{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:24:08Z","timestamp":1790360648696,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T00:00:00Z","timestamp":1458604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Develop and internally validate a survey tool to assess emergency department (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>) physician attitudes, clinical practice, and willingness to perform opiate harm reduction (<jats:styled-content style=\"fixed-case\">OHR<\/jats:styled-content>) interventions and to identify barriers and facilitators in translating willingness to action.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was an anonymous, Web\u2010based survey based on the Theory of Planned Behavior of <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> physicians at three tertiary referral centers. Construction and internal validation of scaled questions was assessed through principal component and Cronbach's alpha analyses. Stepwise linear regression was conducted to measure impact of physician knowledge, attitudes, confidence, and self\u2010efficacy on willingness to perform <jats:styled-content style=\"fixed-case\">OHR<\/jats:styled-content> interventions including opioid overdose education; naloxone prescribing; and referral to naloxone, methadone, and syringe access programs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 200 of 278 (71.9%) physicians completed the survey. Principal component analysis yielded five components: attitude, confidence, self\u2010efficacy, professional impact factors, and personal impact factors. Overall, respondents were willing to perform <jats:styled-content style=\"fixed-case\">OHR<\/jats:styled-content> interventions, but few actually do. Willingness was correlated with attitude, confidence, and self\u2010efficacy (R<jats:sup>2<\/jats:sup>\u00a0=\u00a00.50); however, overall physicians lacked confidence (mean\u00a0=\u00a03.06 of 5, 95% confidence interval [CI]\u00a0=\u00a02.94 to 3.18]). Knowledge, time, training, and institutional support were all prohibitive barriers. Physicians reported that research evidence, professional organization recommendations, and opinions of <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> leaders would strongly influence a change in their clinical practice to incorporate <jats:styled-content style=\"fixed-case\">OHR<\/jats:styled-content> interventions (mean\u00a0=\u00a04.25 of 5, 95% CI\u00a0=\u00a04.18 to 4.32).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared to prior studies, emergency medicine physicians had increased willingness to perform <jats:styled-content style=\"fixed-case\">OHR<\/jats:styled-content> interventions, but there remains a disparity between willingness and clinical practice. Influential factors that may move physicians from \u201cwilling\u201d to \u201cdoing\u201d include dissemination of supportive research evidence; professional organization endorsement; <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> leadership opinion; and addressing time, knowledge, and institutional barriers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12910","type":"journal-article","created":{"date-parts":[[2016,1,27]],"date-time":"2016-01-27T14:02:40Z","timestamp":1453903360000},"page":"455-465","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Emergency Department\u2010based Opioid Harm Reduction: Moving Physicians From Willing to Doing"],"prefix":"10.1111","volume":"23","author":[{"given":"Elizabeth A.","family":"Samuels","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Boston Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Mello","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janette","family":"Baird","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam R.","family":"Kellogg","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Baystate Medical Center Springfield MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Boston Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,3,22]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Drug Poisoning Deaths in the United States, 1980\u20102008. 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