Øystein Bruun Ericson ^1* Desirere Eide ¹ Håvar Brendryen ¹ Philipp Lobmaier ^1,2 Thomas Clausen ¹

• ¹ University of Oslo, Oslo, Norway
• ² Diakonhjemmet Hospital, Oslo, Norway

Background A staff e-learning course was developed to prepare for scaling up a national takehome naloxone (THN) program in Norway. The aims of the study were to a) describe participant characteristics for those that completed a THN e-learning course, b) compare opioid overdose knowledge scores before and after e-learning course completion, and c) to explore subsequent THN distribution by those trained. Methods This was a quasi-experimental pre-test, post-test longitudinal cohort study of individuals completing a THN e-learning course from April 2021 through May 2022. Frequency analyses were performed for participant characteristics and subsequent naloxone distributions at one-week and one-month follow-up. The opioid overdose knowledge scale (OOKS) was used to measure pretest-post-test knowledge among participants. Wilcoxon signed-rank test was performed for comparison between pre-test and post-test. Effect size was calculated using Cohen criteria. Results In total, 371 individuals were included in this study. Most were either nurses or social workers (n=277, 75%). Participant knowledge increased by medium or large effect for all items measured. At one-month follow-up, 15% reported naloxone distribution. During the study period, 94 naloxone kits were distributed. Major reasons for not distributing were 'clients not interested', 'workplace not distributing' and 'workplace in process of distributing'. Conclusions Our findings suggest that an e-learning course is equally effective in terms of knowledge transfer as an in-person classroom setting, and may provide engagement in terms of naloxone distribution. However, our findings also emphasize the importance of clear implementation routines, including support from central coordinators to optimize the implementation process.