Ready, willing, and able: understanding opioid overdose preparedness among college students in the southwestern United States

Introduction The Ready, Willing, Able framework aids in examining emergency response preparedness among college campuses and student communities. There remains a gap in understanding levels of readiness, willingness, and ability in opioid overdose response among college students in the southwestern United States. Methods We conducted a multiple methods protocol using a concurrent triangulation design. A cross-sectional survey was conducted among N = 352 college students at a university in the southwestern United States to measure readiness (i.e., knowledge of campus-based resources), willingness (i.e., comfort in spreading awareness of campus-based naloxone resources), and ability (i.e., reported knowledge of how to use naloxone). Descriptive analyses characterized levels of readiness, willingness, and ability among college students. Five focus groups were also conducted with N = 32 students who reported proximal experiences to overdose (i.e., personally experiencing, witnessing, or knowing someone who had experienced overdose) to understand factors that influenced readiness, willingness, and ability for overdose response preparedness, as well as perceived solutions to improve these domains among college students at their university. Applied thematic analysis and the Ready, Willing, Able framework guided qualitative analyses. Results Survey findings characterized low levels of readiness, moderate levels of willingness, and low levels of ability for opioid overdose response preparedness. Emergent themes from applied thematic analysis revealed facilitating factors (e.g., accessing campus-based naloxone/training from various sources, targeting coursework into health-related tracks, granular details on overdose response protocol) and barriers (e.g., lack of advertisement of university resources, apathy/stigma toward overdose response preparedness, ineffective training) to overdose response preparedness. Students offered a multitude of solutions to improve readiness (e.g., expanding access to and awareness for university-based resources), willingness (e.g., empathy-based messaging to promote awareness), and ability (e.g., hands-on and step-by-step trainings) in overdose response preparedness. Conclusion Findings highlighted areas of need among college students in improving opioid overdose response readiness, willingness, and ability in emergency preparedness. Student perspectives and expertise, as well as institutional resources (i.e., overdose education and naloxone distribution services, media-based awareness initiatives), should guide efforts to improve opioid overdose response preparedness on college campuses.