Learn Harm Reduction: Outcomes and Impact of a Shared Learning Community in the US South

Background and Purpose: The Deep US South (AL, FL, GA, LA, MS, NC, SC, TN, TX) experiences significant burdens of both the HIV and opioid epidemics, with 8 states demonstrating the highest HIV prevalence rates, and 7 states demonstrating significant increases in drug overdose deaths. These epidemics have created an urgent need for organizations to implement evidence-informed approaches to provide stigma-free, person-centered care. Harm reduction (HR) is an evidence-informed approach that aims to reduce the negative multi-level consequences associated with substance use. However, despite HR being a promising approach, few organizations know about or implement HR approaches in the US South. LEARN HR is a shared learning organizational intervention that builds the capacity of HIV service providers in the US South. Implemented in a group learning environment, LEARN HR aims to enhance knowledge, change attitudes and build skills of service providers. Thus, the aims of this presentation are to: a) describe LEARN HR, and b) discuss the mixed methods evaluation of the LEARN HR pilot study.

Methods: The LEARN HR intervention consists of four main components over the course of six months: bi-weekly virtual group sessions, monthly virtual coaching sessions with an expert consultant, an in-person cohort meeting and the implementation of a project. A pre-test and post-test measuring knowledge, skills, attitudes (KSA) on a 10-point Likert scale were administered to all participants. One sample t-test identified KSA items with significant pre/post change (p<0.05). Qualitative interviews were conducted with participants to better understand the impact of LEARN on themselves and organizations. Thematic analysis was conducted.

Results: Eleven participants engaged in 11 bi-weekly virtual group sessions, 24 coaching sessions and a two-day in person meeting over the course of six month intervention. Participants largely identified as African American/Black (87%) and cis-gender women (33%), transgender (7%) and genderqueer (7%). Participants represented a range of roles within organizations, with the majority possessing a leadership role (73%). Pre/post survey data demonstrated significant increases in 4 out of 4 knowledge items and 3 out of 5 skills items. Three notable qualitative outcomes of LEARN HR emerged: 1) participants translated session content into meaningful changes in their interactions with clients, 2) participation led to harm reduction-related structural changes within organizations (i.e. revising policies and procedures, meaningfully incorporating people living with HIV in organizational leadership) and 3) collectivity of intervention initiated interorganizational networks.

Conclusions and Implications: Our findings indicate that LEARN HR was successful in changing participants’ knowledge and attitudes. LEARN HR also facilitated provider-level changes that trickled up to the organization-level. These changes were imperative in creating an environment that supported and sustained the implementation of HR beyond the life of the intervention. LEARN HR is a collaborative shared learning intervention that educates, equips and empowers organizations to address the symptoms of oppressive structural conditions in their communities. LEARN HR is an innovative model that initiates evidence of applied collective learning, contributing to existing transfer of learning research.