{"title":"Acceptability and Feasibility of a Social Contact Based Intervention for Reduction of Public Stigma Against Persons With Opioid Use Disorder.","authors":"Arshia Sood, Abhishek Ghosh, Kathirvel Soundappan, Renjith Ramakrishna Pillai, Debasish Basu","doi":"10.1177/00207640251370404","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aim: </strong>Opioid Use Disorder (OUD) is a major public health issue, exacerbated by public stigma that hinders treatment-seeking and social integration. This study aimed to adapt and validate a social-contact-based intervention to reduce public stigma against individuals with OUD in India, ensuring cultural relevance and feasibility.</p><p><strong>Methods: </strong>The study followed a two-phase approach: adaptation and validation using the ADAPT framework and Delphi method with 14 multi-disciplinary experts and people with lived experience (PWLE), and pre-experimental, open-label pilot study assessing feasibility, acceptability, and preliminary impact on stigma. Participants (<i>n</i> = 30) attended a 60- to 90-min session combining an educational component with direct social contact with PWLE. Stigma was assessed using a validated questionnaire at baseline, 48 hr, and 3 months. Correlation analysis was done between total stigma and domain-wise scores.</p><p><strong>Results: </strong>The intervention achieved a 90% session completion rate, with 69.2% of approached individuals consenting to participate. Acceptability measures indicated high engagement, with 90% of participants rating the session as useful, although 36.6% found it challenging to reconcile with pre-existing beliefs. Stigma scores significantly improved at 48 hr post-intervention in the Attribution Blame domain (<i>p</i> = .002) and Attribution Exoneration domain (<i>p</i> = .079, trend toward significance). Partial attenuation of stigma reduction effects was observed at 3 months. The Total Stigma Score was significantly correlated with Punishment (<i>r</i> = .733, <i>p</i> < .001), Social Threat (<i>r</i> = .681, <i>p</i> < .001), and Attribution Blame (<i>r</i> = .609, <i>p</i> < .001). Attribution Exoneration negatively correlated with Punishment (<i>r</i> = -.373, <i>p</i> < .05).</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility and acceptability of a culturally adapted, social-contact-based intervention for reducing public stigma against OUD. Shifting blame perceptions may help reduce punitive attitudes.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"207640251370404"},"PeriodicalIF":2.7000,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Social Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00207640251370404","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and aim: Opioid Use Disorder (OUD) is a major public health issue, exacerbated by public stigma that hinders treatment-seeking and social integration. This study aimed to adapt and validate a social-contact-based intervention to reduce public stigma against individuals with OUD in India, ensuring cultural relevance and feasibility.
Methods: The study followed a two-phase approach: adaptation and validation using the ADAPT framework and Delphi method with 14 multi-disciplinary experts and people with lived experience (PWLE), and pre-experimental, open-label pilot study assessing feasibility, acceptability, and preliminary impact on stigma. Participants (n = 30) attended a 60- to 90-min session combining an educational component with direct social contact with PWLE. Stigma was assessed using a validated questionnaire at baseline, 48 hr, and 3 months. Correlation analysis was done between total stigma and domain-wise scores.
Results: The intervention achieved a 90% session completion rate, with 69.2% of approached individuals consenting to participate. Acceptability measures indicated high engagement, with 90% of participants rating the session as useful, although 36.6% found it challenging to reconcile with pre-existing beliefs. Stigma scores significantly improved at 48 hr post-intervention in the Attribution Blame domain (p = .002) and Attribution Exoneration domain (p = .079, trend toward significance). Partial attenuation of stigma reduction effects was observed at 3 months. The Total Stigma Score was significantly correlated with Punishment (r = .733, p < .001), Social Threat (r = .681, p < .001), and Attribution Blame (r = .609, p < .001). Attribution Exoneration negatively correlated with Punishment (r = -.373, p < .05).
Conclusion: This study demonstrates the feasibility and acceptability of a culturally adapted, social-contact-based intervention for reducing public stigma against OUD. Shifting blame perceptions may help reduce punitive attitudes.
背景和目的：阿片类药物使用障碍（OUD）是一个重大的公共卫生问题，由于阻碍寻求治疗和社会融合的公众耻辱感而加剧。本研究旨在调整和验证基于社会接触的干预措施，以减少公众对印度OUD患者的耻辱感，确保文化相关性和可行性。方法：本研究采用两阶段方法：采用ADAPT框架和德尔菲法进行适应和验证，由14名多学科专家和有生活经验的人（PWLE）参与，并进行预实验、开放标签试点研究，评估可行性、可接受性和对病耻感的初步影响。参与者（n = 30）参加了一个60到90分钟的会议，结合了教育部分和与PWLE的直接社会接触。在基线、48小时和3个月时使用有效的问卷对病耻感进行评估。对总柱头与分域得分进行相关分析。结果：干预达到了90%的疗程完成率，69.2%的被接触者同意参与。可接受性指标表明，参与者的参与度很高，90%的参与者认为课程很有用，尽管36.6%的参与者认为与已有的信念调和是一项挑战。在干预后48小时，污名得分在归因责备域（p = .002）和归因免责域（p = .002）显著提高。趋向于重要性)。在3个月时观察到柱头减少效应的部分衰减。总耻感得分与惩罚显著相关(r =。733, p r =。p r =。结论：本研究证明了一种文化适应性的、基于社会接触的干预措施对于减少公众对OUD的耻辱感的可行性和可接受性。改变指责观念可能有助于减少惩罚态度。
期刊介绍：
The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities.
Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas.
The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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