Diffusion of Harm Reduction Knowledge and Skills: Results from a Learning Collaborative for Southern HIV Service Organizations

Background and Purpose

The impact of translational research on policy and practice is often limited by significant time lags and barriers (Morris et al., 2011). Additionally, translational research is not justice-oriented in that implementation standards are time and resource intensive, thus preventing the translation of evidence-based practices in real-world settings. Researchers must blend theories of implementation, dissemination, and diffusion to facilitate timely impact (Green et al., 2014). Learning collaboratives foster translational research by coalescing individuals to learn from subject matter experts through multiple interactive sessions (Bos et al., 2007; Mitchell et al., 2011). This study builds on authors’ previous work developing and implementing a learning collaborative with HIV service organizations (HSOs) in the U.S. South (LEARN HR; Ali et al., 2021) in which participants receive harm reduction (HR) training, funding, and project implementation coaching. While previous research found that LEARN HR facilitates individual- and organizational-level changes (McCormick et al., 2021), little is known about the ways that knowledge diffusion may broaden the impact and sustainability of learning collaborative outcomes. Thus, using a justice lens, this study: 1) examines if and how diffusion of knowledge occurred among LEARN HR participants, and 2) describes the types of knowledge diffusion that occurred and whom recipients were.

Methods

The LEARN HR cohort consisted of six HSOs across five Southern states. The cohort participated in 12 cohort training sessions and five individualized project implementation coaching sessions. Researchers conducted in-depth virtual qualitative evaluation interviews with six organizations lasting between 60-75 minutes. The semi-structured interview protocol addressed participant experiences in LEARN HR and the impact of their participation on individual factors (e.g., knowledge and skills) and organizational changes (e.g., changes to structures or processes). Data were analyzed by multiple coders using inductive thematic analysis.

Results

LEARN HR participants were predominately African American/Black (n=7, 64%), cisgender women (n=6, 55%), and organizational leaders (n=7, 64%). Transfer of learning was evident among all LEARN HR participants, with the most commonly reported knowledge diffusion to community partners (n=6, 55%), co-workers (n=4, 36%), and friends/family (n=3, 27%). Knowledge diffusion occurred through informal conversations, meetings, trainings, presentations, and social media. Participants diffused a range of knowledge, including what HR is, why HR approaches are needed, how HR can be applied in various settings, and their LEARN HR organizational change projects. The most common barrier to knowledge transfer was ambivalence or resistance from learners.

Conclusions and Implications

Study findings suggest that LEARN HR fostered HR knowledge diffusion through diverse means to a variety of audiences, suggesting participants reached those who may not have learned about HR otherwise. Participants were confident in their abilities to diffuse knowledge gained to their personal and professional networks. This is essential for the translation of HR as a social justice-oriented evidence-based approach into HSOs across the U.S. South. Future research is needed to examine what inhibits participant knowledge diffusion, as well as what changes occur on the part of the recipient as a result of knowledge diffusion.