Determining the Feasibility and Acceptability of a Novel Stigma Resistance Text Message Intervention for People who Use Drugs

项目摘要 在过去的二十年里，近85万美国人死于过量服用。耻辱仍然是一个下- 解决了终结毒品流行的主要障碍。物质使用污名减少治疗和伤害 减少吸毒者的使用（PWUD），并与吸毒增加有关， 抑郁症、社会孤立和许多其他健康功能的社会心理指标。虽然 以教育和社会接触为重点的干预措施已证明在减少污名化方面取得了成功 公众的态度，更少有人知道如何干预自我污名，负面情绪PWUD 关于他们的药物使用。为PWUD制定科普和抵制污名的策略可以提高质量 并减少这一人群的过量用药。抵制污名是一种很有前途的方法， 通过自我赋权和积极的身份认同形成的韧性。根据NIDA的优先事项， 耻辱和发展恢复支持战略，本申请的目标是制定和评估一个 针对PWUD的污名抵抗短信干预。嵌套在NIDA资助的俄亥俄州阿片类药物项目中 (UG3/UH 3DA 044822），该提案的具体目标是：1）识别PWUD自我污名亚组， 描述八个州的农村PWUD中相关的人口统计学、健康和药物使用风险因素， 使用潜在类别分析的站点队列; 2）识别与耻辱相关的态度和信仰以及短信内容 和交付偏好，通过迭代启发式访谈与20个农村俄亥俄州PWUD; 3）开发一个四- 每周自动每日短信污名抵抗干预;和4）评估可行性， 接受性，和初步的干预效果，在一个样本的30个农村俄亥俄州PWUD在积极的 使用.健康沟通和行为健康告知的迭代收敛混合方法设计 理论将指导互动信息的发展，这些信息被假设为增加耻辱感 减少自我羞辱。该提案将为自我污名干预奠定基础， 提供进一步的证据，证明短信是一种具有成本效益、有影响力的方式， 到达人口。除了计划中的研究，申请人还提出了培训，以提高他的 从理论上理解污名，提高他的定量分析能力，加强他的能力， 健康传播战略，并通过学术演讲建立他的沟通记录， 出版物。在共同赞助人Vivian Go博士和William米勒博士以及其他 合作者，这项研究和培训计划将有助于申请人的职业轨迹， 独立混合方法药物使用和污名研究员。

Project Summary Nearly 850,000 Americans have died from overdose in the past two decades. Stigma remains an under- addressed central barrier to ending the drug epidemic. Substance use stigma reduces treatment and harm reduction utilization among people who use drugs (PWUD) and is associated with increased drug use, depression, social isolation, and numerous other psychosocial indicators of healthy functioning. Though interventions focused on education and social contact have proven successful in reducing stigmatizing attitudes in the public, much less is known about how to intervene on self-stigma, the negative feelings PWUD have about their drug use. Developing strategies for PWUD to cope with and resist stigma may promote quality of life and reduce overdose in this population. Stigma resistance is a promising approach that promotes resilience through self-empowerment and positive identity formation. In line with NIDA’s priorities of reducing stigma and developing recovery support strategies, the goal of this application is to develop and evaluate a stigma resistance text message intervention for PWUD. Nested within the NIDA-funded Ohio Opioid Project (UG3/UH3DA044822), the specific aims of the proposal are to: 1) Identify PWUD self-stigma subgroups and describe associated demographic, health, and drug use risk factors among rural PWUD in an eight-state multi- site cohort using latent class analysis; 2) identify stigma-related attitudes and beliefs and text message content and delivery preferences through iterative elicitation interviews with 20 rural Ohio PWUD; 3) develop a four- week automated daily text message stigma resistance intervention; and 4) evaluate the feasibility, acceptability, and preliminary effectiveness of the intervention in a sample of 30 rural Ohio PWUD in active use. An iterative convergent mixed-methods design informed by health communication and behavioral health theories will guide the development of interactive messages that are hypothesized to increase stigma resistance and reduce self-stigma. This proposal will lay the groundwork for a self-stigma intervention and provide further evidence for text messaging as a cost-effective, impactful modality for engaging this hard-to- reach population. Alongside the planned research, the applicant proposes training that will enhance his theoretical understanding of stigma, advance his quantitative analysis skills, strengthen his competence in health communication strategies, and build his communication record through scholarly presentations and publications. Under the expert mentorship of co-sponsor Drs. Vivian Go and William Miller and other collaborators, this research and training plan will contribute to the applicant’s career trajectory as an independent mixed-methods substance use and stigma researcher.