Engagement as an ethical imperative in harm reduction involving at-risk youth

Background: The focus of the article is the engagement of at-risk youth in harm reduction interventions for illicit drug use. Literature in the fields of education, recreation, health education. and community development suggest that engaging young people in the planning, implementation and evaluation of harm reduction interventions will not only benefit those who participate, but will contribute to the sustainability and effectiveness of the interventions. Methods: A review of published research about the efficacy of harm reduction interventions for at-risk youth was undertaken. Results: Harm reduction interventions with at-risk youth have focused on researcher-delivered, short-term educational sessions in which engagement is a minor consideration. Assumptions about how to engage at-risk youth are untested and problematic to incorporate when executing harm reduction strategies. Conclusions: If harm reduction approaches are ethically mandated to address the meaningful engagement of at-risk youth, there are many challenges pertaining to the nature and outcomes of such engagement that need to be investigated in future research. (C) 2007 Elsevier B.V. All rights reserved.