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Auriol C, Raynal P, Cantisano N. Stigmatization of drinking patients with liver cancer: The role of socioeconomic status. Heliyon 2024; 10:e29105. [PMID: 38623242 PMCID: PMC11016613 DOI: 10.1016/j.heliyon.2024.e29105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 03/08/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
Patients with liver cancer may face stigmatization due to cancer, alcohol consumption, or both. This study addresses gaps in the existing literature regarding stigmatization of alcohol-related liver cancer patients, particularly its connection with socioeconomic status (SES). The study explores whether the SES of a fictional character with alcohol addiction and liver cancer influences stigma levels reported by participants. Additionally, it investigates how participants' personal characteristics, such as alcohol consumption and healthcare professional status, impact stigmatization. This study aims to provide new insights regarding the role of stigmatization in liver cancer treatment and management, emphasizing in socioeconomic determinants. The method is based on three scenarios describing a woman character with alcohol abuse and liver cancer. The scenarios depicted a woman character with either low, medium or high SES. Each participant (N = 991) was randomly assigned to one of the three scenarios. After reading it, each participant answered questionnaires assessing negative attitudes towards the character. Four scales were used: "Negative attributions about people with health problems", "Causality of cancer", "Controllability of drinking" and "Reluctance to helping behavior". Data were analyzed using ANOVA and t-tests. The scenario describing a character with a low SES significantly received more "Negative attributions about people with health problems" than the character with medium or high SES. Participants having higher alcohol consumption themselves showed lower stigma scores for three out of four scales than participants with lower consumption. In addition, participants identified as health professionals had lower stigma scores regarding the scales "Negative attributions about people with health problems" and "Controllability of drinking", and higher scores for the subscale "Reluctance to helping behavior", compared with non-professionals. A character with low SES received more negative attributions than the one with higher SES. Participants' own alcohol consumption and professional status (being health professional or not), influenced their stigmatizing attitudes.
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Affiliation(s)
- Camille Auriol
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Patrick Raynal
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Nicole Cantisano
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
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2
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Bauer AG, Bellot J, Bazan C, Gilmore A, Kideys K, Cameron A. Cultural considerations for substance use and substance use disorders among Black men. Bull Menninger Clin 2024; 88:108-127. [PMID: 38836848 DOI: 10.1521/bumc.2024.88.2.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
There are complex cultural considerations for understanding, assessing, and treating substance use disorders (SUD) among Black men, from the initiation of substance use through SUD-related outcomes. This narrative review provides insight into some of these factors, including the individual, interpersonal, and community-level risk and protective factors (e.g., family and social roles, religiosity, racism and discrimination, exposure to trauma and adversity) underlying relative risk for substance use and disparities in SUD-related outcomes. This article also highlights the ways that public attitudes and policies related to substance use have contributed to ongoing inequities in SUD treatment access for Black men. Recommendations for clinical research and practice include increasing focus on measurement equivalence, creating pathways for access to community-based and specialty treatment, and providing services that are culturally affirming, relevant, and appropriate. Comprehensive efforts are needed to reduce SUD-related inequities and promote positive well-being among Black men and their communities.
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Affiliation(s)
- Alexandria G Bauer
- Center of Alcohol & Substance Use Studies and the Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey
| | - Jahnayah Bellot
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey
| | - Carolyn Bazan
- School of Health Professions, Rutgers University, Piscataway, New Jersey
| | - Ayanna Gilmore
- New York State Psychiatric Institute, New York, New York
| | - Kaan Kideys
- Center of Alcohol & Substance Use Studies, Rutgers University, Piscataway, New Jersey
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3
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Krendl AC, Perry BL. Stigma Toward Substance Dependence: Causes, Consequences, and Potential Interventions. Psychol Sci Public Interest 2023; 24:90-126. [PMID: 37883667 DOI: 10.1177/15291006231198193] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Substance dependence is a prevalent and urgent public health problem. In 2021, 60 million Americans reported abusing alcohol within the month prior to being surveyed, and nearly 20 million Americans reported using illegal drugs (e.g., heroin) or prescription drugs (e.g., opioids) for nonmedical reasons in the year before. Drug-involved overdose rates have been steadily increasing over the past 20 years. This increase has been primarily driven by opioid and stimulant use. Despite its prevalence, drug dependence is one of the most stigmatized health conditions. Stigma has myriad negative consequences for its targets, including limiting their access to employment and housing, disrupting interpersonal relationships, harming physical and mental health, and reducing help-seeking. However, because research on stigma toward people with substance use disorders (SUDs) is relatively sparse compared with research on stigma toward other mental illnesses, the field lacks a comprehensive understanding of the causes and consequences of SUD stigma. Moreover, it remains unclear how, if at all, these factors differ from other types of mental illness stigma. The goal of this review is to take stock of the literature on SUD stigma, providing a clear set of foundational principles and a blueprint for future research and translational activity.
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Affiliation(s)
- Anne C Krendl
- Department of Psychological and Brain Sciences, Indiana University Bloomington
| | - Brea L Perry
- Department of Sociology, Indiana University Bloomington
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4
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Atlam D, Kaylı DŞ, Durusoy R. Development of public stigma scales on alcohol use disorder and substance use disorder. J Ethn Subst Abuse 2023:1-18. [PMID: 37665219 DOI: 10.1080/15332640.2023.2253172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Different attitudes toward alcohol use disorder (AUD) and substance use disorders (SUD) require different evaluation. We aimed to develop and validate two measurement tools that evaluate the public stigma in terms of the stigma model: Public Stigma toward Alcohol Use Disorder Scale (PS-AUDS) and Public Stigma toward Substance Use Disorder Scale (PS-SUDS). The study was conducted with 503 individuals from Turkey. The 20 item- PS-AUDS explained 67.6% of the total variance. The 23 item -PS-SUDS explained 68.7% of the total variance. Cronbach alpha values of the scales were between .93 and .96. Results showed that the scales are valid and reliable.
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Affiliation(s)
- Demet Atlam
- Ege University Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Izmir, Turkey
| | - Derya Şaşman Kaylı
- Department of Social Work, Manisa Celal Bayar University Faculty of Health Sciences, Manisa, Turkey
| | - Raika Durusoy
- Department of Public Health, Ege University Faculty of Medicine, Izmir, Turkey
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5
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Effects of media representations of drug related deaths on public stigma and support for harm reduction. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 111:103909. [PMID: 36399962 DOI: 10.1016/j.drugpo.2022.103909] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/21/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Drug related deaths (DRD) are at historically high levels in the United Kingdom (UK), but some approaches that have the potential to reduce risk of mortality remain controversial. Public support makes an important contribution to drug policy development but there are high levels of public stigma towards people who use drugs (PWUD), and this is partly shaped by media representations. We investigated whether depiction of the characteristics of decedents represented in news articles about DRD was associated with differences in stigmatising attitudes and support for harm reduction policy. METHODS We undertook a cross-sectional online study with a randomised design, conducted with a nationally representative sample (UK). Participants (N = 1280) were randomly presented with one of eight simulated news stories that reported on a DRD that differed with respect to drug (ecstasy or heroin), and the gender (male or female) and age (younger or older) of the decedent. Data were analysed using MANOVA. RESULTS Data were obtained for 1248 participants (51.0% female; mean age 45.7±15.4). Stigma was higher towards depictions of male, older, and heroin deaths (all p < .001). Harm reduction support was higher in those participants seeing older compared to younger subjects (p = .035), and the older ecstasy decedent compared to younger decedent (p = .029). CONCLUSION Presentation of some types of DRD are associated with higher public stigma towards the decedent than others. Those groups developing agenda-setting activities designed to reduce stigma or foster public support for harm reduction policies should consider the different ways in which audiences may respond to the depiction and framing of DRD in news media.
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6
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Blended-eLearning Impact on Health Worker Stigma Toward Alcohol, Tobacco, and Other Psychoactive Substance Users. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00914-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Abstract
This study evaluated factors affecting the completion of blended-eLearning courses for health workers and their effect on stigma. The two courses covered the screening and management of harmful alcohol, tobacco, and other substance consumption in a lower-middle-income country setting. The courses included reading, self-reflection exercises, and skills practice on communication and stigma. The Anti-Stigma Intervention-Stigma Evaluation Survey was modified to measure stigma related to alcohol, tobacco, or other substances. Changes in stigma score pre- and post-training period were assessed using paired t-tests. Of the 123 health workers who registered, 99 completed the pre- and post-training surveys, including 56 who completed the course and 43 who did not. Stigma levels decreased significantly after the training period, especially for those who completed the courses. These findings indicate that blended-eLearning courses can contribute to stigma reduction and are an effective way to deliver continuing education, including in a lower-middle-income country setting.
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7
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Chen AT, Johnny S, Conway M. Examining stigma relating to substance use and contextual factors in social media discussions. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 3:100061. [PMID: 36845987 PMCID: PMC9948814 DOI: 10.1016/j.dadr.2022.100061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 04/02/2022] [Accepted: 04/29/2022] [Indexed: 10/18/2022]
Abstract
Background Stigma associated with substance use can have severe negative consequences for physical and mental health and serve as a barrier to treatment. Yet, research on stigma processes and stigma reduction interventions is limited. Aim We use a social media dataset to examine: 1) the nature of stigma-related experience related to substance use; and 2) salient affective and temporal factors in the use of three substances: alcohol, cannabis, and opioids. Methods We harvested several years of data pertaining to three substances - alcohol, cannabis, and opioids - from Reddit, a popular social networking platform. For Part I, we selected posts based on stigma-related keywords, performed content analysis, and rendered word clouds to examine the nature of stigma associated with these substances. In Part II, we employed natural language processing in conjunction with hierarchical clustering and visualization to explore temporal and affective factors. Results In Part I, internalized stigma was most commonly exhibited. Anticipated and enacted stigma were less common in posts relating to cannabis compared to the other two substances. Work, home, and school were important contexts in which stigma was observed. Part II showed that temporal markers were prominent; post authors shared stories of substance use journeys, and timelines of their experience with quitting and withdrawals. Shame, sadness, anxiety, and fear were common, with shame being more prominent in alcohol-related posts. Conclusion Our findings highlight the importance of contextual factors in substance use recovery and stigma reduction and offer directions for future interventions.
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Affiliation(s)
- Annie T. Chen
- University of Washington School of Medicine, Biomedical Informatics and Medical Education, Box 358047, 850 Republican St., Seattle, WA 98109, United States,Corresponding author at: University of Washington School of Medicine, Biomedical Informatics and Medical Education, Box 358047, 850 Republican St., Seattle, WA 98109.
| | - Shana Johnny
- University of Washington School of Nursing, Box 357260, Seattle, WA 98195, United States
| | - Mike Conway
- University of Utah, Department of Biomedical Informatics, 421 Wakara Way #140, Salt Lake City, UT 84108, United States,University of Melbourne, School of Computing and Information Systems, Parkville VIC 3052, Australia
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8
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DiClemente CC, Crisafulli MA. Relapse on the Road to Recovery: Learning the Lessons of Failure on the Way to Successful Behavior Change. JOURNAL OF HEALTH SERVICE PSYCHOLOGY 2022; 48:59-68. [PMID: 35464099 PMCID: PMC9014843 DOI: 10.1007/s42843-022-00058-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Among individuals seeking to change health-related behaviors, relapse is a common experience. Whether it occurs very soon after initiating a change attempt or after several years of sustained changed behavior, it can be discouraging for patients and clinicians alike. Although there is a tendency in healthcare to try to ignore failure, we posit that moving on too quickly results in missed opportunities to learn critical lessons that may promote successful change in the future. In this paper, we use addictive behavior as a lens through which to explore the phenomenon of relapse. We review key insights from the Transtheoretical Model (TTM), including the importance of debriefing failure to promote successive approximation learning while recycling through stages of change. We also offer practical, evidence-based strategies for working effectively with relapse in clinical practice, which we suggest creates a more integrated, client-centered, and personalized approach to care.
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9
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Kaynak Ö, Whipple CR, Bonnevie E, Grossman JA, Saylor EM, Stefanko M, McKeon C, Smyser J, Kensinger WS. The Opioid Epidemic and the State of Stigma: A Pennsylvania Statewide Survey. Subst Use Misuse 2022; 57:1120-1130. [PMID: 35459425 DOI: 10.1080/10826084.2022.2064506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: The opioid epidemic is a public health crisis. Among initiatives surrounding treatment and prevention, opioid use disorder (OUD) stigma has emerged as a subject for intervention. Objectives: This study examines overall results and demographic differences of three subscales of a public stigma survey instrument: general attitudes, social distance, and treatment availability and effectiveness. Methods: A statewide sample of Pennsylvanian adults (N = 1033) completed an online survey about the opioid epidemic. Weighted percentage level of agreement was reported for each item. To determine significant differences in responding across demographic groups (gender, race, and urban/rural status), multiple one-way ANOVAs were analyzed. Significant differences in the level of agreement and disagreement (p < .05) were reported. Results: The majority of respondents agreed that the opioid epidemic is a problem and that anyone can become addicted to opioids; however, many Pennsylvanians still disagree that OUD is a medical disorder and continue to endorse social distance beliefs of people with OUD. Most participants agreed that there are effective treatments available, and that recovery was possible; however, a large portion of participants were unsure whether specific treatments are effective. Subscale mean differences were significant for gender and age. Conclusions/Importance: Findings highlight that stigmatized attitudes, behaviors, and beliefs about individuals who use opioids are still prevalent and that uncertainty remains about the effectiveness of OUD treatment. OUD interventions should use targeted messaging in order to impact the ongoing opioid crisis.
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Affiliation(s)
- Övgü Kaynak
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, USA
| | - Christopher R Whipple
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, USA
| | | | - Joe A Grossman
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, USA
| | - Erica M Saylor
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, USA
| | | | | | - Joe Smyser
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, USA
| | - Weston S Kensinger
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, USA
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10
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Barry DT, Oberleitner DE, Beitel M, Oberleitner LMS, Gazzola MG, Eller A, Madden LM, Zheng X, Bergman E, Tamberelli JF. A Student Walks into Class … Vignettes to Identify Substance Use Disorder Models of Illness among College Students. Subst Use Misuse 2022; 57:1523-1533. [PMID: 35787230 DOI: 10.1080/10826084.2022.2091787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Illness models, including illness recognition, perceived severity, and perceived nature can affect treatment-seeking behaviors. Vignettes are a leading approach to examine models of illness but are understudied for substance use disorders (SUDs). We created vignettes for multiple common DSM-5 SUDs and assessed SUD illness models among college students. METHODS Seven vignettes in which the protagonist meets DSM-5 diagnostic criteria for SUDs involving tobacco, alcohol, cannabis, Adderall, cocaine, Vicodin, and heroin were pilot tested and randomly assigned to 216 college students who completed measures related to illness recognition, perceived severity, and perceived nature. MANOVAs with Scheffe post-hoc tests were conducted to examine vignette group differences on models of illness. RESULTS Vignettes met acceptable levels of clarity and plausibility. Participants characterized the protagonist's substance use as a problem, a SUD, or an addiction most frequently with Vicodin, heroin, and cocaine and least frequently with tobacco and cannabis. Participants assigned to the Vicodin, heroin, and cocaine vignettes were the most likely to view the protagonist's situation as serious and life-threatening, whereas those assigned to the cannabis vignette were the least likely. Numerically more participants characterized the pattern of substance use as a problem (91%) or an addiction (90%) than a SUD (76%), while only 15% characterized it as a chronic medical condition. CONCLUSIONS Illness recognition and perceived severity varied across substances and were lowest for cannabis. Few participants conceptualized SUDs as chronic medical conditions. College students may benefit from psychoeducation regarding cannabis use disorder and the chronic medical condition model of SUDs.
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Affiliation(s)
- Declan T Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - David E Oberleitner
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Psychology, University of Bridgeport, Bridgeport, Connecticut, USA
| | - Mark Beitel
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - Lindsay M S Oberleitner
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA.,Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Marina Gaeta Gazzola
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,APT Foundation, Inc, New Haven, Connecticut, USA
| | - Anthony Eller
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lynn M Madden
- APT Foundation, Inc, New Haven, Connecticut, USA.,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xiaoying Zheng
- APT Foundation, Inc, New Haven, Connecticut, USA.,Yale University, New Haven, Connecticut, USA
| | - Emma Bergman
- APT Foundation, Inc, New Haven, Connecticut, USA.,Quinnipiac School of Medicine, Hamden, Connecticut, USA
| | - Joseph F Tamberelli
- APT Foundation, Inc, New Haven, Connecticut, USA.,Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
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11
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Hetrick AT, Young AM, Elman MR, Bielavitz S, Alexander RL, Brown M, Waddell EN, Korthuis PT, Lancaster KE. A cross-sectional survey of potential factors, motivations, and barriers influencing research participation and retention among people who use drugs in the rural USA. Trials 2021; 22:948. [PMID: 34930410 PMCID: PMC8690874 DOI: 10.1186/s13063-021-05919-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Despite high morbidity and mortality among people who use drugs (PWUD) in rural America, most research is conducted within urban areas. Our objective was to describe influencing factors, motivations, and barriers to research participation and retention among rural PWUD. METHODS We recruited 255 eligible participants from community outreach and community-based, epidemiologic research cohorts from April to July 2019 to participate in a cross-sectional survey. Eligible participants reported opioid or injection drug use to get high within 30 days and resided in high-needs rural counties in Oregon, Kentucky, and Ohio. We aggregated response rankings to identify salient influences, motivations, and barriers. We estimated prevalence ratios to assess for gender, preferred drug use, and geographic differences using log-binomial models. RESULTS Most participants were male (55%) and preferred methamphetamine (36%) over heroin (35%). Participants reported confidentiality, amount of financial compensation, and time required as primary influential factors for research participation. Primary motivations for participation include financial compensation, free HIV/HCV testing, and contribution to research. Changed or false participant contact information and transportation are principal barriers to retention. Respondents who prefer methamphetamines over heroin reported being influenced by the purpose and use of their information (PR = 1.12; 95% CI: 1.00, 1.26). Females and Oregonians (versus Appalachians) reported knowing and wanting to help the research team as participation motivation (PR = 1.57; 95% CI: 1.09, 2.26 and PR = 2.12; 95% CI: 1.51, 2.99). CONCLUSIONS Beyond financial compensation, researchers should emphasize confidentiality, offer testing and linkage with care, use several contact methods, aid transportation, and accommodate demographic differences to improve research participation and retention among rural PWUD.
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Affiliation(s)
- Angela T Hetrick
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, USA.
| | - April M Young
- Department of Epidemiology, University of Kentucky, Lexington, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, USA
| | - Miriam R Elman
- Oregon Health & Science University-Portland State University School of Public Health, Portland, USA
| | - Sarann Bielavitz
- Oregon Health & Science University-Portland State University School of Public Health, Portland, USA
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, USA
| | | | - Morgan Brown
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, USA
| | - Elizabeth Needham Waddell
- Oregon Health & Science University-Portland State University School of Public Health, Portland, USA
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, USA
| | - P Todd Korthuis
- Oregon Health & Science University-Portland State University School of Public Health, Portland, USA
- Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, USA
| | - Kathryn E Lancaster
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, USA
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12
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Clements AD, Cyphers N, Whittaker DL, McCarty B. Initial Validation and Findings From the Willing/Ready Subscale of the Church Addiction Response Scale. Front Psychol 2021; 12:733913. [PMID: 34733210 PMCID: PMC8558616 DOI: 10.3389/fpsyg.2021.733913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Addiction has been a global health crisis over recent decades and worsened substantially during COVID-19 lockdowns. We report on the development, validation, and findings from an instrument developed to assess the readiness of churches in the Appalachian Highlands to address addiction. The Church Addiction Response Scale (CARS) is a 41-item, three section measure assessing "What are your views about addiction?" (14 items), "What are your views about interacting with people who are addicted to drugs?" (11 items), and "What do you think the church's role is in addressing addiction?" (16 items). The CARS was found to be unidimensional with strong internal consistency and initial evidence of construct validity was positive. Most respondents reported willingness to assist people living with addiction, but many reported that they felt underprepared, thus were not ready. Areas of preparation were largely those that could be addressed through training, such as understanding the physiology and psychology of addiction, available treatment options, and how to avoid doing harm. Thus, with adequate training, the likelihood of equipping a church-based workforce to provide support for people living with addiction seems attainable.
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Affiliation(s)
- Andrea D Clements
- Department of Psychology, East Tennessee State University, Johnson City, TN, United States.,Uplift Appalachia, Johnson City, TN, United States.,East Tennessee State University Ballad Health Strong BRAIN Institute, Johnson City, TN, United States
| | - Natalie Cyphers
- Division of Nursing, DeSales University, Center Valley, PA, United States
| | | | - Brett McCarty
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.,Duke Divinity School, Duke University, Durham, NC, United States
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13
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Parnarouskis L, Jouppi RJ, Cummings JR, Gearhardt AN. A randomized study of effects of obesity framing on weight stigma. Obesity (Silver Spring) 2021; 29:1625-1634. [PMID: 34431611 PMCID: PMC10826923 DOI: 10.1002/oby.23247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Growing evidence suggests highly processed foods may trigger an addictive-like process, which is associated with obesity. Other research suggests an addictive-like process occurs in response to eating itself, rather than specific foods. Addiction-based obesity explanations raise concerns about double stigmatization of people with obesity and addiction. This study compared effects of obesity framings on external and internalized weight stigma. METHODS The study was preregistered via Open Science Framework. Four hundred and forty-seven adults read an informational passage that described food addiction, eating addiction, or calorie balance explanations for obesity or a control passage about memory. Participants then completed external and internalized weight stigma measures. RESULTS Participants in the food addiction condition reported higher internalized weight stigma compared with those in the control condition. Obesity framing did not significantly affect external weight stigma compared with the control. CONCLUSIONS These findings suggest that food addiction explanations for obesity may elicit greater internalized weight stigma than non-obesity-related messages. Addiction-based and traditional obesity explanations do not appear to influence external weight stigma. Illuminating the effects of obesity framing on stigma will help researchers communicate discoveries in ways that mitigate stigma.
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Affiliation(s)
| | | | - Jenna R. Cummings
- Jenna R. Cummings is now at the Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Ashley N. Gearhardt
- Jenna R. Cummings is now at the Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
- The University of Michigan, Department of Psychology, Ann Arbor, MI, USA
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14
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Sattler S, Zolala F, Baneshi MR, Ghasemi J, Amirzadeh Googhari S. Public Stigma Toward Female and Male Opium and Heroin Users. An Experimental Test of Attribution Theory and the Familiarity Hypothesis. Front Public Health 2021; 9:652876. [PMID: 33959582 PMCID: PMC8096178 DOI: 10.3389/fpubh.2021.652876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Drug abuse and addiction exist around the world. People addicted to drugs such as opium or heroin often encounter dehumanizing discriminatory behaviors and health-care systems that are reluctant to provide services. Experiencing discrimination often serves as a barrier to receiving help or finding a home or work. Therefore, it is important to better understand the mechanisms that lead to the stigmatization of drug addiction and who is more prone to stigmatizing behaviors. There is also a dearth of research on whether different patterns of stigma exist in men and women. Therefore, this study investigated factors affecting gender-specific stigmatization in the context of drug addiction. In our vignette study (N Mensample = 320 and N Womensample = 320) in Iran, we experimentally varied signals and signaling events regarding a person with drug addiction (i.e., N Vignettes = 32 per sample), based on Attribution Theory, before assessing stigmatizing cognitions (e.g., blameworthiness), affective responses (e.g., anger), and discriminatory inclinations (e.g., segregation) with the Attribution Questionnaire. We also tested assumptions from the Familiarity Hypothesis by assessing indicators of respondents' familiarity with drug addiction (e.g., knowledge about addiction). Results, for example, show higher stigma if the person used "harder" drugs, displayed aggressive behavior, or had a less controllable drug urge. Self-attributed knowledge about addiction or prior drug use increased some forms of stigma, but diminished others. These findings only partially converged between men and women. We suggest that anti-stigma initiatives should consider information about the stigmatized person, conditions of the addiction, and characteristics of stigmatizers.
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Affiliation(s)
- Sebastian Sattler
- Institute for Sociology and Social Psychology, University of Cologne, Cologne, Germany.,Institut de Recherches Cliniques de Montréal, Montréal, QC, Canada
| | - Farzaneh Zolala
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Baneshi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Javad Ghasemi
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Saber Amirzadeh Googhari
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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15
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Witte TH, Jaiswal J, Mumba MN, Mugoya GCT. Stigma Surrounding the Use of Medically Assisted Treatment for Opioid Use Disorder. Subst Use Misuse 2021; 56:1467-1475. [PMID: 34116605 DOI: 10.1080/10826084.2021.1936051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study sought to determine whether certain factors influenced public stigma toward the use of medication to treat opioid use disorders (MOUD). Method: In a series of 3 studies using between-subjects designs, hypothetical MOUD patients matched in age and educational status with the participants were varied in systematic ways to determine whether certain factors influenced stigmatizing views of the patients. Results: Study 1 (n = 142) determined that stigma levels were elevated for hypothetical patients receiving agonist medication for OUD compared to other medications or no medication at all. Study 2 (n = 144) found that hypothetical patients receiving opioid agonist medication for either heroin or pain pills were equally stigmatized and stigmatized more than hypothetical patients on nicotine agonist medication. Study 3 (n = 151) showed that stigmatizing attitudes did not change as a result of enhanced treatment services for hypothetical MOUD patients (i.e. therapy as a supplement to medication). Conclusions/Importance: Results indicate that patients receiving agonist medication for an OUD may be the target of public stigma. Public education on the efficacy of agonist medications for OUD is urgently needed to help reduce such stigma, which may facilitate treatment delivery, treatment adherence, and treatment success.
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16
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Sumnall HR, Hamilton I, Atkinson AM, Montgomery C, Gage SH. Representation of adverse childhood experiences is associated with lower public stigma towards people who use drugs: an exploratory experimental study. DRUGS-EDUCATION PREVENTION AND POLICY 2020. [DOI: 10.1080/09687637.2020.1820450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Harry R. Sumnall
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Ian Hamilton
- Department of Health Sciences, University of York, York, UK
| | - Amanda M. Atkinson
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | | | - Suzanne H. Gage
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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17
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Kalichman S, Banas E, Kalichman M, Mathews C. Stigmatisation of alcohol use among people receiving antiretroviral therapy for HIV infection, Cape Town, South Africa. Glob Public Health 2020; 15:1040-1049. [PMID: 32053472 DOI: 10.1080/17441692.2020.1724314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Antiretroviral therapy (ART) effectively treats HIV infection, with improved longevity and quality of life among people living with HIV. Alcohol use, however, remains a robust barrier to ART. This study, for the first time, examined the effects of the stigmatisation of alcohol use on ART adherence. Patients receiving ART in Cape Town, South Africa who currently drink alcohol (N = 187) and those who do not drink alcohol (N = 106) completed measures of alcohol use, alcohol-ART adherence, and alcohol-ART stigma. Participants also provided permission to access their most recent HIV viral load from clinic medical records. Results of a mediation model demonstrated significant detrimental effects of alcohol use on ART adherence. In addition, the indirect effects of alcohol use on ART adherence through alcohol-ART stigma was also significant, indicating that alcohol-ART stigma at least in part mediates the association between alcohol use and ART adherence. The same pattern of results was observed in relation to HIV viral load obtained from medical records. Interventions designed to address alcohol use as a barrier to ART adherence should incorporate alcohol-ART stigma as a barrier to adherence as well as a barrier to participating in adherence interventions.
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Affiliation(s)
- Seth Kalichman
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
| | - Ellen Banas
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA.,Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
| | - Moira Kalichman
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT, USA
| | - Catherine Mathews
- Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
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18
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Ippolito TA. Safe in the Rooms of A.A.: How Anonymity Helps Reduce the Stigma of Help-seeking and Reinforces Solidarity and Group Cohesiveness. ALCOHOLISM TREATMENT QUARTERLY 2020. [DOI: 10.1080/07347324.2019.1647772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Tracy A. Ippolito
- PEAKS Laboratory (Participatory, Experientially-based Applied Knowledge for Social Change), FSU School of Communication, Tallahassee, Florida, USA
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