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Although data is lacking, experts' observations and anecdotal evidence overwhelmingly suggest that only a tiny minority of treatment facilities currently provide overdose education -- including preventing, recognizing and responding to an overdose and the risks of mixing certain substances -- or offer naloxone.
Overall, experts' observations focused on students and student learning, whereas non-experts focused more on discrete aspects of teaching.
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Citizen observations were compared with the visual observations performed by trained expert observers, and mean correlations between citizen and expert observations were calculated using the bootstrapping method: 0.72, 95% confidence interval (CI) [0.53 0.86]; 0.65, 95% CI [0.35 0.86]; and 0.56, 95% CI [0.29 0.76] for the years 2011, 2012 and 2013.
A prospective, observational design was applied, combining extended structured expert observations and self-report measures [ 7, 19].
Figure 1 Comparison of the geographical locations of the citizen and expert observations in the summer of 2011.
We calculated the correlations between the weekly averages of citizen and expert observations for each year.
In the summer of 2012, 4427 expert observations and 319 citizen observations (156 mobile) were received, and in the summer of 2013, 4150 expert observations and 465 citizen observations (134 mobile) were performed (Table 1). Figure 1 presents a comparison of the locations of the expert observation sites with the citizen observations for the summer of 2011.
Figure 2 Weekly averages of citizen and expert observations and 95% confidence intervals in the summer of 2011. Figure 3 Weekly averages of citizen and expert observations and 95% confidence intervals in the summer of 2012. Figure 4 Weekly averages of citizen and expert observations and 95% confidence intervals in the summer of 2013.
Observations by untrained citizen observers were collected in the summers of 2011, 2012 and 2013 and compared with the trained expert observations.
We then calculated new sampled averages for each week, and used those in calculating the correlations between citizen and expert observations.
To analyse the spatial distribution of the citizen and expert observations the numbers of observations were calculated for rectangles sized one degree (latitude) by two degrees (longitude) covering the whole dataset.
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