Court navigators and opportunities for disseminating overdose prevention strategies

Abstract

Objective. Describe how navigator programs from three New England states (Connecticut, Maine, and Massachusetts) function to connect individuals using court services to community-based treatment and services. Hypothesis. Implementation science frameworks can be used to analyze how multiple court programs function to inform replication and address gaps in the use of overdose prevention strategies. Method. The Template for Intervention Description and Replication (TIDieR) Implementation informed semi-structured interviews as part of an exploratory mixed-methods analysis of court navigator programs. Analysis of interviews based on the TIDieR and administrative data on client contacts (n = 436) were analyzed. A subsample of clients with additional background information (n = 249) was used to examine court navigator recommendations. Results. The TIDieR revealed court navigator programs shared basic intervention characteristics but varied dramatically by resources and organization contexts. Nearly half (46.5%) of clients were self-referred and more than two-thirds (69.1%) approved follow-up but varied by program. Of those allowing follow-up, more than one-third (35.7%) had previously experienced an overdose. Court navigators were significantly more likely to refer clients with a history of overdose to locations where they can receive naloxone (the opioid overdose antidote) though only one program had naloxone on hand. Conclusion. Navigators are employed by community organizations with access to courthouses to provide resources to those passing through. These efforts can be implemented to support linkages to treatment and services but there is a significant gap in the allocation of overdose prevention strategies in court settings and court navigator programs have the potential to address this unmet need.