Initial psychometric testing of the harm reduction self-efficacy scale

Abstract

Abstinence self-efficacy, belief in one’s ability to abstain, has been identified as a predictor of substance use behavior change. Yet, many people who use substances do not want to abstain. Self-efficacy for achieving a range of goals (i.e. abstinence or harm reduction) would be more widely applicable and might also predict substance use behavior change. The current study reports on the development of the Harm Reduction Self-Efficacy Scale (HRSES), adapted from the Situational Confidence Questionnaire and other measures of behavioral regulation, to assess one’s self-efficacy to limit their substance use consistent with their own substance use goals. Participants were recruited from online support groups for individuals with varied personal goals for substance use. The current primary analyses included 226 individuals who completed the HRSES. Using exploratory factor analysis, we found support for a four-factor solution reflecting self-efficacy in different situations that might promote substance use: negative emotions and situations, positive social situations, low self-regulation, and pleasant emotions. Each subscale was generally negatively correlated with substance use and positively correlated with quality of life, indicating greater self-efficacy was associated with less substance use and greater quality of life. Additional work is needed to test the psychometric properties of the HRSES, particularly confirmation of the factor structure in larger and more racially and ethnically diverse samples. The HRSES has promising psychometric properties and high clinical utility with wider applicability to a range of substance use goals.