A Mixed Methods Exploration of Stigma, Discrimination, and Sleep Among Those on Medication for Opioid Use Disorder

项目摘要 睡眠不足发生在多达65%的OUD患者中。睡眠不足的患病率是 可归因于并发因素如精神健康障碍、慢性疼痛和药物使用（例如， 苯二氮卓类药物滥用），但对社会因素的作用还不十分了解。持续存在的社会 这一人群中的因素和关切是耻辱和歧视。MOUD上的人被污名化 由于许多原因，包括OUD本身，治疗状况和其他可能的原因， 个人特征或社会问题（例如，种族、性别、社会经济地位和监禁史） 这可能会导致交叉羞辱和交叉歧视。然而， 睡眠不足的耻辱和歧视与交叉经验和对睡眠不足的看法之间的关系 对MOUD患者的羞辱和歧视还不太了解。建议的目的 融合混合方法研究，嵌套在NIH HEAL资助的机制研究（CLOUDS研究- 阿片类药物使用障碍与睡眠的联系）是为了检查OUD相关的 污名化和交叉歧视与睡眠不足的患者对MOUD。我们将解决 目的1：研究（1a）OUD相关污名;（1b）交叉污名;（1c） 歧视;（1c）自我报告和客观测量（腕关节活动记录仪）睡眠不足;在患者中 在MOUD [量化]上。假设：与OUD相关的污名和交叉歧视与以下因素相关： MOUD患者的睡眠不足增加，同时控制疼痛，感知压力和精神 健康目标2：描述（1）个人如何看待耻辱，歧视和睡眠问题;（2） 污名化与歧视的交叉现象;（3）经验与认知如何关联 睡眠（睡眠）目标3：全面了解污名化与 通过定量和定量相结合的方法， 目标1和2的定性数据[混合方法]。与NIDA的战略重点一致， 由于影响吸毒轨迹的因素之间存在着复杂的相互作用，拟议的研究培训提案将 为持续的研究生涯提供必要的基础，专注于研究可改变的 社会心理因素对吸毒者健康的影响。

PROJECT SUMMARY Sleep deficiency occurs in as many as 65% of people with OUD. The prevalence of sleep deficiency is attributable to concurrent factors such as mental health disorders, chronic pain, and medication use (e.g., benzodiazepine abuse), however the contribution of social factors are not well understood. Persistent social factors and concerns within this population are stigma and discrimination. People on MOUD are stigmatized and discriminated against for a number of reasons including OUD itself, treatment status and possibly other personal characteristics or social issues (e.g., race, gender, socioeconomic status, and incarceration history) that may contribute to intersectional stigma and intersectional discrimination. However, the relationship between stigma and discrimination with sleep deficiency and intersectional experiences and perceptions of stigma and discrimination among patients on MOUD are not well understood. The purpose of the proposed convergent mixed methods study, nested within the NIH HEAL funded mechanistic study (CLOUDS STUDY- Collaboration Linking Opioid Use Disorder and Sleep) is to examine the relationship between OUD-related stigma, and intersectional discrimination with sleep deficiency among patients on MOUD. We will address the following aims: Aim 1: Examine the relationships between (1a) OUD-related stigma; (1b) intersectional discrimination; (1c) self-reported and objectively measured (wrist actigraph) sleep deficiency; among patients on MOUD [quantitative]. Hypothesis: OUD-related stigma and intersectional discrimination are associated with increased sleep deficiency among patients on MOUD while controlling for pain, perceived stress, and mental health. Aim 2: Describe (1) how individuals perceive issues of stigma, discrimination, and sleep; (2) the intersectional phenomena of stigma and discrimination; (3) how experiences and perceptions associate with sleep [qualitative]. Aim 3: Gain a comprehensive understanding of the relationship between stigma and discrimination with sleep deficiency among patients on MOUD through integration of quantitative and qualitative data from Aims 1 and 2 [mixed methods]. Aligned with NIDA's strategic priority of understanding complex interactions of factors influencing drug use trajectories, the proposed research training proposal will provide an essential foundation for a sustained research career focused on investigating modifiable psychosocial factors influence on health among those who suffer from drug addiction.