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

背景污名是对特定人群的负面刻板印象，导致他人对他们不公平。许多使用毒品(PWUD)的人都有健康问题，并面临极端程度的耻辱。他们在获得医疗和药物治疗服务时往往受到恶劣的对待，导致他们推迟未来寻求帮助。这会使治疗变得更加困难和昂贵，他们更有可能死亡。耻辱还可能影响政策制定者关于如何最好地管理毒品使用的决定，形成实施可减少与毒品有关的危害的新服务的障碍。虽然有减少对PWUD的污名的运动，但与此同时，污名被用作一种工具，试图阻止人们做不健康的事情。例如，“去正常化”和污名化吸烟可能导致了吸烟率的降低。污名化PWUD是否会减少更广泛人群中的药物使用，考虑到它造成的危害，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残障人士的污名，改善福祉，增加获得支持的意愿，并促进引入减少伤害干预措施。探讨如何平衡利用污名作为一种公共卫生工具，以阻止吸毒及其对残疾儿童的负面影响。我将回顾关于报文传送的现有研究，旨在减少对PWUD的耻辱。我将与不同的公共卫生和戒毒机构合作，招募和访问大约40名在政策、公共卫生和戒毒治疗领域工作的人，以了解他们对PWUD的态度，以及他们对利用耻辱来阻止药物使用的看法。3.将与学者、政策利益攸关方和残疾人联合会举办两次研讨会，讨论是否以及何时有理由利用耻辱来尝试和阻止吸毒。4.我会与325名市民(透过公众调查平台招聘)，以及三组专业人士--政策、公共卫生及戒毒治疗专业人员(与专业机构合作及透过公共机构通讯招聘)--进行一项研究，探讨不同类型讯息的影响。参与者将被提供对没有额外信息的吸毒者的描述，或者五种描述中的一种，其中包括旨在减少耻辱的额外信息。然后，他们将回答关于他们对这个人的感觉的问题，以及在他们使用药物时保护他们安全的干预措施(减少伤害干预)。将进行统计分析，以了解哪些额外信息导致的污名化态度最少，并更多地支持减少伤害的干预措施。5.我将与PWUD合作，制定一系列干预措施，以减少公众和专业观众的耻辱，包括短片、书面信息和图表。公众参与通常情况下，PWUD没有足够地参与有关他们的研究或决策。为了确保这项研究不是这样，一组通过布里斯托尔戒毒服务招募的PWUD将监督该项目；PWUD将被邀请参加研讨会，并在成果和研究论文的制作方面进行合作。这些成果--短片、书面信息和图片--将有助于由戒毒慈善机构和NHS组织的全国反耻辱运动。-它们还将在合作的公共卫生和倡导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。-研究成果将提交到学术期刊和会议上，并由合作组织在社交媒体和时事通讯中分享。-在这个项目之后，我将进行进一步的研究，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.