From Knowledge to Action: Engaging Washington's Commercial Fishing Community in Substance Use Awareness and Prevention.

Objectives Commercial fishing is among the most hazardous occupations in the United States, with high rates of injury, chronic pain, and opioid-related overdose deaths. Washington's fishing community has expressed concern about substance use, highlighting the need for practical, industry-specific training. Methods This project applied the Knowledge to Action (KTA) framework to adapt and implement an overdose response training within the Fishermen First Aid and Safety Training (FFAST) program in Washington state. Training combined a didactic presentation, hands-on naloxone (NARCAN®) administration practice, and distribution of harm reduction materials. Results There were 25 commercial fishermen who participated, primarily shellfish harvesters. In pre-training, 54% reported knowledge of naloxone (NARCAN®) administration, yet 91% did not carry naloxone (NARCAN®) on their vessels, revealing a gap between knowledge and practical application. Post-training, 100% reported increased knowledge and confidence, and 70% indicated plans to include naloxone (NARCAN®) in their first aid kits. Participants emphasized the value of hands-on practice and identified several barriers, including occupational isolation, limited access to healthcare, and stigma. Conclusions Integrating overdose response into established safety programs provides a feasible, community-driven strategy to address opioid risk among fishermen. This training improves emergency preparedness and highlights the importance of translating theoretical knowledge into action within high-risk, remote occupational settings such as commercial fishing vessels.