The Impact of Interprofessional Harm Reduction Trainings on Clinician and Student Knowledge, Attitude, and Stigma

Harm reduction is a grassroots, practical set of strategies to mitigate the negative consequences of drug use, and it is a movement that acknowledges that people may not stop using drugs. Clinician stigma remains a barrier to implementation of harm reduction practices, which further disempowers and jeopardizes the health of people who use drugs (PWUD). Our study objective was to understand the impact of interprofessional harm reduction trainings on health professions students' and clinicians' knowledge and stigma toward PWUD.

Harm reduction outreach specialists, faculty physicians, and individuals with lived experience delivered 3 virtual, interactive trainings. We conducted pre-/post-surveys of knowledge and stigma. Stigma was evaluated using a validated instrument, the Medical Condition Regard Scale. Using SPSS Version 29, pre- and post-survey responses were compared using McNemar's test for paired knowledge/attitude categories, paired t-test for stigma scores. Our institutional IRB reviewed this study as exempt research.

Of 313 participants, the majority were medical (n = 116, 37%), dental (n = 66, 22%), pharmacy (n = 17, 5%), or nursing (n = 16, 5%) students. Ninety-four participants submitted pre- and post-training surveys; 87 fully completed both surveys. Although baseline knowledge of harm reduction was high, knowledge/attitudes showed a trend toward improvement. Comfort in applying harm reduction was enhanced from pre- to post-training (68%-95%, P < .001), and respondents increasingly applied harm reduction strategies, from 62% pre-training to 86% post-training (P < .001). Participant stigma scores improved from 50 + 8 pre-training, and 53 + 8 post-training (P < .001).

Harm reduction curricula developed and administered by interprofessional teachers, including those with lived experience, may reduce stigma toward PWUD, increase clinician comfort, and support consistent application of harm reduction practices in those with prior elevated baseline knowledge. Our work highlights the importance of including harm reduction training in interprofessional education.