SMART Trial: Intrapersonal and Interpersonal Stigma Reduction

Phase 2

Completed

Conditions: Opioid Use
Substance Use Disorders
Stigma, Social
Opioid-use Disorder

Interventions: Other: Intrapersonal Stigma Reduction
Other: Interpersonal Stigma Reduction

Registration Number: NCT04693416

Lead Sponsor: University of Tennessee

Brief Summary: The goal of this project is to develop a multicomponent stigma reduction intervention to address intrapersonal (individual) stigma regarding Opioid Use Disorder (OUD). The intervention will address this cost/benefit evaluation among individuals known to face intersecting stigma of OUD and African American race, with treatment elements chosen explicitly to increase the value of treatment using salient forms of reward, and to ease perceived costs through explicit services in an effort to encourage the occurrence of the first treatment visit for OUD.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 71

Inclusion Criteria

18 years of age or older
Identify as African American, Black, or mixed race
Identify as someone with a substance use disorder who is not currently in treatment OR a support person of someone enrolled
Access to a telephone for follow-up assessment
Reside in the Memphis, TN area

Exclusion Criteria

Unable to understand consent procedures

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Intrapersonal Stigma Reduction	Intrapersonal Stigma Reduction	The intervention will include education about substance use disorders (diagnosis, prognosis, and treatment), goal setting to assist the individual in preparing for change, and decisional balance to assist the individual in measuring the costs and benefits about disclosure of mental health problems and exercises to practice how to disclose. Facilitation of an intake assessment for treatment will be offered (with assistance in making the appointment, getting transportation and childcare, and securing a pro-bono status at a outpatient treatment facility).
Interpersonal Stigma Reduction	Interpersonal Stigma Reduction	The intervention for family members and support persons of enrolled intrapersonal participants will include education about substance use disorders (diagnosis, prognosis, and treatment), stigma reduction, and how to provide support for someone with substance use disorder.

Primary Outcome Measures

Name	Time	Method
Drug Use Stigmatization Scale Score	Pre/post intervention (week 0: post-test immediately followed intervention)	The Drug Use Stigmatization Scale measures stigma against drug users. The scale contains 7 items scored on a 5-point likert scale with higher scores representing higher stigma. The score is the average score of the seven items. Min score = 1, Max score = 5. Reported mean is the change in these scores (pre score - post score), so a positive number for the mean is a reduction in stigma.
Enacted Stigma (Intrapersonal)	Immediately before and 2-weeks post-intervention delivery	Change in Enacted Stigma subscore from Substance Use Stigma Mechanisms Scale (SU-SMS) pre- and post-intervention. All responses are given on a 5-point Likert-type scale, with higher scores indicating greater endorsement of substance use stigma. Enacted (6 items) scale can be created by taking the average of the item responses given. Minimum score = 6, Maximum score = 30. Reported mean is the change in these scores (pre score - post score), so a positive number for the mean is a reduction in stigma using average scores from the Enacted Stigma subscore.
Internalized Stigma (Intrapersonal)	Immediately before and 2-weeks post-intervention delivery	Change in Internalized Stigma subscore from Substance Use Stigma Mechanisms Scale (SU-SMS) pre- and post-intervention. All responses are given on a 5-point Likert-type scale, with higher scores indicating greater endorsement of substance use stigma. Enacted (6 items) scale can be created by taking the average of the item responses given. Minimum score = 6, Maximum score = 30. Reported mean is the change in these scores (pre score - post score), so a positive number for the mean is a reduction in stigma using average scores from the Internalized Stigma subscore.
Stigma of Drug Users Scale Score	Pre/post intervention (week 0: post-test immediately followed intervention)	The Stigma of Drug Users Scale measures stigma. There are 10 items scored on a 5-point likert scale. Higher scores indicate higher stigma. The score is the average of the 10 items (Min score = 1, Max score = 5). The reported mean for this outcome measure is the change in this score pre and post intervention (pre score - post score). A positive mean indicates a reduction in stigma.
Anticipated Stigma (Intrapersonal)	Immediately before and 2-weeks post-intervention delivery	Change in Anticipated Stigma subscore from Substance Use Stigma Mechanisms Scale (SU-SMS) pre- and post-intervention. All responses are given on a 5-point Likert-type scale, with higher scores indicating greater endorsement of substance use stigma. Enacted (6 items) scale can be created by taking the average of the item responses given. Minimum score = 6, Maximum score = 30. Reported mean is the change in these scores (pre score - post score), so a positive number for the mean is a reduction in stigma using average scores from the Anticipated Stigma subscore.
Exposure to Drug Users Index Score	Pre/post intervention (week 0)	Exposure to drug users index includes questions regarding if a participant has been exposed to a drug user at home, at work, at school, etc. (7 items; No = 0, Yes = 1). Score is total count (min score = 0, max score = 7). Higher scores indicate more exposure to drug users. Reported mean is the change in this score pre and post intervention (post score - pre score).

Secondary Outcome Measures

Name	Time	Method
Engagement in Treatment	2-weeks post-intervention	Number of participants in intrapersonal arm who made an appointment for treatment after receiving the intervention.