.

Researchers would benefit from such evidence due to thelack of previous studies having addressed this subject and the insight thatwould be provided regarding an increasingly prevalent social and criminalissue. Practitioners in the field of law enforcement would benefit from suchevidence based on the revelation of potential strategies for training policeofficers to reduce response times and to be more proactive in preventionefforts involving opiate addiction. Finally, policymakers may benefit fromevidence of an intervention designed to improve knowledge and skills of policeofficers responsible for responding to youth opiate overdose by implementingwidespread reform in existing guidance and also instilling a specific set ofguidelines that officers can adhere to when called in for such episodes. ProblemStatement and Theoretical AssumptionProblem Statement: Theinterest is youth opiate addiction and the lack of knowledge and training ofeffective responses in the case of youth opiate overdose.

Theory:  Police officer training specific to youth opiateaddiction and overdose will improve knowledge and skills pertaining to overdoseresponse in police officers. The research question to be addressed in theproposed study is, “Can specialized training, including signs, symptoms, andemergency response strategies, improve police officers’ knowledge and efficacyin regards to youth opiate overdose?” Variablesand HypothesisThe dependent variable is the knowledge andskills regarding youth opiate overdose. The independent variable is police officertraining. It is hypothesized that an educational and skillstraining intervention will lead to significantly greater improvements inknowledge and response regarding youth opiate overdose. Youth opiate overdose knowledge will be assessed throughan examination based on course materials presented throughout the interventionand scored by the primary investigator. Emergency response skills will bemeasured based on a subjective evaluation of a simulated response and scoredsubjectively by a team of three evaluators, including the primary investigatorand two senior law enforcement officers trained in addiction and overdoseresponse. Population/ Sample            Thepopulation of interest in the proposed study will include law enforcementofficers in the United States who are tasked with responding to incidents orcases of youth opiate overdose. There are estimated to be slightly more thanone million law enforcement officers in the United States.

However, the exactnumber called upon to manage cases of youth opiate overdose is unknown andlikely to vary considerably by location. The exploratory and novel nature ofthe research topic precludes the ability to accurately obtain a random sampleof officers who face cases of youth opiate overdose.             Instead, an opportunitysample will be obtained for the purpose of the intervention. Two separate locallaw enforcement agencies will be contacted and at least 10 age- and gender-matchedofficers from each agency will be solicited for participation in theinvestigation.

One agency will be randomly allocated to the intervention groupand another will be placed in the no-treatment control group. Both groups willundergo baseline and post-study assessment for knowledge and skills related toyouth opiate overdose response. However, just the treatment group will receivethe educational intervention.             Although this studyutilizes a non-probability sampling strategy, the novelty of this researchtopic is believed to warrant the use of such an approach in order to ensurethat the participants who are recruited match the strict inclusion criteria.These include being a currently employed law enforcement officer in the UnitedStates, over the age of 18, and having had previous experience in responding toyouth opiate overdose. All other potentially available law enforcement officerswho have not had prior experience with such incidents were excluded fromrecruitment.

The resulting sample will include 20 law enforcement officers thatare matched based on age and gender and who are randomly allocated to atreatment or intervention group based on clusters, which will consist of theagency at which they are employed. ResearchDesign            Theresearch design is derived from evidence gathered in the literature review(i.e., Degenhardt et al., 2014; Frank et al.

, 2015;Mitra, Wood, Nguyen, Kerry, & DeBeck, 2015; Nargiso, Ballard, & Skeer,2015; Miller, Griffin, & Gardner, 2016; Saloner, Feder, & Krawczyk, 2017).A quantitative, quasi-experimental intervention design will be used in theproposed study. The study is quantitative because objective, numerical dataindicating officers’ knowledge of youth opiate overdose and skills inresponding to such incidents will be obtained prior to, and following, thestudy period. The study is quasi-experimental because true random sampling isnot used and there is no placebo condition. Instead, an opportunity sample willbe obtained, and cluster random sampling will be used based on the lawenforcement agency in which each officer is employed.             An intervention groupwill be compared to a no-treatment control. Figure 1 illustrates the researchdesign that will be used. Once participants are allocated into their groupsbased on cluster random assignment and age and gender matching.

Baselinetesting of knowledge and skills related to youth opiate overdose will thenoccur, consisting of a quantitative instrument battery derived from evidence ofyouth opiate overdose and best practices from the literature (Degenhardt et al., 2014; Frank et al., 2015; Mitra et al.,2015; Nargiso et al., 2015; Miller et al., 2016; Saloner et al., 2017).Each officer will also then undergo a simulated response scenario and judgedfor skill demonstration by two law enforcement education instructors, as wellas the primary investigator.

The mean score across these three raters will beused to indicate response skills. Figure 1. Illustration of intervention Intervention                   Pretest on DVs                     Educational Intervention      Posttest on DVs                             Cluster Random Assignment and Age/Gender Matching              Control               Pretest on DVs                                                                 Posttest on DVs                                           Time1                                        Time 2                          Time 3 DataCollection            Datawill be collected during two periods, including Time 1 and Time 3 (see Fig. 1).Primary data will consist of knowledge and education of youth opiate overdoseresponse best practices and skill demonstration. The former will be assessedthrough a novel instrument battery designed for the purposes of this study.

Findings and conclusions drawn from evidence in the literature regarding youthopiate overdose antecedents and symptoms, as well as best practices for lawenforcement response, will be used to generate items for the survey (Degenhardtet al., 2014; Frank et al., 2015; Mitra et al., 2015; Nargiso et al., 2015;Miller et al., 2016; Saloner et al., 2017). All survey responses will be based on a five-pointLikert scale, in which participants are asked to indicate the level to whichthey are asked to indicate the degree to which they agree or disagree with certainstatements pertaining to youth opiate overdose and best practices for lawenforcement response.

In addition, each officer will undergo a 10-minutesimulated youth opiate overdose scenario and required to demonstrate skill inadhering to best response strategies. Scoring will be done by two lawenforcement educators and the primary investigator and ratings will be based onfactors like response time, interaction with victim and witnesses, referral,and follow-up. The mean score obtained from the three raters will be used toindicate skill across each of these dimensions. During the intervention phase, the treatment group willundergo a four-week training and education program led by the primaryinvestigator and two law enforcement educators. The intervention will consistof four weekly sessions involving a theoretical component and a practicalsegment in which officers practice their newly acquired skills. The controlgroup will undergo no additional training.

Following the intervention phase,both groups will undergo the same testing as was performed during Time 1 in thepre-intervention phase. Data analysis will be performed using a between subject’sanalysis of variance to compare changes in pre- to post-test knowledge andskill with regard to youth opiate overdose response between the treatment andcontrol groups. An a priori alphalevel of 0.95 will be set and differences will be considered significant if theprobability of statistical error or chance is less than five percent (i.

e., p< 0.05).

Relevant post-hoc tests will be performed based on the nature ofthe data and to determine where individual sources of difference exist betweenthe two groups. Results will be used to draw conclusions about the efficacy ofan educational and skills training program for law enforcement officers taskedwith responding to youth opiate overdose. Consideration            Thenovelty of this research subject and instrument battery may limit the constructvalidity of this study. Additionally, this study may be limited in externalvalidity and generalizability to the broader population of law enforcementofficers because of the non-probability sample. However, this study isexploratory in nature and it is hoped that findings lead to future researchthat expands upon some of the design restrictions of the current investigation.The use of three raters during the skills assessment and mean score will bedone to increase the reliability of this subjective assessment.             Despite theseconsiderations, findings from this study may be useful in improving uponexisting knowledge and skills of law enforcement officers who are tasked withresponding to cases of youth opiate overdose.

These results may lead to futureresearch on the subject that addresses issues of validity and generalizability.Additionally, findings may lead to policy reform designed to enhance theknowledge and skills of officers throughout the country.  References Degenhardt, L., Charlson, F.

, Mathers, B., Hall, W. D.,Flaxman, A. D., Johns, N.

, & Vos, T. (2014). The global epidemiology andburden of opioid dependence: results from the global burden of disease 2010study. Addiction, 109(8), 1320-1333.Frank, D., Mateu-Gelabert,P., Guarino, H.

, Bennett, A., Wendel, T., Jessell, L.

, & Teper, A. (2015).High risk and little knowledge: overdose experiences and knowledge among youngadult nonmedical prescription opioid users.

International Journal of DrugPolicy, 26(1), 84-91.Miller, J. M., Griffin, O.H., & Gardner, C. M.

(2016). Opiate treatment in the criminal justicesystem: a review of crimesolutions. gov evidence rated programs. American Journalof Criminal Justice, 41(1), 70-82.Mitra, G., Wood, E.

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(2015). Drug use patterns predict risk ofnon-fatal overdose among street-involved youth in a Canadian setting. Drugand Alcohol Dependence, 153, 135-139.

Nargiso, J. E., Ballard, E.L., & Skeer, M.

R. (2015). A systematic review of risk and protectivefactors associated with nonmedical use of prescription drugs among youth in theUnited States: a social ecological perspective. Journal of Studies on Alcoholand Drugs, 76(1), 5-20.Saloner, B., Feder, K. A.

,& Krawczyk, N. (2017). Closing the medication-assisted treatment gap foryouth with opioid use disorder. Journal of the American Medical Association:Pediatrics, 171(8), 729-731.