Gaining Support for Community-Based Syringe Services Programs (SSPs) – Communication Toolkit

Ann Forsythe, PhD1, Betsy Smither, MPH2 and Karen Resha, MA1, (1)NCHHSTP/OD/HCSO, Centers for Disease Control and Prevention, Atlanta, GA, (2)Public Health and Healthcare, Oak Ridge Associated Universities (ORAU), Oak Ridge, TN

Background: Syringe services programs (SSPs) are community-based prevention programs that can provide a range of services, including linkage to substance use disorder treatment; access to and disposal of sterile syringes and injection equipment; and vaccination, testing, and linkage to care and treatment for infectious diseases. The purpose of this project was to conduct formative research, audience message testing, and materials development to inform and design a communication toolkit that would assist harm reduction (HR) partners and SSPs gain community support.

Program background: Previous research has shown that law enforcement and community leaders have concerns, and often misunderstandings, about what services SSPs provide and how they operate in their local community. It is vital to begin by identifying the top concerns, or barriers to support, of local law enforcement and community leaders and then address these barriers directly, using effective communication strategies.

Evaluation Methods and Results: To inform the development of the SSP communication toolkit, our research questions included: 1) What are the knowledge, attitudes, beliefs, and behaviors (KABs) of target audiences SSPs and the core services they provide? 2) What are the key barriers and facilitators to SSP acceptance among target audiences? 3) What audience variables and SSP facets impact KABs, facilitators, and barriers? 4) What successful strategies (and core messages) are being used to address objections to, stereotypes of, or myths about PWID (people who inject drugs) and community based SSPs held by various target audiences? 5) What promising strategies including models or theories from psychology and health communication have potential application for addressing stigma related to PWID and SSPs among target audiences?

To address these questions, we conducted exploratory and formative research to include a five-year harm reduction environmental scan and literature review; a SSPs materials audit of currently available materials and information; quarterly social media listening analysis to understand the landscape of sentiments from the general population, law enforcement, community leaders, and public safety; key informant interviews (n=20) with harm reduction experts, partners, community-based SSPs, city/local community leaders, and law enforcement administrators/officers; and a series of KAB web-based surveys (n=400) with policy makers, general public and other segmented audiences (parents/Moms with children) and faith-based organization leaders (n=430) to gain insight into knowledge, attitudes and beliefs around harm reduction services and community-based SSPs.

Conclusions: To effectively reach people and change attitudes, the SSP health communication toolkit applied formative research methods and is a resource that harm reduction partners can use to uniquely tailor key messages (to reduce barriers and acceptance of SSPs) and materials that support or bolster their efforts for SSP implementation. The toolkit contains FAQs, fact sheets, talking points, PowerPoint templates for community training, social media, and an online webinar training on how local SSPs can use the toolkit.

Implications for research and/or practice:

Framing SSPs as a public health issue can help reduce HIV and HCV infections by providing effective comprehensive community-based prevention and intervention programs that include: vaccination, testing, linkage to care, linkage to substance use treatment, and access to and disposal of syringes and injection equipment.