Community Social Services Research Articles

“Ajudar” – a practice with people with mental disorders treated with long-acting injectables

Abstract Issue Mental Health problems are one of the main causes of disability and morbidity. We think it is pertinent to intervene, providing special care for people with mental disorders and their families. We developed the project “Ajudar” (“To Help”), in a municipality in Northern Portugal. Description of the problem “Ajudar” started in 2013. Its main goal is to contribute to reducing the impact of mental disorders. Its objectives are to identify people with mental disorders treated with long-acting injectables (LAI) and to promote treatment adherence. We identified the Health Units (HU) where these patients take the medication and verified their compliance. An informatic alert was issued when there was non-compliance and we participated in home visits when patients did not show up. We also checked the situation if there was involuntary treatment. We wanted to know if this practice contributed to treatment compliance and to reduce involuntary treatment. Results We gradually identified more people, from 47 in 2013 to 108 in 2024. In 2013, 7 people with mental disorders treated with LAI had an involuntary treatment, whereas in 2019 it was 4. We didn’t analyze data from 2020 to 2022, due to the COVID-19 pandemic. We don’t have the complete data from 2023 yet. Lessons Within the years of “Ajudar”, there was a more than twofold increase in the identified patients and a reduction of almost fourfold of the patients that had an involuntary treatment. Analyzing these data one must be careful due to small numbers bias. We think that a similar project is feasible in other settings. In our response to this Public Mental Health issue, we collaborated with everyone involved with these patients, from health profissionals to resources in the community (social services, community leaders, etc). Key messages • There was a decrease to almost ¾ in the number of patients that had an involuntary treatment. • Involvement with the community is key.

Spatial context and informal caregivers’ Well-being: A case study of a Carer Café project in Hong Kong

This paper evaluates how a Hong Kong community Carer Café program reduce the informal (unpaid) caregivers’ navigation burden of social and health care service system. The cafés took place once biweekly at pantries and activity rooms of social service centers, community centers, and churches, which installed temporary decorations to create a café-like environment. his article will use the conceptual framework of spatial context, including spatial propinquity, spatial composition, and spatial configuration, to highlight four mechanisms in the process of informalization. They are (a) changing layout; (b) promoting spatial propinquity of caregivers; (c) creating a spatial composition facilitating social interaction; and (d) allowing the caregivers to use informal spaces flexibly. Qualitative data from 26 respondents, including social workers, project staff, volunteers, and users, sheds light on the details of four mechanisms. Results show that the Carer Cafés were transformed into a safe and caregiver friendly third place by the informalization process. Thus, caregivers from communities visit cafés frequently. These frequent visits facilitate the Cafés become a hub for informal caregivers access different resources and supports. This paper suggest that spatial context would be an important consideration to further explore in the future community caregiver support service practice and policy.

The right to be rural: Farm community development and social services in Zimbabwe’s resettlement areas

ABSTRACT At a time when practitioners and scholars are crystallized around reconnoitering the outcomes of Zimbabwe’s fast track land reform, focus on farm community development and social services in the resettlements is paltry. These communities were envisaged to be enablers and guarantors of rural and national development. Applying a Transformative Social Policy approach and qualitative methodology, the article draws on nuanced insights from the resettlement areas with the principal aim of advancing pathways for improving farm community development. The study shows that fast track communities are characterized by multiple and enduring lacunae in social services particularly schools, clinics, potable water, shopping centers, accessible roads, and reliable transport. However, the farmers are responding in agentive and innovative ways to reduce the challenges. This study enriches community development theory, and informs policy-makers on pertinent aspects that should inform policy and practice in relation to social services and development in resettlement areas.

Pursuing a Deep Ecology of Rural Volunteerism: An Extended Conceptual Framework for Sustainable Social Service Delivery and Community Development

Pursuing a Deep Ecology of Rural Volunteerism: An Extended Conceptual Framework for Sustainable Social Service Delivery and Community Development

Supporting the nutrition-related health and well-being of people experiencing socio-economic disadvantage: Findings from a national survey.

People experiencing socio-economic disadvantage face significantly higher rates of diet-related health inequities. This study aimed to explore barriers, opportunities and potential solutions in providing food and nutrition services to people experiencing socio-economic disadvantage from the perspective of services providers. The present study is part of a broad co-design model to improve service provision for people experiencing socio-economic disadvantage. A cross-sectional online survey involving 33 open and closed-ended questions was distributed to Australian governmental and non-governmental organisations providing nutrition-related support to people experiencing socio-economic disadvantage aged 16 years and over. Data were analysed using frequency distributions and conceptual content analyses. Sixty-eight responses were analysed. Services are predominantly offered by charitable organisations (90%), funded through private donations (66%) and reliant on volunteers (100%). Barriers to supporting clients' nutrition needs include financial constraints, limited community engagement, understaffing, insufficient resources and knowledge gaps. Opportunities and solutions for enhancing support include increasing government funding, advocacy initiatives, stronger community collaboration and more holistic, customised services. Proposed recommendations include establishing purpose-built facilities or wrap-around services to expand access to health services, life skills, training and educational programs. Services face challenges including volunteer reliance, limited resources and inadequate government support, hindering food provision. Client barriers include transportation costs and lack of social support. With dedicated financial support, services can offer comprehensive assistance, including community spaces, staffing, health and social services and training. Community partnerships can maximise funding impact. Solutions must address overall well-being and broader social determinants such as income inequality and housing.

Building Bridges: Increasing Access to Care and Continuation of Medication for Opioid Use Disorder Through Community Partnerships

The opioid epidemic continues to pose a formidable challenge to public health, necessitating innovative approaches to enhance access to care and support continuity of treatment for individuals with opioid use disorder (OUD). Opioid overdose-related deaths in Detroit have increased over four-fold from 1999 to 2019, yet the rate of medication for opioid use disorder (MOUD) prescriptions in Detroit has been half the rate compared to Michigan as a whole. Limited access to care remains a major factor in continued opioid use, which is driven in part by an individual’s insurance coverage. As the largest payer of substance use disorder services in the United States, Medicaid plays a central role in efforts to address the opioid epidemic. Over half of the Detroit population is either enrolled in Medicaid or uninsured. Henry Ford Hospital (HFH) continues to treat hospitalized patients with OUD. Post-discharge follow-up appointments for continuation of MOUD have been shown to increase rates of prolonged abstinence, reduce rates of readmission, and decrease mortality rates. Despite HFH’s significant community impact, there have been limitations on which insurance carriers are accepted at our institution when patients try to establish outpatient primary care or specialty addiction medicine services for MOUD. This insurance-driven barrier has consequently limited our ability to provide best practices in supporting patients with OUD. To address this disparity, we aimed to investigate the impact of leveraging our partnership with Community Health and Social Services (CHASS) Clinic, a local Federally Qualified Health Center network, as an opportunity for underinsured and non-insured patients with OUD to have increased access to post-discharge follow-up appointments with qualified providers for continuation of MOUD. In collaboration with the HFH Addiction Medicine Consult team, HFH Primary Care Physicians, and CHASS MOUD providers, we designed a multifaceted intervention to improve the continuum of care for patients with OUD. We established a post-discharge referral pathway between HFH and CHASS, enhancing communication channels to facilitate care coordination. If a patient was admitted to HFH with a diagnosis of OUD and received an Addiction Medicine consult, the primary team was advised to arrange a post-discharge follow-up appointment for MOUD. The location of the appointment was determined by the patient’s insurance. Patients already established with HFH, or with commercial insurance, were scheduled with HFH providers for MOUD. Patients with Medicaid or no insurance were scheduled with CHASS MOUD providers. In the six months prior to implementation, only 3 of 60 (5%) of patients with a diagnosis of OUD that received an Addiction Medicine consult were scheduled to have a post-discharge follow-up for MOUD. In three months after implementation, 8 of 32 (25%) patients received post-discharge follow-up for MOUD. By utilizing the partnership between HFH and CHASS, our intervention was associated with a five-fold higher rate of follow-up appointments for continuation of MOUD. These findings underscore the effectiveness of community partnerships in addressing barriers to care and enhancing treatment for individuals with OUD.

Reclaimed Voices: The Silent Impact of Women’s Experiences of Homelessness

Background: Homelessness is a rising crisis that affects hundreds of thousands of individuals in America; but affects women differently than men. The experiences women face while homeless can translate into traumatic experiences and profoundly shape an individual's story of homelessness. These experiences prompt a need to change the systems that contribute to homelessness. Purpose: This study aims to highlight trauma across women's experiences of homelessness. Methods: Data collection for this research was conducted through qualitative interviews with eight women experiencing homelessness in Modesto, California. NVivo, a qualitative data analysis software, was used to format the interviews, identifying common code words that developed into overlapping themes. Results: The eight interviews of women experiencing homelessness identified core emerging themes of causes of homelessness, fear of loneliness, quality, and type of available services, perception of homelessness, and an understanding of the societal constructs of homelessness and gender. This research confirmed that some women experiencing homelessness are less likely to report traumatic experiences and seek support from their local social service community providers. The limitations of the smaller sample size only captured a small scale of the problem being analyzed to a potentially larger issue. Conclusion: Services should begin focusing on asking more trauma-informed questions, not only to improve care but to allow more women experiencing homelessness the chance to seek help; this is the only way to begin understanding how their traumatic experiences have impacted their livelihood.

Social Factors Associated with Insecurity in Nigerian Society

The study examines the societal issues that contribute to the level of insecurity in Nigerian society using the Autoregressive Distributed Lag (ARDL) co-integration technique with data from 1991 to 2022. The variables used as independent and societal factors generating insecurity include the unemployment rate; the high cost of living in society; insufficient funds for education, community social services, healthcare services, and infrastructure; and agricultural development. Among the criteria evaluated, inadequate school financing and the unemployment rate appear to be the most significant sources of insecurity in society as a result of young people’s involvement in abduction, violence, and other societal issues. The study recognizes that government measures aimed at reorienting society towards a peaceful environment for habitation are critical. It is of the utmost importance to provide employment for young people and adequately support schools in order to lower the number of youngsters who are not in school. These out-of-school children are readily persuaded to join groups that make society untenable. Thus, free education is strongly suggested to engage and develop their thoughts in a constructive manner so that they can be valuable to society.

Access to primary health care: perspectives of primary care physicians and community stakeholders

BackgroundAction on the social determinants of health is important to strengthen primary health care and promote access among underserved populations. We report on findings from stakeholder consultations undertaken at one of the Canadian sites of the Innovative Models Promoting Access-to-Care Transformation (IMPACT) program, as part of the development of a best practice intervention to improve access to primary health care. The overarching objective of this qualitative study was to understand the processes, barriers, and facilitators to connect patients to health enabling community resources (HERs) to inform a patient navigation model situated in primary care.MethodsFocus groups and interviews were conducted with primary care physicians, and community health and social service providers to understand their experiences in supporting patients in reaching HERs. Current gaps in access to primary health care and the potential of patient navigation were also explored. We applied Levesque et al., (2013) access framework to code the data and four themes emerged: (1) Approachability and Ability to Perceive, (2) Acceptability and Ability to Seek, (3) Availability and Accommodation, and Ability to Reach, and (4) Appropriateness.ResultsDeterminants of access included patient and provider awareness of HERs, the nature of the patient-provider relationship, funding of HERs, integration of primary and community care services, and continuity of information. Participants’ perspectives about the potential scope and role of a patient navigator provided valuable insight for the development of the Access to Resources in the Community (ARC) navigation model and how it could be embedded in a primary care setting.ConclusionAdditional consultation with key stakeholders in the health region is needed to gain a broader understanding of the challenges in caring for primary care patients with social barriers and how to support them in accessing community-based primary health care to inform the design of the ARC intervention.

In Case You Haven't Heard…

Linda Hurley, president and CEO of CODAC Behavioral Health Care, is on the verge of launching yet another trailblazing treatment program. A fully integrated “health and wellness” facility, it will offer opioid treatment program services along with primary care, mental health services, dental care and an on‐site full‐service pharmacy, as well as a peer recovery community center and social services. Hurley's move is no surprise to people in the substance use disorder field, as she has been leading the way for decades from her base in Rhode Island, a small state where many innovations are possible, but only Hurley has set a standard for all other states. So it's no surprise that many organizations line up to give her awards. Most recently, the National Council for Mental Wellbeing will recognize her during their conference next week, where she will give a speech to accept the organization's “Lifetime Achievement Award.”

The Effectiveness of Regional Regulation Number 19 of 2021 on Beggars and Buskers in Pontianak City

This study aims to assess the effectiveness of Regional Regulation No. 19 of 2021 in addressing the presence of beggars and buskers in Pontianak. Data sources include primary and secondary data, with analysis guided by Dunn's Evaluation Theory, focusing on five indicators: program understanding, target accuracy, timeliness, goal achievement, and real change. This theory elucidates the nexus between government decision-making and regulation implementation. Data were collected through observation, interviews, and document analysis as part of qualitative descriptive research. Informants, comprising Pontianak City social service employees, buskers, beggars, and community members, were selected using Purposive Sampling. The regulation was instituted in response to the fluctuating numbers of beggars and buskers in Pontianak from 2019 to 2023. Findings indicate a necessity for the regulation to better align with Effectiveness Indicators, notwithstanding commendable progress in actual change indicators. Nonetheless, further enhancements are required for the regulation to achieve optimal effectiveness.

Menstruating while homeless: navigating access to products, spaces, and services

BackgroundPeople experiencing homelessness (PEH) in the United States face substantial challenges related to menstruation, exacerbated by the COVID-19 pandemic. Limited access to period products, heightened stigma, and gynecological challenges contribute to increased hardships for PEH, highlighting the need for improved services and policies to address period equity and overall well-being for this vulnerable population.MethodsWe conducted semi-structured qualitative interviews with PEH (n = 12) and community healthcare and social service providers (e.g., case managers, shelter directors, community health workers, and nurses, n = 12) in Lafayette, Indiana, a city located between Indianapolis and Chicago in the United States. We used thematic analysis techniques for data analysis.ResultsPEH’s limited access to products, services, and safe spaces hindered effective menstruation management within restrictive community contexts. Although community healthcare and service providers offered some support, complex interactions with the healthcare system, stigma, and limited access to spaces exacerbated barriers. The COVID-19 pandemic further intensified these difficulties by closing public spaces, worsening economic conditions, and straining service provider resources.ConclusionsResults highlight critical organizational and policy gaps in the United States for menstruation management resources and services, emphasizing the need for better integration into health and well-being programs for PEH. These insights will advance reproductive and public health research, shedding light on the disparities faced by PEH in managing menstruation in Indiana and contributing to the national discourse on addressing these barriers. Amid the complex landscape of public health, particularly during and after the pandemic, prioritizing menstrual health remains essential for all individuals’ overall well-being, including those experiencing homelessness.

Analysis of the funding of social services from a spatial approach in Andalusia (Spain)

In Andalusia, Community Social Service Centres (CSSCs) are funded by regulations following demographic, geographic, economic, and social disadvantage criteria. This study aims to analyse the geographical distribution of funding per inhabitant of CSSC by catchment area in Andalusia in 2019, and to study the statistical associations between funding and a range of demographic and socioeconomic indicators. The study spatial units (n = 184) included the catchment areas of CSSCs and, in the case of intramunicipal areas in large municipalities, they were grouped at the municipal level. Spatial autocorrelation measures were used to identify spatial clusters of high/low funding rates per inhabitant. Later, nonspatial and spatial regressions were applied to search for associations with different indicators (sex ratio, ageing index, dependency index, emigration rate, immigration rate, unemployment rate, population density, and employment rate in the primary sector). The geographical distribution of the funding of social services in Andalusia was not random since the analyses identified several spatial clusters with significantly high (hot spots) and low (cold spots) funding per inhabitant (p < 0.05). The funding rates were significantly (p < 0.05) and directly associated with the ageing index and the percentage of primary sector employees, and indirectly with the proportion of foreigners in the population and the population density. The hot spots were mainly located in rural and deprived areas, while the cold spots were in urban areas. The variables related to the regulated funding distribution criteria were not fully associated with higher financing. Instead, other additional variables showed significant associations (p < 0.05), such as primary-sector workers and foreign populations. The results showed that spatial analyses may support service assessment and decision-making in social policy.

Community-Based Drug Recovery Program Social Services in Disruptive Times: Experiences of Person Who Use Drugs in Palawan, Philippines

The restricted movements during the COVID-19 pandemic have created challenges for people who use drugs (PWUDs) to access and complete community-based drug rehabilitation program (CBDRP) social services. This study aims to investigate the experiences of PWUDs undergoing CBDRP in Palawan, Philippines during disruptive times such as the COVID-19 pandemic with a focus on the changes in the social service support mechanisms enabling PWUDs to continue in their recovery. 188 PWUDs undergoing CBDRP in the 11 municipalities of Palawan participated in focus group discussions between July to December 2022. Participants were asked about the effects of the consequences of the COVID-19 pandemic such as social isolation; modification in the CBDRP social services delivery and accessibility; shifting focus of the CBDRP in-charge officers; and changing family dynamics. Transcripts were analyzed using thematic analysis and it revealed four themes: (1) Experiences of PWUDs on CBDRP social services support mechanisms as against as planned; (2) Challenges in completing CBDRP; (3) Leadership initiatives observed by PWUD; and (4) Role of local groups and PWUDs’ family in the recovery of PWUDs during COVID 19 pandemic. The study demonstrates a need for a holistic care approach with psychosocial needs support services; enhanced family and community engagement; sustainable livelihoods programs; digital transformation and digital engagement; and capacitating the social service providers particularly those at the barangay level and local groups as vital factors for better CBDRP delivery. Further, the study exposed the necessity for data-driven and context-specific policies flexible and agile enough to enable better social services delivery, community participation, and effective implementation. Keywords: community-based drug program, social services, person who uses drugs, COVID-19, public policy

A collaboration team to build social service partnerships within a safety-net health system

BackgroundTo facilitate safety-net healthcare system partnerships with community social service providers, the Los Angeles County Department of Health Services (LAC DHS) created a new collaboration team to spur cross-agency social and medical referral networks and engage communities affected by health disparities as part of a Sect. 1115 Medicaid waiver in Los Angeles County entitled Whole Person Care-Los Angeles (WPC-LA).MethodsThis observational research reviews three years of collaboration team implementation (2018–2020) through Medicaid-reportable engagement reports, a collaboration team qualitative survey on challenges, facilitators, and recommendations for community engagement. Member reflections for survey findings were conducted with the collaboration team and LAC DHS WPC-LA leadership.ResultsCollaboration team Medicaid engagement reports (n = 144) reported > 2,700 events, reaching > 70,000 individuals through cross-agency and community-partnered meetings. The collaboration team survey (n = 9) and member reflection sessions portrayed engagement processes through outreach, service assessments, and facilitation of service partnerships. The collaboration team facilitated community engagement processes through countywide workgroups on justice-system diversion and African American infant and maternal health. Recommendations for future safety net health system engagement processes included assessing health system readiness for community engagement and identifying strategies to build mutually beneficial social service partnerships.ConclusionsA dedicated collaboration team allowed for bi-directional knowledge exchange between county services, populations with lived experience, and social services, identifying service gaps and recommendations. Engagement with communities affected by health disparities resulted in health system policy recommendations and changes.

Public spending and rural development in Nigeria

The concerns of modern development have been on the need to boost living conditions which involves reducing poverty, unemployment, and inequality. Statistics has proved that these indices are quite high in the rural areas hence, the need to put up the needed actions to facilitate rural development. In this paper, we explored the role of public spending in fostering rural development in Nigeria from 2000 to 2020. The public spending on economic services and that of social and community services were considered, while the key rural development indicators captured were people practising open defecation, access to drinking water (both basic and safely managed), access to sanitation (both basic and safely managed), and access to electricity. The analysis was conducted using the ordinary least squares estimation technique. Findings of the study indicated that public spending on social community services substantially reduced the proportion of rural Nigerians practicing open defecation; and it increases the proportion of rural Nigerians having access to safe drinking water, sanitation, and electricity. This made the study to conclude that public spending is potent in driving rural development in Nigerian hence, the need for increased spending on social and community services in the country.

The Contribution of the Agricultural Food Security Pack Programme to Beneficiary Households in Zambia: A Case Study of Mpulungu District

Small-scale farming provides most of the food produced in Southern Africa. Unfortunately, most vulnerable-but-viable small-scale farmers in Zambia are affected by household food insecurity despite the Zambian government providing them with farming inputs under the food security pack programme. This study investigated the effects of the programme on maize crop production among 147 vulnerable-but-viable farming households in Mpulungu District, using a mixed-methods approach. The study results revealed improved land cultivation, maize crop productivity and access to food by family members after respondents entered the programme. These results imply that the programme contributed positively to the achievement of the aforementioned positive successes, despite the beneficiaries receiving farming inputs late, i.e., outside the planting period. Notwithstanding the many positive effects achieved by the programme, there were some challenges, namely, the late receipt of farming inputs by most beneficiaries, failure by the Zambian government to release timely funds to suppliers of farming inputs, imposition of some male beneficiaries into the programme by politicians, and low literacy levels among most beneficiaries. The study concludes that despite the challenges encountered in the programme implementation, the food security pack programme had positive effects on maize crop production among most of the benefiting vulnerable-but-viable small-scale farmers in Mpulungu District. Therefore, the study recommends scaling up the programme and increasing the number of programme beneficiaries, timely distribution of inputs and budget profiling by the Ministry of Community Development and Social Services — a lead ministry for implementing the programme.

Addressing the Community Resource and Social Service Needs of Families During the COVID-19 Pandemic: Perspectives of Home Visiting Staff and Clients in Georgia.

Home visiting programs provide support services to families and their children to promote positive health outcomes. This study sought to describe strategies employed by home visiting programs during the early phase of the COVID-19 pandemic to address the community resource and social service needs of home visiting clients in Georgia. We conducted a mixed methods study between December 2020 and April 2021 using online surveys and key informant interviews of home visiting staff and clients from 21 program sites. Structured content analysis was conducted of the triangulated data to elicit thematic findings. Due to the pandemic-induced economic conditions, clients expressed increased demand for housing, employment, and childcare support services. Staff experienced challenges with client referrals to these services because of interruptions in social service availability and transitions to virtual services. In response to these challenges, home visiting programs strengthened existing community partnerships and created new collaborations with local agencies to fill any gaps in services. Home visiting programs in Georgia provided critical linkages to community resources for families during the early phase of the pandemic. Preserving this essential home visiting service in future national emergencies will require improved coordination of community resources and social services.

The Lived Experiences of People with Severe Obesity Who Use Community Health and Social Care Services: A Qualitative Interview Study

Evidence indicates growing demand on community health and social care services by people with severe obesity (BMI ≥40 kg/m2), often due to functional limitations. The experiences of this population are largely unexplored. As part of a larger mixed‐methods study, this qualitative study explored the lived experience of people with severe obesity using community health and social care services. Participants were recruited via community professionals and visited at home. They consented to individual, audio‐recorded, semistructured interviews, which were transcribed and analysed using thematic analysis. Nine women and three men (n = 12) participated, aged 40–76 (mean 60) years, BMI ranged from 45 to 74 (mean 59) kg/m2, and eight were housebound. Three overarching themes were identified. Firstly, the hidden struggles of living with a larger body affected all participants, including functional limitations affecting mobility and personal care. These contributed to a sense of being stuck physically, socially, and biographically. Secondly, most participants reported implicit weight bias by a system structurally unprepared to care for people with larger bodies. The majority of participants showed strong internalised weight bias, linked to shame and self‐blame for their poor function and larger bodies. Thirdly, a day‐to‐day coping theme highlighted strategies regularly used by participants: resigned acceptance, avoidance and denial, exercising choice, and support from informal carers. These findings demonstrate that participants experienced unmet physical and psychological care needs associated with living with a larger body, leading to poor quality of care and life. Given rising prevalence, changes to care services are needed. Specific recommendations include staff training about the needs of people with severe obesity, ensuring that the physical infrastructure of care services can safely accommodate people with severe obesity, and improving access to effective, person‐centred weight management treatments.

Opioid Misuse Harm Reduction.

The misuse of opioids by the public is a major health issue. Prescription opioids and nonprescription opioids, such as heroin and opium, are misused in epidemic proportions. When opioids are used incorrectly or illegally, they can lead to drug dependence, addiction, morbidity, and mortality. This program is in collaboration with the Jolt Foundation that provides resources to prevent opioid overdose deaths. This program involves community education on the dangers of opioid use and training on the use of naloxone rescue procedures to prevent overdose deaths. A pretest-posttest design was employed to determine if participants gained knowledge regarding the naloxone administration procedures. The researcher presented 10 community naloxone trainings that included staff from 20 different social service agencies, two schools, and three local churches. Each agency received at least one naloxone kit. The outcomes were met and included educating 137 participants on the risk factors and signs and symptoms of opioid overdose and the proper procedure to administer naloxone. One hundred twenty-eight posttests were returned and showed that the objectives for the project were met. The overall mean score for the pretests was 65.00 ( n = 126) with a standard deviation of 19.01, and the overall mean for the posttests was 86.64 ( n = 128) with a standard deviation of 14.60. Community social service agency staff were successfully educated to respond appropriately to overdose situations in a group training setting as evidenced by significant posttest scores.