Development and Evaluation of Harm Reduction Acceptance Scales

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Development of scales to measure the acceptance of harm reduction is crucial for understanding public attitudes towards harm reduction strategies. This project focuses on creating valid and reliable scales through a systematic process involving item development, data collection, analysis, and refinement. Utilizing strategies and principles, researchers collected and evaluated data from different studies, highlighting the importance of such measurements in advancing harm reduction efforts. Recruitment via Prolific.com helped gather diverse samples for assessment. The initiative emphasized the necessity of assessing harm reduction acceptance for effective public health interventions.


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  1. Development of Scales to Development of Scales to Measure the Acceptance Measure the Acceptance of Harm Reduction of Harm Reduction Budesa, Z., Brown, K., Coffey, B. Ghonasgi, R., Hayes, V., Kondai, R., La Manna, A., Newman, S., Philips, S., Vance, K., Connors, L., Green, L., Lunceford, J., Smith, R., & Winograd, R. P. OSF.IO/EJCYT

  2. Harm Reduction Harm Reduction OSF.IO/EJCYT

  3. Why Measure Harm Reduction Why Measure Harm Reduction Orientation? Orientation? OSF.IO/EJCYT

  4. Single ordinal items (Wild et al., 2021) Focused on knowledge of harm reduction organizations (Baker et al., 2020) Single substance focus (Goddard, et al. 2023) Little validity evidence (Hofschulte, 2012) Single population (Sulzer et al., 2021) Narrow definition of harm reduction (Bonar & Rosenberg, 2010) Survey methods (MacCoun, 2013) No one uses them! Limitations of Limitations of Existing Existing Measures Measures OSF.IO/EJCYT

  5. Item Examples Item Examples Strategies Police officers should have access to naloxone/NARCAN. Sobriety should not be a requirement to access public housing. Principles Drug use will always be part of society. Racism affects the health of people who use drugs. 5-point ordinal scale Strongly Disagree to Strongly Agree OSF.IO/EJCYT

  6. The Process The Process Retained two scales Develop Items Collect more data (CFA & EFA) Strategies 8 Items Principles 7 Items Response Process Evaluation (3 Rounds) 45 Initial Items Analyze Refine items Collect data (EFA) Collect more data (CFA) Repeat Analyze Analyze OSF.IO/EJCYT

  7. Recruitment Recruitment All samples recruited via Prolific.com General US-based sample Response Process Evaluation Study 1 N = 77 Study 2 N = 35 Study 3 N = 10 Study 1 EFA N = 301 Study 2 CFA & EFA N = 402 Study 3 CFA N = 393 OSF.IO/EJCYT

  8. Closely Related Items Closely Related Items People who use drugs should . The general public should . Police officers should . Access to Naloxone safe injection supplies. safe inhalation supplies. People who use drugs should have access to OSF.IO/EJCYT

  9. Closely Related Items Closely Related Items are an appropriate treatment option for people who use drugs. People who use drugs should be able to use [ ] for any length of time. Medications for Opioid Use Disorder People who use drugs should be involved . People in recovery from drug use should be involved . Involvement in Policy and Programs by Recovery Status OSF.IO/EJCYT

  10. OSF.IO/EJCYT

  11. Psychometric Psychometric Statistics Statistics r = -0.07 [-0.16, 0.03] Strategies Mean = 3.5 SD = 0.9 Principles Mean = 2.7 SD = 0.4 OSF.IO/EJCYT

  12. OSF.IO/EJCYT

  13. Next Steps Next Steps Validity & Reliability Evidence Relationships with stigma, closeness with people who use drugs, experience with substance use diagnoses Test-retest reliability Amenability to intervention Measurement invariance OSF.IO/EJCYT

  14. Development of Scales to Development of Scales to Measure the Acceptance Measure the Acceptance of Harm Reduction of Harm Reduction Budesa, Z., Brown, K., Coffey, B. Ghonasgi, R., Hayes, V., Kondai, R., La Manna, A., Newman, S., Philips, S., Vance, K., Connors, L., Green, L., Lunceford, J., Smith, R., & Winograd, R. P. OSF.IO/EJCYT

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