title: Reducing stigma towards substance users through an educational intervention: harder than it looks.
abstract: OBJECTIVE
  Stigma towards people with substance use disorders is pervasive and imbedded in our US culture. Prejudicial attitudes that are part of a health care practitioner's value system are a barrier to people accessing health care and substance use treatment. This study aimed to reduce stigmatizing attitudes of graduate health care professional students by implementing an innovative curriculum combining multiple teaching methods.
  
  
  METHODS
  Physician assistant students received a 3-h educational intervention that consisted of lecture and discussion sessions, direct interaction with a recovering substance user, viewing a film portrayal of addiction and addiction treatment, and written self-reflection. Changes in student attitudes were measured using a subscale of the Attitudes to Mental Illness Questionnaire (AMIQ) instrument and analysis of coded written reflections. A follow-up focus group resulted in additional qualitative insight into attitudes.
  
  
  RESULTS
  Post-intervention scores for the "heroin" AMIQ vignette significantly improved compared to pre-test scores (p<0.007), but the effect was small and the mean post-test scores still reflected very negative attitudes. Students' neutral attitude towards alcohol use did not change as a result of the intervention. Written reflections demonstrated that this sample of students continued to harbor stigma towards people with substance use following the intervention. Focus group data suggested students believed that stigma beliefs about substance use were common among health care professionals, though they believed that their own level and quality of care would not be influenced by these beliefs.
  
  
  CONCLUSIONS
  The persistence of negative attitudes following this and others' educational interventions suggests the need for a new approach to changing health care professionals' stigma towards substance users.
authors.affiliation: Department of Psychiatry, Louisiana State University Health Sciences Center, Baton Rouge, LA, USA, kcrap1@lsuhsc.edu.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Crapanzano
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Vath
authors.forename: Dixie
authors.initials: D
authors.lastname: Fisher
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003479:Curriculum / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D010823:Physician Assistants / Q000193:education* / Q000523:psychology; D057545:Social Stigma; D019966:Substance-Related Disorders / Q000523:psychology*