title: Intervening within and across levels: a multilevel approach to stigma and public health.
abstract: This article uses a multilevel approach to review the literature on interventions with promise to reduce social stigma and its consequences for population health. Three levels of an ecological system are discussed. The intrapersonal level describes interventions directed at individuals, to either enhance coping strategies of people who belong to stigmatized groups or change attitudes and behaviors of the non-stigmatized. The interpersonal level describes interventions that target dyadic or small group interactions. The structural level describes interventions directed at the social-political environment, such as laws and policies. These intervention levels are related and they reciprocally affect one another. In this article we review the literature within each level. We suggest that interventions at any level have the potential to affect other levels of an ecological system through a process of mutually reinforcing reciprocal processes. We discuss research priorities, in particular longitudinal research that incorporates multiple outcomes across a system.
authors: Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA. Electronic address: jonathan.emdin.cook@gmail.com.
authors: Jonathan E
authors: JE
authors: Cook
authors: Department of Psychology, Columbia University, 1190 Amsterdam Ave MC 5501, New York, NY 10027, USA. Electronic address: vpvaughns@psych.columbia.edu.
authors: Valerie
authors: V
authors: Purdie-Vaughns
authors: The Williams Institute, UCLA School of Law, Box 951476, Los Angeles, CA 90095-1476, USA. Electronic address: meyer@law.ucla.edu.
authors: Ilan H
authors: IH
authors: Meyer
authors: Department of Psychology, The University of Texas at Austin, 108 E. Dean Keeton Stop A8000, Austin, TX 78712, USA. Electronic address: justin.ta.busch@gmail.com.
authors: Justin T A
authors: JTA
authors: Busch
mesh_terms: D000223:Adaptation, Psychological; D001290:Attitude; D006291:Health Policy; D006801:Humans; D007398:Interpersonal Relations; D055361:Multilevel Analysis; D011634:Public Health / Q000379:methods*; D057545:Social Stigma
keywords: Disparities; Health; Intervention; Stigma