Drug use has caused devastating impacts on communities worldwide, with over 9.2 million people in the United States misusing opioids annually and more than 46.3 million people meeting the criteria for substance use disorder, making harm reduction strategies an important response measure. However, stigma and knowledge gaps surrounding harm reduction programs, along with changing policy environments, have made improving and sustaining public support a critical challenge, and as social media influencers have been proven effective in delivering public health messages and changing behaviors, The Public Good Projects (PGP) launched the “Appalachian Influence” program in West Virginia in April 2022, utilizing 100 local influencers to build awareness and support for harm reduction principles and services.
PGP conducted two cross-sectional surveys to assess knowledge and attitudes toward harm reduction services and Syringe Services Programs (SSPs) among the general public in West Virginia, with samples consisting of 311 participants at baseline and 300 participants at follow-up who met the eligibility criteria of being over 18 years old, English or Spanish speaking, and residing in West Virginia. Data collection was conducted from April 3-12, 2022 (baseline) and October 12-25, 2022 (follow-up, six months after program implementation), collecting data on general attitudes, beliefs, and policy support toward harm reduction through surveys, along with demographic variables and awareness of harm reduction terms and services (Needle Exchange Programs, Naloxone, Fentanyl Test Strips, etc.). A two-sided Pearson Chi-squared test was used for the analysis method.
According to the study results, the program-exposed group showed significantly higher knowledge of harm reduction services compared to the non-exposed group (mean number of services recognized: 3.40 vs 2.42, p < 0.001), with particularly significant differences in awareness of fentanyl test strips (40.0% vs 19.5%), harm reduction programs (37.1% vs 8.7%), and syringe services programs (32.4% vs 14.4%). Additionally, the program-exposed group demonstrated significantly more positive attitudes and beliefs toward all harm reduction services, showing higher agreement rates than both the non-exposed group and baseline survey results, such as agreement that sterile syringe/needle distribution connects people who use drugs to other health and social services (72.4% vs 51.8%) and that fentanyl test strip distribution makes their community healthier (71.4% vs 49.7%). In terms of policy support, the exposed group showed significantly higher support than the non-exposed group for all services except naloxone, with policy support rates for expanding service access ranging from 68.6%-81.0% in the exposed group compared to 43.1%-66.2% in the non-exposed group.
Takeaway: Social media influencer exposure effectively enhances public knowledge and fosters positive attitudes toward harm reduction, suggesting it may be a promising strategy for building community support for harm reduction programs.