Supporting Harm Reduction Programs

Methods

Below are all SHaRP TA resources related to methods.

Collecting Demographic Data as Syringe Services Programs (last updated: May 25, 2023)

This document introduces some issues for SSPs to consider when writing questions to collect data about race, ethnicity, and gender in order to improve accuracy, in accordance with good practices to prioritize participant safety and protect their privacy. The document also includes tips for training staff and conducting analyses.

Estimating Individual Syringe Coverage at Syringe Services Programs (last updated: July 25, 2023)

Syringe coverage is an indicator that can help SSPs and other stakeholders estimate if people who inject drugs have enough syringes to reduce risks of infections and vein damage. This guidance is focused on calculating syringe coverage for the participants of one program and for sub-groups of participants of a program (e.g. participants who are unhoused). Health departments and researchers who work with SSPs could use this information to meaningfully engage with harm reduction staff to survey people who inject drugs and assess resource gaps. This guidance is supplemented by an example spreadsheet and a brief summary of the evidence to support needs-based syringe distribution.

The recording of the webinar launching this TA can be found here.

Good Practices and Ethical Data Collection at Harm Reduction Programs: A Brief Summary  (last updated: June 28, 2023)

This guidance is for harm reduction programs and for funders and others who require data from programs. This is a brief summary of good and ethical data collection and data use practices in harm reduction programs. The guidance may help programs evaluate their data collection and use practices as well as help funders and others who require harm reduction data to review which data they require.

Institutional Review Board (IRB) Guidance for Harm Reduction Programs (last updated: October 28, 2023)

This document is to help harm reduction programs understand what an Institutional Review Board (IRB) is, what IRBs do, and when to submit a data collection plan to an IRB. We provide an overview of IRBs, explain what it means to collect data from human subjects, discuss the benefits of using an IRB, offer ways to access an IRB, and tell you what to expect when submitting for IRB review.

Is your syringe services program cost-savings to society? A methodological case study (last updated: August 28, 2021)

This academic paper was written by the SHaRP team for SSPs to consider how to calculate if their efforts are creating cost-savings by reducing HIV infections.

Leveraging Informal Qualitative Data Collection and Use at Syringe Services Programs (last updated: March 27, 2023)

This document provides a brief overview of some informal approaches to qualitative data collection and analysis. Specifically, this document focuses on suggestions for how to create potential systems for informal qualitative data collection and analysis at syringe services programs (SSPs), including how to develop an overall objective for data collection. By “informal” data collection, we mean data that can be largely generated from routine service interactions as opposed to formal research activities, such as in-depth interviews, focus group discussions, or community based participatory research.

Leveraging Informal Qualitative Data at SSPs: Video Training

Since the development of the Leveraging Informal Qualitative Data at SSPs guidance document, we’ve led multiple online and in-person trainings of the content. On this page we have video recordings of the training materials. The videos are divided into 5 sections, with each section containing one or more videos. We recommend that you watch videos in order.

Monitoring and Evaluation Toolkit: Data Collection Methods and Pilot Testing  (last updated: September 22, 2023)

The purpose of this guidance is to help syringe services programs (SSPs) and other harm reduction programs in establishing and maintaining data collection practices for program monitoring and evaluation. Programs may find this information useful if they have questions about the types of data they might collect, how they might record it, and how they might test out their methods with staff and participants. This guidance is part of a larger Monitoring and Evaluation Toolkit for SSPs that will serve as a resource for programs in all stages of the monitoring and evaluation process.

Point in Time Survey (PiTS) Toolkit for Use at Syringe Services Programs

A Point in Time Survey (PiTS) allows a syringe services program (SSP) to ask a standardized set of questions from a portion of their clients, providing a snapshot of the population that the SSP serves. These surveys can be a quick and low-cost way to learn about the characteristics, needs, and service utilization patterns of their clients.

PiTS Survey planning, where survey goals and objectives are identified, reviewed, and refined, questions are drafted for consideration, and preparations are taken, including efforts to build staff buy-in and logistics planning.

PiTS survey design, where a survey protocol is developed; sampling method is selected; and survey questions are refined, piloted, arranged into an appropriate flow. The survey is formatted for paper and programmed onto a digital platform if applicable.

PiTS survey implementation, where survey interviewers are trained, a quality assurance plan is developed, participants are notified of the upcoming survey, and survey responses are collected.

PiTS data cleaning and analysis, where data are adjusted for errors, analyzed, and results are reviewed with stakeholders.

PiTS data dissemination and implementation of findings, where survey results are provided to participants and community stakeholders and findings are incorporated to improve programs and services.

Population Size Estimation of People Who Inject Drugs: An Overview of Methodologies (last updated: March 4, 2024)

This document provides an overview of the different methods and considerations for estimating the size of the population who injects drugs. It is primarily intended for local health departments, academia, and other community-based organizations. 

Qualitative Data Quality at Harm Reduction Programs

Qualitative data (e.g., staff notes, comments cards from participants, focus-group discussions, etc.) can play an important role in a syringe service program’s (SSPs) overall monitoring and evaluation strategy. Many programs have qualitative data they have amassed, but it is not clear what it could be used for. Whether you’re collecting new qualitative data, or analyzing pre-existing data, it’s important that the qualitative data you set out to use is comprehensible, detailed, and actionable. This webinar recording (September 19th, 2024) from the SHaRP team reviews and discusses common sources of qualitative data at SSPs, identifies some good practices for collecting qualitative data, and determines how to set an objective using and assess the quality of pre-existing qualitative data.

SSP Indicators Implementation Guide

  • Who is this guide for?
    •  The SSP Indicators Implementation Guide provides basic data points that a wide variety of SSPs could collect to monitor and evaluate their programs. This guide is focused on basic services and may not include some services that are becoming more common at SSPs. While this entire guide is likely useful for funders, government agencies, and others who require data from SSPs, the “Considerations for Funders” section is directly focused on recommendations for those who require these data.
  • How do I use this guide?
    • There are different ways to use the SSP Indicators Implementation Guide. SSPs and funders may read this guide through to understand the context, methodologies, and broader recommendations for data collection that inform why we think these indicators are important as well as good practices for data collection and analysis. We’ve also divided the guide into sections if only a few domains of indicators are of interest, or if a section or two is to be repeatedly referenced, while other sections are read once. We do recommend reading all the information in an indicator section before using that indicator.   

SSP Indicators Implementation Guide: Background and Methods

This project came from conversations the SHaRP team regularly has with SSPs about good practices for data collection and which data to collect. This guide was informed by conversations with SSPs and funders, an analysis of state SSP data requirements, a convening with SSP staff, participants, and funders, and a workgroup and public share back that resulted from the convening.

SSP Indicators Implementation Guide: Supply and Service Provision Indicators

The domain “Supply and Service Provision” refers to the services that a program provides and the supplies that a program distributes. The indicators included in this domain are “count of syringes distributed,” “types of services a program provides,” and “types of supplies a program distributes.”

SSP Indicators Implementation Guide: Service Coverage Indicators

At the population level, the domain “Service Coverage” may refer to the reach of a program in a geographic area. At the individual level, “Service Coverage” may refer to the level of engagement, level of services, or comprehensiveness of services provided to a participant. The indicators included in this domain are “hours per week a program operates,” “program’s service model(s),” and “total participant visits.”

SSP Indicators Implementation Guide: Service Quality Indicators

The domain “Service Quality” refers to the effectiveness of services at improving the wellbeing and meeting the self-identified expectations of participants, staff, and volunteers. It includes the indicators “program activities” and “program needs and barriers to service provision.”

SSP Indicators Implementation Guide: Engagement with People Who Use Drugs Indicators

The domain “Engagement with People Who Use Drugs” refers to the ways that programs empower people who use drugs, include people who use drugs in decision-making, collect feedback from people who use drugs, and incorporate feedback in programming. This domain includes the indicators “how people who use drugs are engaged to give feedback about programs” and “how participants have decision making power in programs.”

SSP Indicators Implementation Guide: Overdose Prevention Indicators

The domain “Overdose Prevention” refers to the program services and activities directed towards preventing fatal overdose. It includes the indicators “count of naloxone doses distributed,” “participant overdose experience,” and “reported overdose reversals.”

SSP Indicators Implementation Guide: Demographics Indicators

The domain “Demographics” refers to participant characteristics at an SSP. It includes the indicators “participant age range,” “participant gender,” and “participant race/ethnicity.”

SSP Indicators Implementation Guide: Structural Violence Indicators

The domain “Structural Violence” refers to the ways that local, regional, and national systems and institutions, including economic, political, cultural, and legal institutions, affect the lives and health of participants. This domain includes the indicators “participant housing status” and “participant interactions with law enforcement.”

SSP Indicators Implementation Guide: Implementation Checklist

The checklist has been developed to help outline the steps required to begin implementing any of the suggested indicators in this guidance. Each phase of implementation includes steps and considerations for integrating the indicators into a program’s data collection system.

Using M&E to Better Serve Your Community: A Four-Part Webinar Series for Health Departments and SSPs in collaboration with the National Association of City and County Health Officials (NACCHO). These webinars, held over the course of 2021 and 2022 covered topics including client-centered models for M&E, statewide data systems, data dashboards for M&E, and the launch of the Point in Time Survey Toolkit.

Using Unique Identifiers Within Syringe Services Programs  (last updated: March 10, 2023)

This guide is intended for syringe services programs (SSPs) and SSP funders to support their understanding of data collection and monitoring. It provides an overview of the benefits and drawbacks of implementing unique identifiers (UID) as a method of data collection. The guide includes considerations for SSPs considering implementing a UID system and considerations for funders who are considering requiring individual-level data from grant recipients.