Year of Publication



Public Health

Degree Name

Dr. of Public Health (Dr.P.H.)

Committee Chair

Dr. Richard Ingram

Committee Member

Dr. Martha Riddell

Committee Member

Dr. Rafael Perez Figueroa


Formative program evaluation is conducted during development and early implementation to ensure a program is feasible, appropriate, and acceptable. The Harm Reduction Initiative (HRI), a program of KIRP, the Kentucky AIDS Drug Assistance (KADAP) Income Reinvestment Program, seeks to address some of the underlying causes of infectious disease vulnerability resulting from drug use by focusing on infectious disease testing and linkage to care among high risk individuals. The primary objective of the evaluation was to achieve the following aims: 1) characterize the need for the program, 2) clarify the theory and logic of the program, 3) inform implementation, and 4) improve the program where necessary.

To conduct this formative evaluation, a focused ethnographic field study approach was used with the purpose of ascertaining, understanding, and describing the four categorical areas of formative program evaluation in the context of the Harm Reduction Initiative. The data collection activities included participant observation and semi-structured interviews. This data analysis was guided by grounded theory methodology to utilize inductive reasoning to develop a theory. All qualitative material gathered in this study (meeting observation and interviews) went through a systematic, three-step, manual coding process starting with open coding which was refined into axial coding by finding relationships in the data and finally emerging into selective coding by identifying core categories.

The methodology and results revealed a program that was necessary, well thought out, carefully deployed, consistently checked for areas of improvement, and modified as necessary. This evaluation presented recommendations that are opportunities to further improve a well-structured program. In order to remain effective and relevant, services must be restructured when necessary to address real and current issues affecting individuals at any given time. In this regard, the Harm Reduction Initiative is as prepared as can be, as it has shown itself capable of the flexibility and adaptation necessary to continue vital services for communities in Kentucky.

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