Changing Perceptions of Risk Reduction Among First Responders: Outcomes of a Training Program in Louisiana

Existing opioid overdose reversal (OOR) trainings for first responders frequently demonstrate improvements in naloxone knowledge and overdose response competencies. While some programs have incorporated broader risk reduction and stigma-related content, these domains are less commonly evaluated directly, particularly using instruments designed for first responder populations. The ULM HERO program implemented a comprehensive risk reduction curriculum for Louisiana first responders and developed the Risk Reduction Attitude Scale (RRAS) to evaluate changes in risk reduction attitudes following training.

To evaluate the impact of the ULM HERO program on first responders' risk reduction attitudes using the RRAS.

This IRB-approved study (October 2023-March 2025) used a single-group pre-post design to evaluate 2-hour in-person risk reduction training for first responders. Participants completed pre- and post-training surveys including demographics and the 22-item Risk Reduction Attitude Scale (RRAS). The RRAS demonstrated acceptable reliability and validity using pre-training data. Pre-post changes were assessed using paired t-tests, effect sizes, and adjusted regression models examining occupation and parish differences statewide.

The sample included 861 Louisiana first responders, primarily law enforcement (80.8%), representing multiple parishes, most commonly Orleans/Jefferson (60.8%) and Ouachita (14.2%). Overall RRAS scores improved significantly post-training (mean increase 3.73 points; dᶻ = 0.65; p < .001). All occupation-parish subgroups demonstrated significant gains (1.99-7.20 points). The largest improvements and highest adjusted post-training scores occurred among non-law enforcement personnel in Ouachita Parish, indicating differential impact by occupational role and geographic context after accounting for baseline scores and participant demographics statewide.

This study demonstrates that a risk reduction focused training program can meaningfully improve attitudes among first responders across multiple parishes in Louisiana. Importantly, improvements were observed across urban and non-urban parishes, including regions traditionally perceived as more conservative. These findings support the scalability of a risk reduction focused training as an effective strategy statewide.