The development and evaluation of the Harm Reduction Self-Efficacy Questionnaire.

Phillips, Kristina T.; Rosenberg, Harold

doi:10.1037/0893-164x.22.1.36

Cited by 11 publications

(4 citation statements)

References 49 publications

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“…Psychologically informed approaches may also shed some light on how best to encourage the use of drug sampling. One survey of the self-efficacy of harm reduction practices, including tester shots, found that adherence to all harm reduction strategies surveyed was markedly lower when respondents were asked to imagine being in withdrawal [ 80 ]. A later study identified being in a hurry to use (24%) and purchasing drugs from a known dealer (20%) as the most significant barriers to the adoption of tester shots [ 81 ].…”

Section: Discussionmentioning

confidence: 99%

Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency

Mars

Ondocsin²,

Ciccarone

2018

Harm Reduct J

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BackgroundInternationally, overdose is the primary cause of death among people injecting drugs. However, since 2001, heroin-related overdose deaths in the United States (US) have risen sixfold, paralleled by a rise in the death rate attributed to synthetic opioids, particularly the fentanyls. This paper considers the adaptations some US heroin injectors are making to protect themselves from these risks.MethodsBetween 2015 and 2016, a team of ethnographers collected data through semi-structured interviews and observation captured in field notes and video recording of heroin preparation/consumption. Ninety-one current heroin injectors were interviewed (Baltimore, n = 22; Chicago, n = 24; Massachusetts and New Hampshire, n = 36; San Francisco, n = 9). Experience injecting heroin ranged from < 1–47 years. Eight participants, who were exclusively heroin snorters, were also interviewed. Data were analyzed thematically.ResultsAcross the study sites, multiple methods of sampling “heroin” were identified, sometimes used in combination, ranging from non-injecting routes (snorting, smoking or tasting a small amount prior to injection) to injecting a partial dose and waiting. Partial injection took different forms: a “slow shot” where the user injected a portion of the solution in the syringe, keeping the needle in the injection site, and continuing or withdrawing the syringe or a “tester shot” where the solution was divided into separate injections. Other techniques included getting feedback from others using heroin of the same batch or observing those with higher tolerance injecting heroin from the same batch before judging how much to inject themselves. Although a minority of those interviewed described using these drug sampling techniques, there is clearly receptivity among some users to protecting themselves by using a variety of methods.ConclusionsThe use of drug sampling as a means of preventing an overdose from injection drug use reduces the quantity absorbed at any one time allowing users to monitor drug strength and titrate their dose accordingly. Given the highly unpredictable potency of the drugs currently being sold as heroin in the US, universal precautions should be adopted more widely. Further research is needed into facilitators and barriers to the uptake of these drug sampling methods.

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Section: Discussionmentioning

confidence: 99%

Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency

Mars

Ondocsin²,

Ciccarone

2018

Harm Reduct J

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“…Although the prevalence rates of harmful outcomes vary depending on the specific health condition and the sample studied, injection drug users (IDUs) experience a variety of negative health outcomes associated with drug injection, including collapsed veins, skin abscesses, Hepatitis, HIV/AIDS, septicemia, infective endocarditis, deep vein thrombosis, tetanus, wound botulism, and overdose (Darke, Ross, & Hall, 1996; Dolan et al, 2004; Havens et al, 2011; Phillips & Rosenberg, 2008; Pollini, McCall, Mehta, Vlahov, & Strathdee, 2006; Seal et al, 2001). Non-injection routes of administration would be a healthier course, but many drug takers will continue to inject illicit drugs and they would benefit from employing harm reduction strategies to reduce the likelihood of experiencing injecting-related health problems (Ritter & Cameron, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the present paper reports on our study of IDUs’ perceived barriers to using two specific, self-initiated harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two different health outcomes (i.e., overdose and bacterial infections, respectively). These two strategies have the advantages of involving little or no monetary expense while holding promise to prevent harmful outcomes that are relatively common among IDUs (Phillips & Rosenberg, 2008; Phillips, Stein, Anderson, & Corsi, 2012). In addition to evaluating perceived barriers to engaging in test shots and pre-injection skin cleaning, we also asked IDUs to describe behaviors they engage in to reduce the risks associated with injecting.…”

Section: Introductionmentioning

confidence: 99%

Injection drug users’ perceived barriers to using self-initiated harm reduction strategies

Bonar

Rosenberg

2013

Addiction Research & Theory

Self Cite

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Introduction and Aims Increasing the frequency with which injecting drug users (IDUs) engage in self-initiated harm reduction strategies could improve their health, but few investigations have examined IDUs’ perceived barriers to engaging in these behaviors. Method We interviewed 90 IDUs recruited from needle exchanges to assess: a) perceived obstacles to their use of two specific harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two unhealthy outcomes (i.e., overdose and bacterial infections, respectively) and b) their use of other risk-reduction practices. Results The most frequently cited barrier for both test shots and skin cleaning was being in a rush to inject one’s drugs. Other, less commonly cited barriers were strategy-specific (e.g., buying drugs from a known dealer as a reason not to do a test shot; not having access to cleaning supplies as a reason not to clean skin). Regarding other risk reduction practices, participants’ most frequently reported using new or clean injecting supplies and avoiding sharing needles and injecting supplies. Discussion and Conclusions Some, but not all, of the barriers generated by participants in our study were similar to those frequently reported in other investigations, perhaps due to differences in the type of sample recruited or in the harm reduction behaviors investigated.

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“…In the second, more complex approach, a set of self-efficacy acts was developed first and then tested under a few salient situations, one by one. For example, Phillips and Rosenberg (2008) developed a multidimensional self-efficacy inventory, the Harm Reduction Self-Efficacy Questionnaire (for drug users). In the questionnaire, a set of 15 coping acts was repeated three times under each of the three salient situations (experiencing withdrawal, feeling depressed, and feeling social pressure to use drugs unsafely).…”

Section: Item Contentmentioning

confidence: 99%

A Meta-Synthesis of Health-Related Self-Efficacy Instrumentation: Problems and Suggestions

Sheer¹

2014

J Nurs Meas

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The development and evaluation of the Harm Reduction Self-Efficacy Questionnaire.

Cited by 11 publications

References 49 publications

Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency

Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency

Injection drug users’ perceived barriers to using self-initiated harm reduction strategies

A Meta-Synthesis of Health-Related Self-Efficacy Instrumentation: Problems and Suggestions

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