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Cid A, Patten A, Beazely MA, Grindrod K. Adapting the Opening Minds Stigma Scale for Healthcare Providers to Measure Opioid-Related Stigma. PHARMACY 2024; 12:105. [PMID: 39051389 PMCID: PMC11270195 DOI: 10.3390/pharmacy12040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024] Open
Abstract
The opioid crisis in Canada continues to cause a devastating number of deaths. Community-based naloxone programs have been identified as one of the solutions for combatting this crisis; however, there are disparities in which pharmacies stock and offer naloxone. Opioid-related stigma is a major barrier for limited naloxone distribution through pharmacies. Therefore, the development of anti-stigma interventions is crucial to improve naloxone distribution in Canada. However, there is no validated tool to specifically measure opioid-related stigma. The Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) is a validated scale used to measure mental illness-related stigma. This study will adapt the OMS-HC by using four different opioid-related terminologies to determine which is the most stigmatizing to use in an opioid-related anti-stigma intervention. Pharmacy students completed four versions of the adapted OMS-HC. The average OMS-HC scores and Cronbach's α co-efficient were calculated for each version. The term "opioid addiction" was found to be the most stigmatizing term among participants and will be used in the adapted version of the OMS-HC in a future anti-stigma interventions.
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Affiliation(s)
- Ashley Cid
- School of Pharmacy, University of Waterloo, 10A Victoria St. S, Kitchener, ON N2G 1C5, Canada; (A.P.); (K.G.)
| | | | - Michael A. Beazely
- School of Pharmacy, University of Waterloo, 10A Victoria St. S, Kitchener, ON N2G 1C5, Canada; (A.P.); (K.G.)
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2
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Wong JCM, Chua JYX, Chan PY, Shorey S. Effectiveness of educational interventions in reducing the stigma of healthcare professionals and healthcare students towards mental illness: A systematic review and meta-analysis. J Adv Nurs 2024. [PMID: 38402635 DOI: 10.1111/jan.16127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
AIM To examine the effectiveness of educational interventions in reducing stigma among healthcare professionals and students towards people with mental illness. DESIGN A systematic review and meta-analysis of randomized controlled trials (RCTs) and cluster RCTs. DATA SOURCES Articles published from database inception to October 2023 were systematically searched from seven databases (CINAHL, Embase, ProQuest Dissertations and Theses Global, PsycINFO, PubMed, Scopus, Web of Science), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Random-effect meta-analyses were conducted. Heterogeneity was evaluated using the I2 statistics and Cochran's Q chi-squared test. A quality appraisal conducted at the study level used the Cochrane risk of bias tool and an outcome-level quality assessment utilized the Grades of Recommendation, Assessment, Development and Evaluation Approach. Publication bias was assessed using the funnel plot. RESULTS Twenty-five articles were included in this review. Meta-analysis reported statistically significant medium and small effect sizes for attitudes towards mental illness and attitudes towards people with mental illness respectively, showing the association between educational interventions and improved attitudes among healthcare professionals and students. However, a statistically non-significant effect was reported for knowledge of mental illness. Subgroup analyses indicated that face-to-face and contact-based interventions were particularly effective at reducing stigma. Notably, single-session interventions were just as effective as multiple sessions, suggesting a potential for resource-efficient approaches. CONCLUSION Educational interventions demonstrate promise in fostering more positive attitudes towards mental health issues. Future research should aim to determine the long-term effects of these interventions and include patient feedback on the stigmatizing behaviours of healthcare professionals and students, to holistically evaluate the effect of interventions. NO PATIENT OR PUBLIC CONTRIBUTION This study is a secondary review and does not require relevant contributions from patients or the public. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Face-to-face contact-based educational sessions have proven to be the most effective. Reinforcing learning may be achieved through a series of repeated single-session interventions.
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Affiliation(s)
- John Chee Meng Wong
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Pao Yi Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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3
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Arensman E, Leduc M, O'Brien C, Corcoran P, Griffin E, Leduc C, Coppens E, Tsantila F, Ross V, Abdulla K, Hauck P, Amann BL, Aust B, Pashoja AC, Cresswell-Smith J, D'Alessandro L, Fanaj N, Greiner BA, Luyten J, Mathieu S, Maxwell M, Qirjako G, Reich H, Sanches S, Tóth MD, Kilroy J, Michell K, Reavley N, McDaid D, Van Audenhove C. Implementation and evaluation of a multi-level mental health promotion intervention for the workplace (MENTUPP): study protocol for a cluster randomised controlled trial. Trials 2023; 24:621. [PMID: 37777787 PMCID: PMC10543326 DOI: 10.1186/s13063-023-07537-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/25/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Well-organised and managed workplaces can be a source of wellbeing. The construction, healthcare and information and communication technology sectors are characterised by work-related stressors (e.g. high workloads, tight deadlines) which are associated with poorer mental health and wellbeing. The MENTUPP intervention is a flexibly delivered, multi-level approach to supporting small- and medium-sized enterprises (SMEs) in creating mentally healthy workplaces. The online intervention is tailored to each sector and designed to support employees and leaders dealing with mental health difficulties (e.g. stress), clinical level anxiety and depression, and combatting mental health-related stigma. This paper presents the protocol for the cluster randomised controlled trial (cRCT) of the MENTUPP intervention in eight European countries and Australia. METHODS Each intervention country will aim to recruit at least two SMEs in each of the three sectors. The design of the cRCT is based on the experiences of a pilot study and guided by a Theory of Change process that describes how the intervention is assumed to work. SMEs will be randomly assigned to the intervention or control conditions. The aim of the cRCT is to assess whether the MENTUPP intervention is effective in improving mental health and wellbeing (primary outcome) and reducing stigma, depression and suicidal behaviour (secondary outcome) in employees. The study will also involve a process and economic evaluation. CONCLUSIONS At present, there is no known multi-level, tailored, flexible and accessible workplace-based intervention for the prevention of non-clinical and clinical symptoms of depression, anxiety and burnout, and the promotion of mental wellbeing. The results of this study will provide a comprehensive overview of the implementation and effectiveness of such an intervention in a variety of contexts, languages and cultures leading to the overall goal of delivering an evidence-based intervention for mental health in the workplace. TRIAL REGISTRATION Please refer to Item 2a and registration ISRCTN14104664. Registered on 12th July 2022.
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Affiliation(s)
- Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland.
- National Suicide Research Foundation, Cork, Ireland.
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Mount Gravatt, QLD, Australia.
| | | | | | - Paul Corcoran
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Eve Griffin
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Evelien Coppens
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium
| | - Fotini Tsantila
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Mount Gravatt, QLD, Australia
| | - Kahar Abdulla
- European Alliance Against Depression E.V, Leipzig, Germany
| | - Pia Hauck
- European Alliance Against Depression E.V, Leipzig, Germany
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institut de Neuropsiquiatria I Addiccions, Barcelona, 08019, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
- Univ. Pompeu Fabra, Barcelona, Spain
| | - Birgit Aust
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | | | - Luigia D'Alessandro
- International Association for Suicide Prevention (IASP), Washington, DC, USA
| | - Naim Fanaj
- College of Medical Sciences Rezonanca, Mental Health Center Prizren, Prishtina, Kosovo
| | | | - Jeroen Luyten
- Department of Public Health and Primary Care, Faculty of Medicine, Leuven Institute for Healthcare Policy, KU Leuven, Belgium
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Mount Gravatt, QLD, Australia
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP-RU), Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Gentiana Qirjako
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Hanna Reich
- German Depression Foundation, Leipzig, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Depression Research Centre of the German Depression Foundation, University Hospital, Goethe University, Frankfurt Am Main, Germany
| | - Sarita Sanches
- Phrenos Center of Expertise for Severe Mental Illness, Utrecht, The Netherlands
- Altrecht Mental Health Care, Utrecht, The Netherlands
| | - Monika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Joseph Kilroy
- The Chartered Institute of Building, Dublin, Ireland
| | - Karen Michell
- Institution of Occupational Safety and Health, Leicester, UK
| | - Nicola Reavley
- School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, Centre for Mental Health, The University of Melbourne, Melbourne, Australia
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Chantal Van Audenhove
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium
- Academic Center for General Practice, KU Leuven, Louvain, Belgium
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Eiroa-Orosa FJ. Beyond recovery: toward rights-based mental health care - A cluster randomized wait-list controlled trial of a recovery and rights training for mental health professionals with or without first person accounts. Front Psychol 2023; 14:1152581. [PMID: 37780153 PMCID: PMC10539929 DOI: 10.3389/fpsyg.2023.1152581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Mental health models grounded in Recovery and Rights are driving the advancement of transformative care systems through multifaceted actions, which encompass Continuing Professional Development. The objective of this work is to evaluate a training activity developed through a participatory process that included people with lived experience of psychosocial distress, their relatives, and mental health professionals. Methods The training focused on alternatives to diagnosis, recovery principles, rights-based care, and peer support. The evaluation followed a cluster randomized wait-list controlled design. Four hundred eighty-eight health professionals from eight care centers were randomized to three experimental conditions: a wait list control, which underwent a one-month interval between the baseline assessment and the training activity, and two experimental groups, with or without first-person accounts, which accessed the training immediately after completing the baseline assessment. The dependent variables measured at all follow-ups were beliefs and attitudes toward mental health service users' rights. One hundred ninety-two professionals completed at least one follow-up and were included in the analyses. Results We observed different evolutions of experimental and control groups with statistically significant differences for tolerance to coercion and total beliefs and attitudes scores. No differences were observed between the groups with or who attended training activities with or without first person accounts. Upon receiving the training activity, the control group had an evolution equivalent to the experimental groups. Discussion The results of this evaluation project provide compelling evidence for the need to expand recovery and rights training activities to reach a larger audience of mental health professionals These training activities hold the potential to positively influence the beliefs and attitudes of mental health professionals, ultimately contributing toward a better future for individuals with lived experience of psychosocial distress.
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Affiliation(s)
- Francisco José Eiroa-Orosa
- Section of Personality, Assessment and Psychological Treatment, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- First-Person Research Group, Veus, Catalan Federation of 1st Person Mental Health Organisations, Barcelona, Spain
- Yale Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, United States
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5
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Zamorano S, Sáez-Alonso M, González-Sanguino C, Muñoz M. Social Stigma Towards Mental Health Problems in Spain: A Systematic Review. CLÍNICA Y SALUD 2023. [DOI: 10.5093/clysa2023a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Tóth MD, Ihionvien S, Leduc C, Aust B, Amann BL, Cresswell-Smith J, Reich H, Cully G, Sanches S, Fanaj N, Qirjako G, Tsantila F, Ross V, Mathieu S, Pashoja AC, Arensman E, Purebl G. Evidence for the effectiveness of interventions to reduce mental health related stigma in the workplace: a systematic review. BMJ Open 2023; 13:e067126. [PMID: 36806140 PMCID: PMC9944311 DOI: 10.1136/bmjopen-2022-067126] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES Increasing access to mental health support is a key factor for treating mental disorders, however, important barriers complicate help-seeking, among them, mental health related stigma being most prominent. We aimed to systematically review the current evidence for interventions focusing on reducing stigma related to mental health problems in small and medium enterprises (SMEs). DESIGN Systematic review with a focus on interventions targeting mental health related stigma in the workplace in accordance with PRISMA guidelines. The methodological quality of included articles was assessed using the Quality Assessment Tool for Quantitative Studies Scale. DATA SOURCES PubMed, Ovid Medline, PsycINFO, Scopus, and Cochrane databases and Google Scholar were searched from January 2010 until November 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included experimental or quasi-experimental studies about workplace interventions aiming to reduce stigma, where the outcomes were measured in terms of stigmatisation against depression, anxiety and/or other mental health problems. DATA EXTRACTION AND SYNTHESIS Records were screened by two independent reviewers after inspecting titles and abstracts and a full-text read of the articles to assess whether they meet inclusion criteria. The results were synthesised narratively. RESULTS We identified 22 intervention studies, 3 with high quality, 13 with moderate quality and 6 with weak quality. Only 2 studies included SMEs, but no study focused on SMEs exclusively . The mode of delivery of the intervention was face to face in 15 studies, online in 4 studies and mixed in 3 studies. We found a significant reduction in stigmatising attitudes in almost all studies (20/22), using 10 different instruments/scales. Effects seemed to be independent of company size. Online interventions were found to be shorter, but seemed to be as effective as face-to-face interventions. CONCLUSIONS Although we did not find interventions focusing exclusively on SMEs, it is likely that antistigma interventions also will work in smaller workplaces. TRIAL REGISTRATION PROSPERO: ID: CRD42020191307.
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Affiliation(s)
- Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Sarah Ihionvien
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Benedikt L Amann
- Centro Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar Medical Research Institute (IMIM), Parc de Salut Mar, Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- University Pompeu Fabra, Barcelona, Spain
| | | | - Hanna Reich
- German Depression Foundation, Leipzig, Germany
- Department for Psychiatry, Psychosomatics and Psychotherapy, Depression Research Center of the German Depression Foundation, Goethe University, Frankfurt, Germany
| | - Grace Cully
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Sarita Sanches
- Phrenos Center of Expertise for Severe Mental Illness, Utrecht, The Netherlands
- Altrecht Mental Health Care, Utrecht, The Netherlands
| | | | - Gentiana Qirjako
- Department of Public Health, University of Medicine, Tirana, Albania
| | - Fotini Tsantila
- LUCAS, Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Arlinda Cerga Pashoja
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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7
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Kolb K, Liu J, Jackman K. Stigma towards patients with mental illness: An online survey of United States nurses. Int J Ment Health Nurs 2023; 32:323-336. [PMID: 36285570 DOI: 10.1111/inm.13084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 01/14/2023]
Abstract
People with mental illness experience significant health disparities, including morbidity and premature mortality. Evidence suggests that stigma is a contributing factor to these observed inequities. The tripartite conceptualization of stigma proposes that three problems underlie stigma: problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). There is limited prior research concerning stigma towards mental illness among nurses in the United States (US). The aims of this study were to assess stigma among US nurses towards patients with mental illness, compare the stigma expressed by nurses working in medical/surgical settings with mental health settings, and identify factors associated with stigma. Participants were recruited online from national professional nursing organizations in the US. We collected demographic data and administered measures of mental health stigma and stigma-related mental health knowledge. Mental health nurses demonstrated comparatively lower levels of stigma and higher levels of knowledge than the medical/surgical nurses. Nursing speciality and personal contact with mental illness were the most significant predictors of stigma and knowledge. Knowledge was found to partially mediate the relationship between nursing speciality and stigma. We found support for the 'contact hypothesis', that is, having a personal experience of mental illness or a friend or family member who has a mental illness is associated with lower stigma towards mental illness. These findings support the development of contact-based and educational anti-stigma interventions for nurses in order to reduce stigma towards mental illness.
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Affiliation(s)
- Kristen Kolb
- New York-Presbyterian Hospital, New York, NY, USA
| | - Jianfang Liu
- Columbia University School of Nursing, New York, NY, USA
| | - Kasey Jackman
- New York-Presbyterian Hospital, Columbia University School of Nursing, New York, NY, USA
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8
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Giralt Palou R, Prat Vigué G, Torà Suarez N, Romeu-Labayen M, Tort-Nasarre G. The development of positive attitudes toward mental health among university nursing students: Countering the role of social desirability. Perspect Psychiatr Care 2022; 58:1680-1690. [PMID: 34873707 DOI: 10.1111/ppc.12976] [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] [Received: 06/28/2021] [Revised: 11/14/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study analyses the evolution of attitudes of nursing students towards mental health, paying particular attention to the influence of social desirability. DESIGN AND METHODS Prospective longitudinal repeated-measures study in a sample of nursing students who completed the Community Attitudes toward Mental Illness scale and The Social Desirability Scale. FINDINGS After their training, and after adjusting for social desirability, students of female gender recognized attitudes that foster humanistic values than their male counterparts. However, attitudes of restrictiveness and authoritarianism continued to be manifested significantly when the students themselves had mental health problems (MHPs), had had previous training, or were older. PRACTICE IMPLICATIONS University courses should continue to foster attitudes of acceptance and destigmatization of people with MHPs, through responses that value authenticity.
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Affiliation(s)
- Rosa Giralt Palou
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Barcelona, Spain.,SaMIS Group, Division of Mental Health, Althaia Foundation, Manresa, Barcelona, Spain
| | - Gemma Prat Vigué
- SaMIS Group, Division of Mental Health, Althaia Foundation, Manresa, Barcelona, Spain
| | - Núria Torà Suarez
- Research & Innovation Unit, Althaia Foundation, Manresa, Barcelona, Spain
| | - Maria Romeu-Labayen
- Mental health department, Adult Mental Health Center Horta Guinardo, Barcelona, Spain.,Department of Public Health, Mental Health and Mother-Infant Nursing, University of Barcelona, L'Hospitalet del Llobregat, Spain
| | - Glòria Tort-Nasarre
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Barcelona, Spain.,GREpS, Health Education Research Group, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
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Abdulla A, Webb HC, Mahmmod Y, Dalky HF. Beliefs and Attitudes of Health Care Professionals Toward Mental Health Services Users’ Rights: A Cross-Sectional Study from the United Arab Emirates. J Multidiscip Healthc 2022; 15:2177-2188. [PMID: 36196232 PMCID: PMC9527001 DOI: 10.2147/jmdh.s379041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/01/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients and Methods Results Conclusion
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Affiliation(s)
- Ayesha Abdulla
- Vice President of Academic Affairs, Higher Colleges of Technology, Dubai, United Arab Emirates
| | - Heather C Webb
- Faculty of Business, Higher Colleges of Technology, Dubai, United Arab Emirates
- Correspondence: Heather C Webb, Higher Colleges of Technology, PO Box 15825, Dubai, United Arab Emirates, Tel +971563688746, Email
| | - Yasser Mahmmod
- Faculty of Health Sciences, Higher Colleges of Technology, Al Ain, United Arab Emirates
| | - Heyam F Dalky
- RN Faculty of Nursing Jordan University of Science & Technology, Irbid, Jordan
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10
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Cid A, Patten A, Beazely M, Grindrod K, Yessis J, Chang F. Protocol for the Optimizing Naloxone Dispensing in Pharmacies (ONDP) Online Continuing Education Program: A Randomized Controlled Trial. PHARMACY 2022; 10:pharmacy10010024. [PMID: 35202073 PMCID: PMC8875968 DOI: 10.3390/pharmacy10010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/10/2022] Open
Abstract
The number of opioid-related deaths in Canada has steadily increased since 2016 and the COVID-19 pandemic has worsened this trend. Naloxone has been pivotal for reducing opioid-related harms and death, and pharmacists play a crucial role in ensuring the supply of naloxone to Canadians through community pharmacies. However, naloxone dispensing by pharmacists is not optimal; in fact, in Ontario, only 50% of pharmacists offer naloxone, despite national guidelines that pharmacists should offer naloxone to everyone with an opioid prescription. When asked why pharmacists do not proactively offer naloxone, recent research has identified that pharmacists need continuing education to boost confidence and knowledge on how to start conversations with patients. The study involves a delayed start, double-blind randomized controlled trial, for Canadian licensed pharmacists and pharmacy technicians. The goals of the program are to increase Canadian pharmacy professional’s knowledge, confidence, and motivation to proactively offer naloxone, as well as to decrease stigma associated with naloxone. The program incorporates behaviour change techniques from the Theoretical Domains Framework and the Theory of Planned Behaviour. The intervention program includes three modules that focus on improving pharmacists’ communication skills by teaching them how to proactively offer naloxone, while the control group will complete a reading assignment on the naloxone consensus guidelines. The program will involve a process and outcome evaluation in addition to a contribution analysis. This program is important for breaking down previously identified barriers and knowledge gaps for why pharmacists currently do not proactively offer naloxone. This study will provide important new information about what behaviour change techniques are successful in improving confidence and motivation in the pharmacy profession and in an online environment. Findings from this study can be used to produce a national naloxone education program that can also be implemented into current pharmacy school curriculum.
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Affiliation(s)
- Ashley Cid
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
| | - Alec Patten
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
| | - Michael Beazely
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
- Correspondence:
| | - Jennifer Yessis
- School of Public Health Sciences, University of Waterloo, 200 University Ave. W, Waterloo, ON N2L 3G1, Canada;
| | - Feng Chang
- School of Pharmacy, University of Waterloo, 10 Victoria St. S A, Kitchener, ON N2G 1C5, Canada; (A.C.); (A.P.); (M.B.); (F.C.)
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11
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Vela MB, Erondu AI, Smith NA, Peek ME, Woodruff JN, Chin MH. Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs. Annu Rev Public Health 2022; 43:477-501. [PMID: 35020445 PMCID: PMC9172268 DOI: 10.1146/annurev-publhealth-052620-103528] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Health care providers hold negative explicit and implicit biases against marginalized groups of people such as racial and ethnic minoritized populations. These biases permeate the health care system and affect patients via patient–clinician communication, clinical decision making, and institutionalized practices. Addressing bias remains a fundamental professional responsibility of those accountable for the health and wellness of our populations. Current interventions include instruction on the existence and harmful role of bias in perpetuating health disparities, as well as skills training for the management of bias. These interventions can raise awareness of provider bias and engage health care providers in establishing egalitarian goals for care delivery, but these changes are not sustained, and the interventions have not demonstrated change in behavior in the clinical or learning environment. Unfortunately, the efficacy of these interventions may be hampered by health care providers’ work and learning environments, which are rife with discriminatory practices that sustain the very biases US health care professions are seeking to diminish. We offer a conceptual model demonstrating that provider-level implicit bias interventions should be accompanied by interventions that systemically change structures inside and outside the health care system if the country is to succeed in influencing biases and reducing health inequities.
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Affiliation(s)
- Monica B Vela
- Department of Medicine, Section of Academic Internal Medicine, University of Illinois College of Medicine in Chicago, Chicago, Illinois, USA;
| | - Amarachi I Erondu
- Department of Internal Medicine and Pediatrics, University of California, Los Angeles Medical Center, Los Angeles, California, USA
| | - Nichole A Smith
- Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Monica E Peek
- Department of Medicine, Section of General Internal Medicine and Chicago Center for Diabetes Translation Research, University of Chicago, Chicago, Illinois, USA
| | - James N Woodruff
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Marshall H Chin
- Department of Medicine and Chicago Center for Diabetes Translation Research, University of Chicago, Chicago, Illinois, USA
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12
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Gupta J, Cardoso L, Kanselaar S, Scolese AM, Hamidaddin A, Pollack AZ, Earnshaw VA. Life Disruptions, Symptoms Suggestive of Endometriosis, and Anticipated Stigma Among College Students in the United States. WOMEN'S HEALTH REPORTS 2021; 2:633-642. [PMID: 35141711 PMCID: PMC8820400 DOI: 10.1089/whr.2021.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
Background: Endometriosis is a chronic gynecological condition impacting 1 in 10 women of reproductive age. Research with adult women documents high levels of disruptions in academic, professional, family, and social lives due to pain. Less research has been conducted with college-aged populations. Although stigma has been noted as a key factor in contributing to diagnostic delay, little research has focused on examining stigma, endometriosis symptoms, and disruptions. This study aims at documenting the frequency of social, academic, and work disruptions experienced by college-aged women due to symptoms suggestive of endometriosis and at examining the relationship between disruptions and anticipated stigma. Methods: An online survey was conducted in April 2019 among a nationally drawn sample (N = 468) of undergraduate women to assess symptoms suggestive of endometriosis, disruptions to daily life, and stigma experiences. Results: High levels of life disruptions due to symptoms suggestive of endometriosis were documented (88% any disruption, 82.7% social, 58.8% academic, and 34.4% work). Adjusted analysis (accounting for demographics and symptoms) showed that any disruptions, social disruptions, academic disruptions, or work disruptions were significantly associated with a higher mean anticipated stigma score (β = 0.37, 95% confidence interval [CI]: 0.15–0.59; β = 0.32, 95% CI: 0.13–0.51; β = 0.32, 95% CI: 0.17–0.46; β = 0.55, 95% CI: 0.23–0.54; respectively). Conclusions: Many young women experience disruptions that affect their academic, work, and social lives. These disruptions due to symptoms suggestive of endometriosis also impact stigma experiences. More interventions tailored to address stigma and minimize disruptions are needed in public health.
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Affiliation(s)
- Jhumka Gupta
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Lauren Cardoso
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Samantha Kanselaar
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Anna M. Scolese
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Alzahra Hamidaddin
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Anna Z. Pollack
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Valerie A. Earnshaw
- Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark, Delaware, USA
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