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County-Based Extension Agents' Perspectives on the Implementation of MedSMA℞T Families for Opioid Safety Education in Kentucky
ABSTRACT
Background:
Prescription opioids are a major pathway to opioid initiation, misuse, and persistent use. Adolescents are particularly at risk due in part to access to leftover medications at home and limited parental awareness of safe storage and disposal. Adolescents tend to prefer game-based and digital formats for opioid education, creating opportunities for engaging, age-appropriate prevention strategies. MedSMA℞T Families is a dual-component digital intervention combining the serious game Adventures in PharmaCity with a personalized Family Medication Safety Plan to promote safe medication practices and opioid risk awareness among adolescents and their families. Interventions targeting adolescents may have a greater and more sustained impact when reinforced across home, school, and community settings. Community-based implementation of MedSMA℞T Families represents a promising approach for reinforcing early learning within these environments.
Objective:
This study evaluated county-based Family and Consumer Sciences (FCS) Extension agents’ perceptions of the implementation of the MedSMA℞T Families intervention, focusing on its acceptability, appropriateness, usability, and educational value for opioid safety education in Kentucky communities.
Methods:
A total of 96 Kentucky FCS Extension agents participated in the study across Central, Eastern, and Western regions of Kentucky. Participants engaged in approximately 30 minutes of gameplay. Surveys were administered using Qualtrics, and in-game data, including engagement time, task completion, and navigation patterns, were captured via Firebase Analytics and BigQuery. Quantitative data were analyzed using descriptive statistics (Pearson’s chi-square or Fisher's exact tests). Qualitative data was collected through open-ended survey responses and analyzed using thematic analysis.
Results:
A total of 92 participants (95.8%) completed the pre-survey, and 52 (54.2%) participants completed the post-survey. Participants spent an average of 25.8 minutes (SD = 8.4) playing the game, engaged with 4.3 (SD = 2.0) levels, and completed 3.9 (SD = 2.5) of the 5 chapters. Engagement varied across levels, with the longest time spent in Chapter 3 (Overdose) (11.1 ± 3.3 minutes) and Level 1 (Storage) (8.8 ± 3.9 minutes). Participants made an average of 3.9 (SD = 2.5) opioid-related decisions that resulted in successful progression. Post-intervention, 78% rated the app as professional and appealing, 54% reported that the interactive app features enhanced engagement, and 53% would recommend it. Qualitative responses highlighted educational value and relevance but noted usability concerns related to pacing and animation style.
Conclusions:
County-based Extension agents perceived MedSMA℞T as an acceptable and useful intervention for implementing opioid safety education in the community. This feedback demonstrates strong enthusiasm for enhancing family-focused opioid safety education. Clinical Trial: N/A
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© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.