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Why Was HR-FaCT Developed?
As harm reduction has gained broader recognition within public health and policy discussions, the term is increasingly used across a wide range of programs and initiatives. However, the application of harm reduction principles varies widely, and some programs adopt the language of harm reduction without fully implementing its core philosophy or practices.
Without a structured framework for evaluating harm reduction fidelity, it can be difficult for practitioners, researchers, and policymakers to determine whether programs claiming to use harm reduction approaches genuinely align with established harm reduction principles.
The Harm Reduction Fidelity & Classification Tool (HR-FaCT) was developed to address this gap by providing a systematic method for evaluating harm reduction alignment across programs, policies, and interventions.
How the HR-FaCT Framework Works
How the HR-FaCT Framework Works
The HR-FaCT framework provides a structured method for evaluating whether programs and policies align with core harm reduction principles. The tool organizes evaluation criteria into a series of domains that assess different aspects of harm reduction philosophy, accessibility, and implementation.
Each domain includes indicators that help evaluators determine the degree to which programs reflect authentic harm reduction practices.
HR-FaCT evaluates programs across several key areas, including:
• Philosophical Alignment – whether the program reflects core harm reduction values and principles.
• Accessibility & Barriers to Participation – the extent to which services are low-barrier and accessible to participants.
• Participant Autonomy – whether individuals retain agency and decision-making authority regarding their own health and behavior.
• Service Implementation – whether programs provide practical harm reduction interventions and support.
• Structural Context – how policies, organizational practices, and external systems influence the delivery of harm reduction services.
Together, these domains provide a systematic framework for evaluating harm reduction fidelity across programs, initiatives, and policies.
