Examining adolescents' opioid knowledge and likelihood to utilize an educational game to promote medication safety.

BACKGROUND: Adolescents' knowledge on opioids is seldom studied, despite the fact young people are one of the groups most affected by the opioid crisis within the United States. There is a need to understand adolescents' perceptions about opioid misuse and safety to create the necessary tools to educate adolescents on safe opioid use. OBJECTIVE: This study sought to understand adolescents' knowledge and perceptions of opioid use and safety as well as their receptiveness to using an educational game for improving medication safety knowledge. METHODS: A 67-item survey was developed to assess adolescents' opioid perceptions, knowledge, and the likelihood of an educational game to enhance their opioid medication safety. A nationally representative sample of US adolescents aged 12 to 18 were recruited via a Qualtrics participant panel to complete the online survey from October through November 2020. Survey questions were grouped into 10 categories to represent key concepts and summarized into concept scores. Concepts were described through means, median, and range as well as percent correct for individual questions. Differences between groups were assessed using Kruskal-Wallis tests. Concept scores and their relation to the participant's age were described by the Pearson's correlation coefficient and the linear model coefficient. RESULTS: A total of 592 responses were analyzed. Male and older participants reported greater perceived opioid knowledge than females. White participants reported higher rates of perceived opioid knowledge, behavioral intent, and knowledge of safe medication disposal than any other racial group. About 80% of participants were receptive to the use of an educational game to increase their opioid safety knowledge. CONCLUSIONS: There are discrepancies in adolescents' knowledge on opioid safety and harm amongst genders, race, and age. Study findings support the use of an educational game to increase adolescents' opioid knowledge. Future studies should design an educational game intended for a diverse audience.

Investigating the Use of a Serious Game to Improve Opioid Safety Awareness Among Adolescents: Quantitative Study.

BACKGROUND: The misuse of opioid medications among adolescents is a serious problem in the United States. Serious games (SGs) are a novel way to promote the safe and responsible management of opioid medications among adolescents, thereby reducing the number of adolescent opioid misuse cases reported annually. OBJECTIVE: This study aimed to examine the effect of the SG MedSMART: Adventures in PharmaCity on adolescents' opioid safety knowledge, awareness, behavioral intent, and self-efficacy. METHODS: A nationally representative sample of adolescents aged 12 to 18 years were recruited online through Qualtrics panels from October to November 2020. Data collection consisted of a pregame survey, 30 minutes of gameplay, and a postgame survey. The pregame and postgame surveys included 66 items examining the participants' baseline opioid knowledge, safety, use, and demographic information. The postgame survey had 25 additional questions regarding the MedSMART game. Gameplay scenarios included 5 levels intended to mimic adolescents' daily life while educating the players about appropriate opioid storage and disposable practices, negative consequences of sharing opioid medications, and the use of Narcan. Survey questions were divided into 10 categories to represent key concepts and were summarized into concept scores. Differences in concept scores were described by overall mean (SD) when stratified by gender, race, school, grade, and age. Differences of change in concept score were analyzed using the Kruskal-Wallis and correlation tests. RESULTS: A total of 117 responses were analyzed. The results showed significant improvement on all concept scores except for Narcan knowledge (mean change -0.04, SD 0.29; P=.60) and safe storage (mean change 0.03, SD 0.20; P=.09). Female participants had greater improvement than males for safe disposal (female mean 0.12, SD 0.25 vs male mean 0.04, SD 0.17; P=.05). Male participants had higher improvement than female participants for misuse behavior (female mean 0.05, SD 0.28 vs male mean 0.14, SD 0.27; P=.04). Perceived knowledge for participants who had non-White or Hispanic racial backgrounds had higher improvement than for non-Hispanic White participants (non-White mean 1.10, SD 1.06 vs White mean 0.75, SD 0.91; P=.03). Older grades were associated with greater improvement in opioid knowledge (correlation coefficient -0.23, 95% CI -0.40 to -0.05; P=.01). There were 28 (23.9%) participants who played all 5 levels of the game and had better improvement in opioid use self-efficacy. CONCLUSIONS: Our findings suggest MedSMART: Adventures in PharmaCity can be used as an effective tool to educate adolescents on the safe and responsible use of prescribed opioid medications. Future testing of the effectiveness of this SG should involve a randomized controlled trial. Additionally, the feasibility of implementing and disseminating MedSMART: Adventures in PharmaCity in schools and health care settings such as adolescent health or primary care clinics, emergency departments, and pharmacies should be investigated.

Towards a critical sociology of risk

Sociologists are growing increasingly skeptical toward research on risk conducted in other fields, and new perspectives on risk are emerging. Topics that merit further exploration include the social construction of risk and risk objects, risk analysis as a type of scientific enterprise, the organizational and institutional forces that shape positions on risk, safety and risk as dynamic properties of social systems, and the social forces that create and allocate risk. In particular, sociologists need to place more emphasis on exploring the roles played by organizations and the state in hazard production and on formulating a political economy of risk. To a significantly greater degree than other disciplines concerned with risk, sociology emphasizes the contextual factors that structure vulnerability to hazards and the linkages that exist between vulnerability and social power

Improving earthquake loss estimation : Review, assessment and extension of loss estimation methodologies

The overall goals of the research are to link engineering system vulnerability analysis with the best-available techniques of economic analysis, to produce integrated models of physical and economic loss, and to improve the efficiency and effectiveness of loss estimation methods through the application of advanced and emerging technologies. This program of research focuses both on general methodological refinements and model improvement and on applications that will support MCEER's power and water lifeline and hospital demonstration projects

Chapter 1 : Earthquakes in the Central and Eastern United States : Social, economic, and policy aspects

This chapter introduces the theme and objectives of the monograph and provides a contextual framework for each of the seven chapters which follow. Each individual chapter contributes to a deeper understanding of the socioeconomic impacts of earthquakes.(AU)

Emergency medical care aspects of the Loma Prieta earthquake

The response to the Loma Prieta earthquake by the emergency medical care system was very effective. The system was able to function effectively due to a fortuitous combination of three factors: (1) the fact that the area possessed an extremely high level of system capability, as indicated by the quantity and quality of medical resources; (2) the fact that essential health-care resources survived the earthquake well, while flexible and redundant system components compensated for damaged and disrupted elements; and (3) the fact that the earthquake produced a comparatively small number of casualties relative to system capability; moreover, most of the medical complaints that resulted were not severe. The Bay Area appears to have made impressive progress in improving its ability to reduce damage and to cope with the problems created by earthquakes. These improvements are reflected in the performance of the emergency health-care system. However, it would be a mistake to extrapolate from the Loma Prieta experience to larger events or to the types of earthquakes that areexpected to occur on faults such as the East Bay's Hayward Fault. Larger events occurring closer to the Bay Area's large population centers would put infinitely greater strains on the emergency medical care system, because many more building collapses would occur, significantly larger numbers of people would be killed and injured, and key components in the health-care system, such as hospitals, would be extensively damaged and disrupted. Rather than creating complacency, the Loma Prieta earthquake should serve as a waring for what the region can expect in future earthquakes

Community and organizational awareness of and preparedness for acute chemical emergencies

An open system model is used to analyze field data from a study of organizational and community preparedness for acute chemical emergencies. In particular, findings are presented on perceptions of threat, social climate and social or interorganizational linkages. It is shown that the awareness of a need for preparedness is not translated into preparedness activities and practices unless there are supportive social factors or conditions (AU)