Learn: Building Evidence through the Development of a Shared Learning Community Focused on Harm Reduction in the US South

Background: In the U.S. South, the opioid and HIV epidemics have created an urgent need for organizations to implement evidence-based approaches to provide stigma free, culturally-appropriate care. Harm reduction (HR) is a set of practical person-centered strategies and an evidenced-based approach to social work practice, that aims to reduce the negative consequences associated with substance use at the individual, community and systemic levels. However, despite HR being a promising approach, few organizations in the South know about HR or implement HR approaches. The oppressive socio-political context in the South, characterized by abstinence-based approaches, racist policies, and lack of resources, is often a barrier to social justice-oriented programs. As such, there is a need to develop community-based, innovative, and racially and economically just programs that promote sustainable change. Shared learning programs bring organizations together around a unified topic and promote empowerment, knowledge and skills sharing as well as network development. However, no shared learning program focused on HR exists in the South. Thus, the aim of this presentation is to discuss: a) the need for intersectional work around HR and b) the development of LEARN HR as a theory-based shared learning model.

Methods: This study takes place in the U.S. South and consisted of two phases. Phase 1 consisted of nine focus groups and 21 stakeholder meetings with service providers and various communities disproportionately impacted by HIV. Questions were centered around substance use programming, needs in their communities and the use of HR approaches. Thematic analysis was employed to establish themes in the data. Phase 2 consisted of a theory- and community-centered development of a shared learning program, in which the qualitative data of Phase 1 was used to contextualize the theory of planned behavior constructs to map out a Southern-focused, evidence-based HR program (LEARN HR).

Results: Three themes emerged from Phase 1 analysis: 1) substance use is very stigmatized in the South; 2) organizations lack knowledge about HR strategies; and 3) there is a need for a mechanism that facilitates change of norms around substance use. Phase 2 focused on the development of LEARN HR. In partnership with a regional HR expert, the Center utilized data from Phase 1 and social justice-oriented, evidence-based research to develop a shared learning community focused on HR in the South. LEARN HR consists of bi-weekly virtual education-based sessions per month for six months in addition to an individualized meeting with the expert facilitator each month to support project implementation. LEARN HR aims to foster collaboration and network-building among organizations, and increase HR knowledge, attitudes and skills of individuals and groups that lead to changed behavior that results in better service provision for individuals most impacted.

Conclusion: LEARN HR is a collaborative shared learning program that aims to close the knowledge gap in the South by educating, equipping and empowering HIV service organizations to address these epidemics in their respective organizations and communities. Innovative models that promote and sustain knowledge, collaboration, and action, such as LEARN HR, are essential in regions with oppressive socio-political conditions.