Using Narratives to Identify Stigma Phenotypes - A Socio-Ecological Approach

项目摘要/摘要 与物质使用障碍(SODS)相关的耻辱可能会对身体产生严重的负面后果 和心理健康；影响就业、住房和社会关系；导致社会疏远；以及服务 作为获得治疗的障碍。现有的减少耻辱的干预措施主要集中在结构性 污名(例如，对医学生或与肥胖症患者合作的专业团体的教育)，但 柱头可以在多个层次和不同的环境中发生。特别是，需要更多的污名。 减少干预措施，目标是那些受自我耻辱影响的人。我们建议通过以下方式解决这一差距 通过从两个不同的故事中收集的描述来描述不同物质使用环境中的耻辱 来源、社交媒体和调查数据。这项建议的长期目标是获得关于以下方面的见解 污名表型--以背景(例如，工作、家庭、学校)、行为者(参与 与耻辱有关的经验)，以及需要减少耻辱干预的情况，以及 适合其目标人群的干预机制。这项提议的意义在于 它关注的是耻辱，因为它直接影响到经历耻辱的人--耻辱是指 减排干预措施匮乏。我们专注于与三种物质有关的耻辱：酒精、大麻和 阿片类药物。我们的三个目标是：1)将自然语言处理和定性研究方法结合起来 确定耻辱的过程，其背景因素，以及在社会环境中减少耻辱的障碍和促进者 媒体语料库；2)我们将进行一项调查，从患有肥皂剧的人那里了解他们是如何 在不同的背景下处理污名问题；以及3)我们将对目标1和目标2的结果进行三角测量，以确定 未来减少污名干预的环境、目标人群和干预机制。我们的 多学科研究团队拥有与该提案相关的多个领域的专业知识，包括NLP、 定性研究和物质使用，是进行研究的理想位置。

Project Summary/Abstract Stigma associated with substance use disorders (SUDs) can have severe negative consequences for physical and mental health; affect employment, housing, and social relationships; result in social alienation; and serve as a barrier to obtaining treatment. Existing stigma reduction interventions have largely focused on structural stigma (e.g. education of medical students or professional groups that work with persons with SUDs), but stigma can occur at multiple levels and in different contexts. In particular, there is a need for more stigma reduction interventions targeting those affected by self-stigma. We propose to address this gap by characterizing stigma in different substance use contexts through narratives collected from two different sources, social media and survey data. The long-term objective of this proposal is to derive insights concerning stigma phenotypes – characterized by setting (e.g., work, home, school), actors (persons involved in the stigma-related experience), and situations in which stigma reduction interventions are needed, as well as intervention mechanisms that are appropriate for their target populations. The significance of this proposal is that it focuses on stigma as it directly affects the persons who experience stigma – an area in which stigma reduction interventions are lacking. We focus on stigma relating to three substances: alcohol, cannabis, and opioids. Our three aims are: 1) we will integrate natural language processing and qualitative research methods to identify stigma processes, their contextual factors, and barriers and facilitators of stigma reduction in a social media corpus; 2) we will administer a survey to elicit narratives from persons with SUDs about how they have dealt with stigma in different contexts; and 3) we will triangulate the findings from Aims 1 and 2 to identify settings, target populations, and intervention mechanisms for future stigma reduction interventions. Our multidisciplinary research team possesses expertise in multiple areas relating to this proposal, including NLP, qualitative research, and substance use, and are ideally positioned to conduct the research.