title: Adaptation and Implementation of an Intervention to Reduce HIV-Related Stigma Among Healthcare Workers in the United States: Piloting of the FRESH Workshop.
abstract: HIV-related stigma has been shown to have profound effects on people living with HIV (PLWH). When stigma is experienced in a healthcare setting, negative health outcomes are exacerbated. We sought to assess the feasibility and acceptability of a healthcare setting stigma-reduction intervention, the Finding Respect and Ending Stigma around HIV (FRESH) Workshop, in the United States. This intervention, adapted from a similar strategy implemented in Africa, brought together healthcare workers (HW) and PLWH to address HIV-related stigma. Two pilot workshops were conducted in Alabama and included 17 HW and 19 PLWH. Participants completed questionnaire measures pre- and post-workshop, including open-ended feedback items. Analytical methods included assessment of measures reliability, pre-post-test comparisons using paired t-tests, and qualitative content analysis. Overall satisfaction with the workshop experience was high, with 87% PLWH and 89% HW rating the workshop "excellent" and the majority agreeing that others like themselves would be interested in participating. Content analysis of open-ended items revealed that participants considered the workshop informative, interactive, well-organized, understandable, fun, and inclusive, while addressing real and prevalent issues. Most pre- and post-test measures had good-excellent internal consistency reliability (Cronbach's alphas ranging from 0.70 to 0.96) and, although sample sizes were small, positive trends were observed, reaching statistical significance for increased awareness of stigma in the health facility among HW (p = 0.047) and decreased uncertainty about HIV treatment among PLWH (p = 0.017). The FRESH intervention appears to be feasible and highly acceptable to HW and PLWH participants and shows great promise as a healthcare setting stigma-reduction intervention for US contexts.
authors.affiliation: 1 Department of Social Work, College of Arts & Sciences, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: D Scott
authors.initials: DS
authors.lastname: Batey
authors.affiliation: 2 Healthcare Organization and Policy, School of Public Health, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Samantha
authors.initials: S
authors.lastname: Whitfield
authors.affiliation: 3 Department of Psychology, College of Arts & Sciences, The University of Alabama , Tuscaloosa, Alabama.
authors.forename: Mazheruddin
authors.initials: M
authors.lastname: Mulla
authors.affiliation: 4 Department of Sociology, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Kristi L
authors.initials: KL
authors.lastname: Stringer
authors.affiliation: 2 Healthcare Organization and Policy, School of Public Health, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Modupeoluwa
authors.initials: M
authors.lastname: Durojaiye
authors.affiliation: 2 Healthcare Organization and Policy, School of Public Health, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Lisa
authors.initials: L
authors.lastname: McCormick
authors.affiliation: 5 Department of Psychology, College of Arts & Sciences, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Bulent
authors.initials: B
authors.lastname: Turan
authors.affiliation: 6 Division of Global Health, International Development Group and HP+, RTI International , Washington, District of Columbia.
authors.forename: Laura
authors.initials: L
authors.lastname: Nyblade
authors.affiliation: 7 Nursing Family, Community & Health Systems, College of Nursing, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Mirjam-Colette
authors.initials: MC
authors.lastname: Kempf
authors.affiliation: 2 Healthcare Organization and Policy, School of Public Health, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Turan
mesh_terms: D000328:Adult; D000407:Alabama; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research; D015203:Reproducibility of Results; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014481:United States
keywords: HIV/AIDS; United States; discrimination; healthcare workers; interventions; stigma