The ReSPect Study - Reducing stigma towards people with issues related to drug use

背景污名是对某些群体的负面刻板印象，导致他人不公平地对待他们。许多使用毒品的人（PWUD）都有健康问题，并面临极端的耻辱。当他们获得医疗保健和药物治疗服务时，他们往往受到很差的待遇，导致他们在未来延迟寻求帮助。这可能使治疗更加困难和昂贵，他们更有可能死亡。污名化还可能影响决策者关于如何最好地管理吸毒的决定，对实施可减少毒品相关危害的新服务构成障碍。虽然有运动减少对PWUD的污名化，但同时污名化被用作试图阻止人们做不健康事情的工具。例如，“去正常化”和污名化吸烟可能导致吸烟率下降。无论对PWUD的污名化是否会减少更广泛人群的药物使用，考虑到其造成的伤害，有必要考虑这是否合理。制定信息干预措施，以减少公众和专业人士对PWUD的污名，改善福祉，提高获得支持的意愿，并促进减少伤害干预措施的引入。探讨如何平衡使用耻辱作为公共卫生工具，以阻止药物使用与其对PWUD的负面影响。我将回顾现有的关于旨在减少对PWUD的污名化的信息传递的研究。我将与多个公共卫生和戒毒机构合作，招募和访问约40名从事政策、公共卫生和戒毒工作的人士，探讨他们对PWUD的态度，以及他们对利用耻辱来阻止吸毒的看法。3.将与学者，政策利益相关者和PWUD组织两个研讨会，讨论是否以及何时使用耻辱来尝试和阻止药物使用是合理的。4.我将与325名公众（通过公共调查平台招募）和三组专业人员（与专业组织合作并通过公共部门通讯招募）进行一项研究，探索不同类型的消息传递的影响。参与者将被提供一个没有额外信息的使用药物的人的描述，或者五个描述之一，带有旨在减少耻辱的额外信息。然后，他们将回答有关他们对该人的感受的问题，以及在他们使用药物时保持他们安全的干预措施（减少伤害的干预措施）。将进行统计分析，看看哪些额外信息会导致最少的污名化态度，并为减少伤害干预措施提供更多支持。5.我将与PWUD合作，开发一系列干预措施，以减少公众和专业观众的耻辱感，包括短片，书面信息和图形。公众参与通常，PWUD没有充分参与有关它们的研究或决策。为了确保这项研究不会出现这种情况，通过布里斯托的药物治疗服务招募的一组PWUD将监督该项目; PWUD将被邀请参加研讨会，并合作制作产出和研究论文。产出-短片，书面信息和图形将有助于由药物治疗慈善机构和NHS组织的全国反耻辱运动。它们还将在合作的公共卫生和宣传组织网络中广泛分享，并与医疗保健专业人员的培训材料一起传播。研究结果将提交给学术期刊和会议，并由合作组织在社交媒体和通讯中分享。在这个项目之后，我将期待进行进一步的研究，以评估信息传递的影响。

Background Stigma is the negative stereotyping of certain groups of people, which leads others to treat them unfairly. Many people who use drugs (PWUD) have health problems and face extreme levels of stigma. They are often treated poorly when they access healthcare and drug treatment services, leading them to delay seeking help in the future. This can make treatment more difficult and expensive, and they are more likely to die. Stigma may also affect policymakers' decisions about how best to manage drug use, forming a barrier to implementing new services that could reduce drug-related harm. Whilst there are campaigns to reduce stigma towards PWUD, at the same time stigma is used as a tool to try and stop people from doing unhealthy things. For example, 'de-normalising' and stigmatising smoking may have led to reduced smoking rates. Whether or not stigmatising PWUD reduces drug use in the wider population, it is necessary to consider if this is justified given the harm it causes.Aims1. Develop messaging interventions to reduce public and professional stigma towards PWUD, to improve wellbeing, increase willingness to access support, and facilitate the introduction of harm reduction interventions.2. Explore how to balance the use of a stigma as a public health tool to discourage drug use with its negative impacts on PWUD.Methods1. I will review existing research on messaging intended to reduce stigma towards PWUD.2. In collaboration with various public health and drug treatment organisations, I will recruit and interview approximately 40 people who work in policy, public health and drug treatment, to explore their attitudes towards PWUD and their views on using stigma to discourage drug use. 3. Two workshops will be organised with academics, policy stakeholders, and PWUD to discuss if and when it is justifiable to use stigma to try and discourage drug use. 4. I will conduct a study exploring the impacts of different types of messaging with 325 members of the public (recruited via a public survey platform), and three groups of professionals - working in policy, public health, and drug treatment (recruited in collaboration with professional organisations and via a public sector newsletter). Participants will be provided either a description of someone who uses drugs without additional information, or one of five descriptions with additional information intended to reduce stigma. They will then answer questions about how they feel about the person, and interventions to keep them safe when they use drugs (harm reduction interventions). A statistical analysis will be performed to see which additional information led to the least stigmatising attitudes, and more support for harm reduction interventions. 5. In collaboration with PWUD, I will develop a series of interventions to reduce stigma for public and professional audiences, including short films, written information, and graphics. Public involvementOften, PWUD are not involved enough in research or decisions about them. To make sure this isn't the case for this research, a group of PWUD, recruited via Bristol's drug treatment service will oversee the project; and PWUD will be invited to the workshops and collaborate in the production of outputs and research papers. Outputs- The short films, written information, and graphics will contribute to a national anti-stigma campaign being organised by drug treatment charities and the NHS.- They will also be shared widely amongst the networks of collaborating public health and advocacy organisations and disseminated alongside training materials for healthcare professionals.- Research findings will be submitted to academic journals and conferences and shared by collaborating organisations on social media and in newsletters.- Following this project, I will look to undertake further research to evaluate the impacts of the messaging.