This study pilot tests a novel community-embedded, technology-supported overdose response intervention that aligns medical care, public health, and social service systems to improve outcomes for persons following the experience of an overdose among people living in the Skid Row area of Los Angeles, CA. The intervention proposes to dismantle the structural racism that channels marginalized communities into overburdened low-resource medical systems with limited capacity to address underlying health and social needs, and that excludes these communities from having a voice in how these systems operate. Trained peer responders will use a Bluetooth-enabled respiratory monitoring system to assess patients’ breathing and oxygen levels during and after overdose response, potentially eliminating the need for emergency transport to the hospital and emergency department (ED) for low-acuity patients. At the same time, peer responders can connect patients to community-based health and social services to support underlying social determinants of health through coordinated care with service providers. In situations when an individual requires emergency transport after experiencing an overdose, a continuity card containing basic incident data and contact information is placed in participants’ belongings to promote autonomy and ease of follow-up. The intervention enables peer responders from the community to redirect and coordinate care delivery, inform protocol development, and participate in program governance. The intervention integrates the health and social needs of patients into public health and EMS response systems in order to reduce racial blind spots in existing professional practices and enable equity-informed service delivery planning. 

The Sidewalk Project (TSP), operates a holistic wellness center offering wound care, harm reduction supplies and education, housing navigation, and peer support. Collaboration with the busiest EMS hub in the country, LA Fire Department Station 9, and LA General Hospital, allows close medical care alignment and the ability to evaluate impact on ED utilization and patient flow. The LA County Department of Public Health and Substance Abuse Prevention and Control will support material distribution and data sharing. Social service partners, including Homeless Health Care LA, Blue Hollywood Street Sanctuary, and the Skid Row Action Plan, will support post-overdose care and long-term service engagement. 

The pilot study will assess response-driven data collection from 30 patients who receive peer-led breathing monitoring and post-overdose service connections. Following successful resuscitation and retrieval of informed consent to use their data in our research, quantitative data will include real-time respiratory monitoring (oxygen saturation, breathing rate), naloxone administered, EMS interaction, and service engagement metrics. Self-report instruments utilized  include the Clinical Opioid Withdrawal Scale, Ecological Momentary Assessments, and adapted tools for measuring harm reduction engagement, social support, and mental health status. Qualitative data will be collected through semi-structured interviews and focus groups with participants, peer responders, EMS providers, and hospital staff.

Principal Investigator: 
Beth Wiese, PhD
Director of Research, The Sidewalk Project

Project Details:

Year: 2025
Funding Amount: $200,000
Status: Active