# Studying the PhilAdelphia Resilience Project as a Response to Overdose (SPARRow)

> **NIH ALLCDC R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $768,834

## Abstract

The opioid crisis has hit Philadelphia particularly hard, with over 46 overdose deaths per 100,000 residents in
2017, twice the national average. In response, the City of Philadelphia developed an overarching prevention
strategy, the Resilience Project, which includes both services targeted toward people who use opioids and
neighborhood environment interventions that address the blighted conditions where most overdoses occur.
The objective of this proposal, Studying the PhilAdelphia Resilience Project as a Response to
Overdose (SPARROw), is to evaluate the effectiveness and implementation of two Resilience Project
programs to reduce opioid overdose: (1) the Alternative Response Unit (ARU) that accompanies
ambulances responding to overdoses and aims to deliver harm reduction and care linkage to people
who refuse hospital transport, and (2) blight remediation of abandoned buildings and land. This
application leverages a natural experiment within the Resilience Project implementation to evaluate its impact
on overdose outcomes. We hypothesize that interventions targeted at the time and place of opioid overdose –
including the ARU and blight remediation – will be more effective at preventing overdose compared to standard
Emergency Medical Services (EMS) care or absence of environmental modifications. We will: 1) Determine
the effectiveness of the Resilience Project ARU on opioid overdose outcomes for patients who refuse
transport after overdose. Using a quasi-experimental design, we will compare the proximal overdose
outcomes (rates and timing of treatment linkage) and distal overdose outcomes (fatal and non-fatal overdoses)
for patients who receive ARU engagement compared to those who, due to timing or location restrictions,
receive traditional EMS care alone. 2) Evaluate the impact of Resilience Project blight remediation
activities on fatal and non-fatal opioid overdose. We will use a difference-in-difference design to compare
fatal and non-fatal overdoses in the 60 days before and after any given remediation effort compared to the
same time period in two nearby locations that did not get remediated but had comparable pre-blight
remediation overdose rates. 3) Evaluate implementation of the Resilience Project by a) characterizing the
fidelity of ARU intervention in Kensington, b) measuring factors that moderate ARU fidelity, including
blight, c) assessing barriers and facilitators to ARU implementation, and d) determining the costs for
ARU and blight remediation interventions. We will characterize which ARU components are completed for
each patient encounter (take home naloxone, rapid treatment referral, transportation to treatment, obtain
phone number, and/or phone follow-up). We will also measure potential moderating factors including ARU
team composition and nearby blight in real time at ARU engagement locations using validated photographic
methods. We will characterize barriers and facilitators to implementation with ARU provider interviews. La...

## Key facts

- **NIH application ID:** 10023243
- **Project number:** 5R01CE003143-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** ZACHARY Franklin MEISEL
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2020
- **Award amount:** $768,834
- **Award type:** 5
- **Project period:** 2019-09-30 → 2021-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10023243

## Citation

> US National Institutes of Health, RePORTER application 10023243, Studying the PhilAdelphia Resilience Project as a Response to Overdose (SPARRow) (5R01CE003143-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10023243. Licensed CC0.

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