Types and Sources of Stigma on Opioid Use Treatment and Recovery Communities on Reddit.
Types and Sources of Stigma on Opioid Use Treatment and Recovery Communities on Reddit.
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DOI：
10.1080/10826084.2022.2091786
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发表时间：
2022
影响因子：
2
通讯作者：
Nobles, Alicia L.
中科院分区：
文献类型：
--
作者：
Kepner, Wayne;Meacham, Meredith C.;Nobles, Alicia L.
关键词：
数字媒介同伴支持可能改善阿片类药物使用障碍（OUD）的恢复。我们的目标是研究人们在Reddit上的在线OUD康复社区（子Reddit）寻求支持的耻辱的类型和来源。我们从三个subreddits中提取了所有包含柱头关键词的帖子，以及一个不包含柱头关键词的随机样本。我们进行了演绎内容分析，以确认帖子自我描述的耻辱经历，并确定耻辱的类型（条件，干预）和来源（基于提供者的，公共的，自我的，结构性的）。259个帖子自我报告了一次耻辱的经历。大多数帖子描述了与OUD药物相关的干预耻辱感。讨论干预病耻感的帖子承认病耻感在治疗决策和治疗项目质量中的作用。最常见的污名来源是公众（包括家庭成员）、以提供者为基础（医疗保健和药房工作人员）、结构性（工作场所、执法部门、儿童保护服务和以戒断为基础的自助团体）和自我。没有帖子提到礼貌污名。帖子寻求帮助，引导他们的经历，并参与宣传，以对抗污名化的叙述。我们的研究表明，在线社区的人们寻求支持，以披露和管理Reddit上的耻辱经历，其方式与线下社区的人们相似，但值得注意的是，没有讨论礼貌耻辱。由于每个子Reddit都是不同需求的缩影，我们建议在现有的Reddit社会规范下，这些子Reddit的利益相关者和公共卫生之间开发协作资源的未来工作领域。
Digitally-mediated peer support may improve opioid use disorder (OUD) recovery. Our objective was to examine the types and sources of stigma that people seek support for in online OUD recovery communities (subreddits) on Reddit. We extracted all posts containing stigma keywords from three subreddits as well as a random sample that do not contain stigma keywords. We conducted deductive content analysis to confirm that the post self-described an experience of stigma and identify the type (condition, intervention) and source (provider-based, public, self, structural) of stigma. Two-hundred and fifty-nine posts self-reported a stigmatizing experience. The majority of posts described an intervention stigma associated with medications for OUD. Posts discussing intervention stigma acknowledged the role of stigma in their treatment decision-making and quality of their treatment program. The most frequent sources of stigma were the public (including family members), provider-based (healthcare and pharmacy workers), structural (workplace, law enforcement, child protective services, and abstinence-based self-help groups), and self. No posts mentioned courtesy stigma. Posts sought assistance in navigating their experiences and participating in advocacy to counter stigmatized narratives. Our study indicates that people in online communities seek support to disclose and manage experiences of stigma on Reddit in similar ways to people in offline communities with the noted exception of an absence of discussions of courtesy stigma. Since each subreddit is a microcosm of varying needs, we suggest areas of future work for collaborative resources developed between stakeholders of these subreddits and public health that work within the preexisting Reddit social norms.
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