Entry Category
Program Entry – Best Public Safety
Name of Intervention/ Program
Rural Rhode Island Naloxone Distribution Campaign
Background and Situation Analysis
Rhode Island’s overdose crisis has touched every city and town in the state. While overdose deaths tied to prescription drugs have leveled off, illicit fentanyl and stimulants continue to drive the epidemic. Historically, public health messaging and resource distribution have concentrated in urban centers, leaving rural communities underserved despite facing comparable risk. The Rhode Island Department of Health (RIDOH) identified 13 towns in particular need of targeted outreach. Fatal overdose data for these regions revealed a distinct demographic and substance-use profile: 60% of fatal overdoses involved opioids and 55% involved stimulants, with 60% of decedents between ages 35–54, 60% male, and 95% non-Hispanic white. This data pointed to an audience less likely to be reached by campaigns designed around urban, younger, or more diverse populations, and underscored the need for a rural-specific strategy. Rural communities also present structural communications challenges: lower social media penetration, dispersed populations, limited public transit and outdoor advertising infrastructure, and in many cases, deeper stigma around substance use rooted in tight-knit community dynamics. Naloxone access points, while expanding statewide through pharmacies and community programs, were not consistently reaching these populations. RIDOH engaged Reach Consulting to design and execute a targeted overdose prevention campaign for these regions. The campaign built on RIDOH’s existing “Help Stop Overdoses” creative platform and prior SMS/MMS outreach efforts, but required new strategic thinking to reach a rural audience effectively — including hyper-local out-of-home placements (gas stations, convenience stores, laundromats), regional newspaper partnerships, streaming audio/video targeting by geography, and a geo-targeted text messaging component sent directly to phones in the 13 priority towns. This combination of hard epidemiological data, an underserved rural audience, and a stigma-reduction mandate set the strategic foundation for the campaign that followed.
Priority Audiences(s)
The campaign targeted three interconnected audiences across Rhode Island’s 13 priority towns: individuals who use substances, who may be unaware of fentanyl contamination risks; potential bystanders, including family members, caregivers, and friends who could intervene during an overdose; and broader community stakeholders — local businesses, faith organizations, schools, libraries, healthcare offices, and town leaders — positioned to distribute resources and de-stigmatize conversations around substance use. Given regional overdose data showing a predominantly white, male, 35–54 population, messaging was calibrated for a rural demographic often overlooked by urban-centric prevention campaigns, while Spanish-language materials addressed the region’s growing Hispanic population.
Behavioral Objectives
While the campaign aimed to build awareness of fentanyl contamination risks, its core success measures were behavioral and included moving rural Rhode Islanders from awareness to action. Specifically, the campaign sought to: – Drive naloxone requests. Motivate residents to request free, mail-delivered naloxone kits, reducing the friction and stigma often associated with obtaining naloxone in person at a local pharmacy in a small, close-knit community. – Increase bystander preparedness. Encourage family members, friends, and community members to carry naloxone and feel confident recognizing and responding to an overdose, positioning naloxone as a routine “first aid kit” item rather than a signal of drug use in the household. – Prompt help-seeking behavior. Encourage individuals who use substances, and their loved ones, to engage with local treatment, recovery, and overdose prevention resources rather than avoiding them out of shame or fear of judgment. – Generate direct response engagement. Convert paid media exposure and text message outreach into measurable actions: link clicks, naloxone orders, and two-way text replies, allowing RIDOH to track real behavior change rather than impressions alone. – Normalize community-level conversation. Equip community stakeholders (businesses, libraries, faith organizations) to display and distribute campaign materials, embedding overdose prevention messaging into everyday rural community touch points.
Description of Strategy/Intervention
To reach a geographically dispersed, historically underserved rural audience, Reach Consulting designed a 12 week, multi-channel campaign built on RIDOH’s existing “Help Stop Overdoses” creative platform, layering data-driven targeting with hyper-local, community-based tactics rarely deployed together in a single public health push. Rather than a statewide approach, the strategy centered on overdose data for the 13 priority towns. This data informed not only which platforms to prioritize, but where, down to specific gas stations, convenience stores, and newspaper distribution areas, ensuring media dollars concentrated where risk was highest rather than where reach was easiest to buy. The $44,000 media plan combined six distinct channels, each selected for a specific gap in rural reach: – Paid social: English and Spanish static, motion, and video ads on Facebook and Instagram built broad awareness and linked directly to language-specific naloxone order forms, removing steps between click and conversion. – Streaming audio and video: Non-skippable ads on platforms like Disney+, Hulu, Pandora, and iHeartMedia targeted households specifically in the 13 priority towns, reaching residents through everyday routines and personal devices rather than relying on geographically imprecise broadcast buys. – Local newspaper: Print ads across 19 weekly newspapers reached rural adults less active on digital platforms, reinforced by no-cost digital display value-add placements on affiliated news sites. – Gas pump video ads: A rural-specific tactic placing messaging directly at the pump in 3 rural towns, later expanded to capture a captive audience during a routine, high-frequency activity in car-dependent communities. – Out-of-home posters and standees: Placed in 38 hyper-local locations (laundromats, convenience stores, bars/restaurants, coffee shops), chosen using overdose risk data, with brochures and window/door clings as added touch points in trusted, everyday community spaces. The message strategy relied on creative that used de-stigmatizing, normalizing language like “Upgrade your first aid kit” and “Help Stop Overdoses”. By framing naloxone as a routine precaution rather than a marker of drug use in the household, campaign messaging lowered psychological barriers to action in tight-knit rural communities. The centerpiece of the intervention was a single, geo-targeted text message sent directly to 80,000 phones across all 13 priority towns, a tactic uniquely suited to rural outreach where digital ad targeting can be imprecise and community trust is paramount. The message linked directly to the naloxone order form and offered a bilingual opt-in, with pre-approved canned responses ready for real-time, two-way engagement. This direct-response mechanism converted passive awareness into an immediate, trackable action step. Reach Consulting monitored performance at the campaign midpoint and adjusted in-flight by expanding gas pump placements from 5 to 10 stations to ensure full budget utilization and reach, and using engagement data to inform which creative variants deserved continued investment. Together, these tactics reflected a strategy built specifically for rural conditions: layering broad-reach digital and streaming media with hyper-local, trust-based touch points, and using a single well-crafted, data-backed text message as the campaign’s most direct call to action.
Implementation
The campaign launched April 1st with a coordinated, phased media rollout running through June 24th, with select placements extending into early July. Social, streaming, print, and gas pump ads ran continuously across the full flight, while out-of-home posters were placed at least 30 days ahead of the text messaging campaign, ensuring residents encountered campaign messaging in-market before receiving a direct text. At the campaign midpoint, Reach used performance data to optimize spend. The targeted SMS/MMS text message was deployed as a single send on June 3rd, timed to reach residents during one of the region’s busiest month, maximizing the likelihood that recipients would see and act on the message during a period of heightened community activity. The message drove directly to the naloxone order form and outperformed all of RIDOH’s previous overdose prevention texts.
Evaluation Methods and Results
Reach Consulting evaluated the campaign using a mixed-methods approach, combining quantitative platform analytics (impressions, click-through rate, cost-per-click, opt-out and reply rates) with qualitative data (verbatim social media comments and text message replies) and historical benchmarking against RIDOH’s prior overdose prevention campaigns and industry standards. Performance was tracked weekly, reported at mid- and end-of-campaign, and measured against both platform-level engagement and the campaign’s ultimate behavioral goal: naloxone kit requests. Across all paid channels, the campaign generated over 3.8 million impressions and a blended 2.1% click-through rate, more than double the cross-industry benchmark. Meta ads alone reached 532,975 unique Rhode Islanders with a 2.3% CTR, while streaming video ads achieved a 98.2% completion rate, reflecting strong audience receptivity to campaign messaging across formats. The June 3rd targeted text message was the standout result of the campaign. Sent to 79,769 phones across the 13 priority towns, it achieved a 5.4% click-through rate, more than double the 2.5% average CTR across all overdose prevention texts Reach has ever sent for RIDOH, and well above the 2.4% CTR from 2023 and 1.2% from 2024. This made it, by a wide margin, the most engaging overdose prevention text RIDOH has ever deployed. The result validated two strategic choices: linking directly to the naloxone order form (removing a step present in earlier campaigns) and using de-stigmatizing, “first aid kit” framing to lower the psychological barrier to engagement. The campaign’s core behavioral objective, connecting rural residents to free naloxone, was met with the strongest results the program has recorded. In April 2026, 799 naloxone kits were ordered statewide, a 273% increase over March 2026 (214 kits) and a 555% increase year-over-year over April 2025 (122 kits). Fentanyl test strip requests rose in parallel, with 286 ordered in April 2026, up 198% from March and 146% year-over-year. In the specific week the text message was sent, 962 naloxone kits were ordered, more than any other week across the full 12-week campaign, directly linking the text send to the campaign’s single largest spike in lifesaving resource requests. Beyond volume, the data pointed to genuine audience expansion: 71% of respondents were requesting their first-ever naloxone kit, and one-third of kits went to individuals 55 and older, a demographic often overlooked in youth-focused overdose prevention efforts and consistent with the older, rural profile identified in RIDOH’s regional overdose data. Together, these results demonstrate that a rural-targeted, data-informed, multi-channel strategy anchored by a single well-timed, well-crafted text message can outperform historical benchmarks and convert awareness directly into action.
Entry Number: 13