Does a Survivorship Model of Opioid Use Disorder Improve Public Stigma or Policy Support? A General Population Randomized Experiment.
Does a Survivorship Model of Opioid Use Disorder Improve Public Stigma or Policy Support? A General Population Randomized Experiment.
复制标题
阿片类药物使用障碍的生存模型是否会改善公众耻辱或政策支持？
DOI：
10.1007/s11606-022-07865-y
复制
发表时间：
2023
影响因子：
5.7
通讯作者：
McGinty,EmmaE
中科院分区：
文献类型：
--
作者：
Pytell,JarrattD;Chander,Geetanjali;Thakrar,AshishP;Ogunwole,SMichelle;McGinty,EmmaE
背景阿片使用障碍(OUD)的慢性病模型得到了许多公共卫生当局的推广，但高水平的耻辱仍然存在，而对使OUD患者受益的政策的支持率却很低。目的确定与慢性病模型相比，OUD的生存模式是否能改善公众的耻辱和对阿片类药物相关政策的支持。探索种族或性别是否会缓和任何影响。设计在线、基于片段的随机研究。参与者通过市场研究公司招募的美国成年人。干预参与者观看了描绘OUD持续缓解的8个片段中的一个。Vignettes根据OUD模式(生存、慢性病)和Vignette个体的种族(黑人、白人)和性别(男性、女性)而有所不同。主要测量(1)公众污名，通过对社会距离的渴望、对危险的感知和对Vignette个体的整体感觉来衡量。(2)支持7项阿片类药物相关政策。总体感觉在感觉温度计(0/冷-100/暖)上测量。污名和政策支持反应在Likert量表上被分成两部分，分别表示积极(4，5)或消极/冷漠(1-3)。关键结果1440名潜在参与者中，1172人(81%)进入分析。与慢性病(平均67，SD23；差异4，95%CI 1-6)相比，暴露于生存模式导致了更温暖的感觉(平均72，SD23)。小插曲个体的种族或性别不会对其产生影响。结论与慢性病模型相比，OUD生存模型改善了总体感觉，但我们没有发现该模型对公众污名或政策支持的其他领域有影响。对这一小说的生存模式进行进一步的提炼和检验，可以改善舆论。
BackgroundThe chronic disease model of opioid use disorder (OUD) is promoted by many public health authorities, yet high levels of stigma persist along with low support for policies that would benefit people with OUD.ObjectiveDetermine if a survivorship model of OUD, which does not imply a chronic, relapsing disease state, compared to a chronic disease model improves public stigma and support for opioid-related policies. Explore if race or gender moderates any effect.DesignOnline, vignette-based randomized study.ParticipantsUS adults recruited through a market research firm.InterventionParticipants viewed one of 8 vignettes depicting a person with OUD in sustained remission. Vignettes varied in terms of the OUD model (survivorship, chronic disease) and vignette individual’s race (Black, White) and gender (man, woman).Main Measures(1) Public stigma measured by desire for social distance, perceptions of dangerousness, and overall feelings toward the vignette individual. (2) Support for 7 opioid-related policies. Overall feelings were measured on a feelings thermometer (0/cold–100/warm). Stigma and policy support responses were measured on Likert scales dichotomized to indicate a positive (4, 5) or negative/indifferent (1–3) response.Key ResultsOf 1440 potential participants, 1172 (81%) were included in the analysis. Exposure to the survivorship model resulted in warmer feelings (mean 72, SD 23) compared to the chronic disease (mean 67, SD 23; difference 4, 95%CI 1–6). There was no effect modification from the vignette individual’s race or gender. There was no significant difference between OUD models on other measures of public stigma or support for policies.ConclusionsThe survivorship model of OUD improved overall feelings compared to the chronic disease model, but we did not detect an effect of this model on other domains of public stigma or support for policies. Further refinement and testing of this novel, survivorship model of OUD could improve public opinions.