Browsing by Subject "Social stigma"

Now showing 1 - 4 of 4
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    Narrative enhancement and cognitive therapy (NECT) to improve social functioning in people with serious mental illness: study protocol for a stepped-wedge cluster randomized controlled trial
    (BMC, 2021-02-08) Dubreucq, J.; Faraldo, M.; Abbes, M.; Ycart, B.; Richard-Lepouriel, H.; Favre, S.; Jermann, F.; Attal, J.; Bakri, M.; Cohen, T.; Cervello, C.; Chereau, I.; Cognard, C.; De Clercq, M.; Douasbin, A.; Giordana, J.Y.; Giraud-Baro, E.; Guillard-Bouhet, N.; Legros-Lafarge, E.; Polosan, M.; Pouchon, A.; Rolland, M.; Rainteau, N.; Roussel, C.; Wangermez, C.; Yanos, P.T.; Lysaker, P.H.; Franck, N.; Psychiatry, School of Medicine
    Background: Self-stigma is highly prevalent in serious mental illness (SMI) and is associated with poorer clinical and functional outcomes. Narrative enhancement and cognitive therapy (NECT) is a group-based intervention combining psychoeducation, cognitive restructuring and story-telling exercises to reduce self-stigma and its impact on recovery-related outcomes. Despite evidence of its effectiveness on self-stigma in schizophrenia-related disorders, it is unclear whether NECT can impact social functioning. Methods: This is a 12-centre stepped-wedge cluster randomized controlled trial of NECT effectiveness on social functioning in SMI, compared to treatment as usual. One hundred and twenty participants diagnosed with schizophrenia, bipolar disorder or borderline personality disorder will be recruited across the 12 sites. The 12 centres participating to the study will be randomized into two groups: one group (group 1) receiving the intervention at the beginning of the study (T0) and one group (group 2) being a control group for the first 6 months and receiving the intervention after (T1). Outcomes will be compared in both groups at T0 and T1, and 6-month and 12-month outcomes for groups 1 and 2 will be measured without a control group at T2 (to evaluate the stability of the effects over time). Evaluations will be conducted by assessors blind to treatment allocation. The primary outcome is personal and social performance compared across randomization groups. Secondary outcomes include self-stigma, self-esteem, wellbeing, quality of life, illness severity, depressive symptoms and personal recovery. Discussion: NECT is a promising intervention for reducing self-stigma and improving recovery-related outcomes in SMI. If shown to be effective in this trial, it is likely that NECT will be implemented in psychiatric rehabilitation services with subsequent implications for routine clinical practice.
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    Opioid Use Disorder Stigma, Discrimination, and Policy Attitudes in a National Sample of U.S. Young Adults
    (Elsevier, 2021) Adams, Zachary W.; Taylor, Bruce G.; Flanagan, Elizabeth; Kwon, Elizabeth; Johnson-Kwochka, Annalee V.; Elkington, Katherine S.; Becan, Jennifer E.; Aalsma, Matthew C.; Psychiatry, School of Medicine
    Purpose: A small fraction of people with opioid use disorder (OUD) receives appropriate care. Public opinion about addiction contributes to the availability and accessibility of effective treatment services. Little is known about such attitudes toward OUD among young adults, a population at heightened risk for OUD onset. The current study examined endorsement of social stigma, discrimination, and policy attitudes about OUD and hypothesized correlates of such attitudes (familiarity with OUD, criminal justice involvement, respondent demographic characteristics). Methods: A national sample of 190 young adults (weighted n = 408; 69% female, 42% White, non-Hispanic) aged 19-29 years completed web and telephone surveys covering opioid social stigma, discrimination, policy attitudes, personal experience with opioids, and criminal justice, and participant characteristics (age, sex, race, education, employment, income). Linear regressions were performed to examine associations between respondent characteristics and attitudes. Results: Young adults, on average, endorsed moderate levels of stigma and discrimination toward people with OUD and support for treatment-oriented policies. Stigma was positively associated with discrimination and negatively associated with support for policies favorable to people with OUD. Regression results revealed that more negative attitudes toward OUD were endorsed as a function of older age and less personal experience or familiarity with OUD. Conclusions: Heterogeneity in young adults' attitudes about OUD may be explained, in part, by personal characteristics and familiarity with OUD. Adolescence may be an opportune developmental period to prevent or reduce public stigma related to OUD and MOUD and increase public attitudes in support of expanded access to effective OUD treatments.
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    Pre-Exposure Prophylaxis (PrEP) Dissemination: Adapting Diffusion Theory to Examine PrEP Adoption
    (Springer, 2021) Schuyler, Ashley; Alidina, Zainab; Dolcini, M. Margaret; Harper, Gary; Fortenberry, J. Dennis; Singh, Ryan; Jamil, Omar; Pollack, Lance; Catania, Joseph; Pediatrics, School of Medicine
    PrEP adoption among African-American men-who-have-sex-with-men (AAMSM) remains low. We applied Diffusion-of-Innovations (DOI) theory to understand PrEP adoption processes among young HIV-negative/status unknown AAMSM (AAYMSM; N = 181; 17-24 years). Quantitative and qualitative analyses were used to examine predictors of PrEP diffusion stages. Most AAYMSM were in the persuasion stage (PrEP-aware, hadn't adopted; 72.4%). Our results suggest that model antecedents are DOI stage-specific. PrEP awareness (knowledge stage) was associated with lower levels of social stigma (p < .03) and greater health literacy (p < .05), while sexual risk (p < .03) and education (p < .03) predicted PrEP adoption (12.2%). PrEP efficacy and side effects were primary innovation characteristics influencing adoption receptivity in the persuasion stage. Interventions to improve PrEP diffusion should be tailored to stage-specific antecedents depending on how a community is stratified across the DOI stages.
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    Supporting Occupational Justice for Transgender and Gender-Nonconforming People Through Narrative-Informed Theater: A Mixed-Methods Feasibility Study
    (American Occupational Therapy Association, 2021-07-01) Wasmuth, Sally; Leonhardt, Bethany; Pritchard, Kevin; Li, Chih-Ying; DeRolf, Annie; Mahaffey, Lisa; Psychiatry, School of Medicine
    Importance: Societal stigma gravely impedes occupational justice for transgender and gender-nonconforming (TGNC) people, producing vast health disparities for this population. Objective: To test the feasibility of an intervention to reduce stigma and improve the well-being of TGNC people. Design: A parallel, mixed-methods design was used to test feasibility in the areas of acceptability, demand, and limited efficacy. Setting: Community. Participants: Forty-two audience members and 5 TGNC interviewees. Intervention: Virtual, narrative-informed play reading and moderated discussion about gender diversity and affirmative care. Outcomes and Measures: The valid and reliable Acceptance and Action Questionnaire-Stigma was used to assess stigma beliefs. An open-ended, qualitative question assessed TGNC interviewees' experiences. Results: Recruitment and participant responses to the intervention indicated feasibility in the areas of acceptability, demand, and limited efficacy. However, future efforts at obtaining a diverse TGNC sample are needed. Conclusions and relevance: The intervention decreased stigma beliefs in audience members and offered a positive experience for TGNC participants. Feasibility outcomes warrant future efficacy testing. What This Article Adds: This article adds an innovative intervention for promoting occupational justice to support the health and well-being of TGNC people. The community-based intervention facilitates change in societal attitudes and stigmatizing beliefs.