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20年里，近85万美国人死于服药过量。耻辱仍然是一种不成熟的 解决了结束毒品流行的中心障碍。物质使用耻辱减少治疗和伤害 在吸毒者中减少使用(PWUD)，并与更多的药物使用相关， 抑郁、社交孤立和许多其他健康功能的心理社会指标。尽管 事实证明，以教育和社会接触为重点的干预措施在减少污名化方面取得了成功 在公众的态度上，更少人知道如何干预自卑、消极情绪 有关于他们吸毒的信息。为PWUD制定应对和抵制污名的策略可能会提高质量 减少这一人群中的过量用药。抵制污名是一种很有希望的方法，它可以促进 通过自我赋权和积极的身份认同形成韧性。与NIDA的优先事项保持一致 耻辱和开发恢复支持战略，此应用程序的目标是开发和评估 针对PWUD的抗污名短信干预。嵌套在NIDA资助的俄亥俄阿片类药物项目中 (UG3/UH3DA044822)，该提案的具体目标是：1)确定PWUD自我污名亚群和 描述在八个州的多个州的农村PWUD中与人口统计、健康和药物使用相关的危险因素 使用潜在类别分析进行站点队列；2)识别与污名相关的态度和信念以及文本消息内容 通过对俄亥俄州20个农村PWUD的迭代启发式访谈和交付偏好；3)开发四个- 每周自动每日短信抵制污名干预；以及4)评估可行性， 俄亥俄州30个农村现役残障患者干预的可接受性和初步有效性 使用。基于健康传播和行为健康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污名 抵抗和减少自我污名。这一提议将为自我污名干预和 提供进一步的证据，证明短信作为一种经济高效、有影响力的方式来参与这一难以- 触达人群。除了计划中的研究，申请者还建议进行培训，以提高他的 对污名的理论认识，提高他的定量分析技能，增强他的能力 健康沟通策略，并通过学术演讲和 出版物。在联合赞助商Go博士和William Miller博士的专家指导下 合作者，这项研究和培训计划将有助于申请者的职业发展轨迹 独立的混合方法物质使用和污名研究人员。

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.