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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 50 of 53 Research Studies DisplayedFox AB, Earnshaw VA, Taverna EC
Conceptualizing and measuring mental illness stigma: the Mental Illness Stigma Framework and critical review of measures.
In this article, the authors bring together the different foci of mental illness stigma research with the Mental Illness Stigma Framework (MISF). The MISF provides a common framework and set of terminology for understanding mechanisms of mental illness stigma that are relevant to the study of both the stigmatized and the stigmatizer. The investigators apply this framework to systematically review and classify stigma measures used in the past decade according to their corresponding stigma mechanisms.
AHRQ-funded; HS022986.
Citation: Fox AB, Earnshaw VA, Taverna EC .
Conceptualizing and measuring mental illness stigma: the Mental Illness Stigma Framework and critical review of measures.
Stigma Health 2018 Nov;3(4):348-76. doi: 10.1037/sah0000104.
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Keywords: Behavioral Health, Social Stigma
Rice WS, Turan B, White K
Norms and stigma around unintended pregnancy in Alabama: associations with recent contraceptive use and dual method use among young women.
This study investigated the role of unintended pregnancy norms and stigma in contraceptive use among young women in Alabama. A total of 390 women aged 18-24 were surveyed from November 2014 to October 2015 at university and public health clinics. These women were considered at risk for unintended pregnancy and sexually transmitted diseases. Compared to nonusers, users of contraceptives were more likely to be White, nulliparous, from the university and had higher income. Disapproval of unintended pregnancy by close family and friends was associated with greater contraceptive use.
AHRQ-funded; HS013852.
Citation: Rice WS, Turan B, White K .
Norms and stigma around unintended pregnancy in Alabama: associations with recent contraceptive use and dual method use among young women.
Women Health 2018 Nov-Dec;58(10):1151-66. doi: 10.1080/03630242.2017.1414099.
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Keywords: Sexual Health, Pregnancy, Social Stigma, Women, Young Adults
Zuckerman KE, Lindly OJ, Reyes NM
Parent perceptions of community autism spectrum disorder stigma: measure validation and associations in a multi-site sample.
In this study, the investigators developed a brief, English/Spanish bilingual parent-reported scale of perceived community autism spectrum disorder (ASD) stigma and tested it in a multi-site sample of Latino and non-Latino white parents of children with ASD.
AHRQ-funded; HS000063.
Citation: Zuckerman KE, Lindly OJ, Reyes NM .
Parent perceptions of community autism spectrum disorder stigma: measure validation and associations in a multi-site sample.
J Autism Dev Disord 2018 Sep;48(9):3199-209. doi: 10.1007/s10803-018-3586-x..
Keywords: Autism, Disabilities, Social Stigma, Social Determinants of Health, Behavioral Health
Muenks CE, Sewell WC, Hogan PG
Methicillin-resistant staphylococcus aureus: the effects are more than skin deep.
The purpose of the study was to assess the psychosocial effects of a methicillin-resistant Staphylococcus aureus (MRSA) diagnosis on the households of children with MRSA skin and soft tissue infection (SSTI). The study found that primary caregivers of children with MRSA SSTI reported changing their health behaviors, altering their interactions with people outside of their home, and feeling isolated by others in response to their child's MRSA diagnosis.
AHRQ-funded; HS021736.
Citation: Muenks CE, Sewell WC, Hogan PG .
Methicillin-resistant staphylococcus aureus: the effects are more than skin deep.
J Pediatr 2018 Aug;199:158-65. doi: 10.1016/j.jpeds.2018.04.002..
Keywords: Caregiving, Children/Adolescents, Family Health and History, Methicillin-Resistant Staphylococcus aureus (MRSA), Social Stigma
Rice WS, Logie CH, Napoles TM
Perceptions of intersectional stigma among diverse women living with HIV in the United States.
This study conducted 76 interviews with diverse women with HIV from varied socioeconomic backgrounds in Birmingham AL, Jackson MI, Atlanta GA, and San Francisco CA, who were enrolled in the Women's Interagency HIV Study (WIHS). The purpose was to examine perceptions of intersectional stigma among women living with HIV. The women interviewed shared their perceptions of the various forms of stigma and discrimination they had experienced, most commonly related to gender, race, income level, as well as their incarceration histories and weight. The study’s findings highlight the complexity of the social processes of marginalization, and the need for public health strategies to promote wellbeing among women living with HIV and to reduce social structural and health disparities.
AHRQ-funded; HS013852.
Citation: Rice WS, Logie CH, Napoles TM .
Perceptions of intersectional stigma among diverse women living with HIV in the United States.
Soc Sci Med 2018 Jul;208:9-17. doi: 10.1016/j.socscimed.2018.05.001..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Social Stigma, Women
Crockett KB, Rice WS, Turan B
Associations between multiple forms of discrimination and tobacco use among people living with HIV: the mediating role of avoidance coping.
This study examined the use of tobacco among people living with HIV (PLWH) and their use of it as a coping mechanism for multiple forms of discrimination. Many PLWH face stigma and discrimination associated with HIV and race and sexual orientation. This cohort study recruited 202 PLWH from a HIV primary care clinic in Birmingham, AL between 2013 and 2015. Participants were surveyed on their tobacco use and it showed an association with avoidance coping.
AHRQ-funded; HS013852.
Citation: Crockett KB, Rice WS, Turan B .
Associations between multiple forms of discrimination and tobacco use among people living with HIV: the mediating role of avoidance coping.
J Acquir Immune Defic Syndr 2018 May 1;78(1):9-15. doi: 10.1097/qai.0000000000001636..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Tobacco Use
Kay ES, Rice WS, Crockett KB
Experienced HIV-related stigma in health care and community settings: mediated associations with psychosocial and health outcomes.
This study examined the effects of HIV-related stigma in 203 patients at a Southeastern US urban HIV clinic. Psychosocial and health outcomes related to stigma in community and health care settings was investigated. The study showed that stigma was associated with subclinical outcomes such as viral nonsuppression, poor mental health and interpersonal outcomes. Interventions to address stigma in health care settings were recommended to help these patients.
AHRQ-funded; HS013852.
Citation: Kay ES, Rice WS, Crockett KB .
Experienced HIV-related stigma in health care and community settings: mediated associations with psychosocial and health outcomes.
J Acquir Immune Defic Syndr 2018 Mar;77(3):257-63. doi: 10.1097/qai.0000000000001590..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Urban Health
Harper KJ, Osborn CY, Mayberry LS
Patient-perceived family stigma of type 2 diabetes and its consequences.
The objective of this study was to assess the frequency of type two diabetes (T2D) family stigma and its association with helpful and harmful diabetes-specific family behaviors and psychological and behavioral consequences of stigma. Perceptions/experiences of T2D-related family stigma were common in the study’s sample and associated with consequences of stigma including concealment and resentment of self-care, which may affect clinical outcomes.
AHRQ-funded; HS022990.
Citation: Harper KJ, Osborn CY, Mayberry LS .
Patient-perceived family stigma of type 2 diabetes and its consequences.
Fam Syst Health 2018 Mar;36(1):113-17. doi: 10.1037/fsh0000316..
Keywords: Diabetes, Family Health and History, Social Stigma
Calabrese SK, Earnshaw VA, Magnus M
Sexual stereotypes ascribed to black men who have sex with men: an intersectional analysis.
This online, survey-based study used an inductive, intersectional approach to characterize the sexual stereotypes ascribed to Black men who have sex with men (MSM) by the U.S. general public, their distinctiveness from those ascribed to Black men and MSM in general, and their relative prototypicality as compared to dominant subgroups.
AHRQ-funded; HS022986.
Citation: Calabrese SK, Earnshaw VA, Magnus M .
Sexual stereotypes ascribed to black men who have sex with men: an intersectional analysis.
Arch Sex Behav 2018 Jan;47(1):143-56. doi: 10.1007/s10508-016-0911-3..
Keywords: Racial and Ethnic Minorities, Social Stigma
Turan B, Rogers AJ, Rice WS
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
There is insufficient research on the impact of perceived discrimination in healthcare settings on adherence to antiretroviral therapy (ART), particularly among women living with HIV, and even less is known about psychosocial mechanisms that may mediate this association. Cross-sectional analyses were conducted in a sample of diverse women living with HIV enrolled in the Women's Interagency HIV Study (WIHS), a multi-center cohort study to investigate these issues.
AHRQ-funded; HS013852.
Citation: Turan B, Rogers AJ, Rice WS .
Association between perceived discrimination in healthcare settings and HIV medication adherence: mediating psychosocial mechanisms.
AIDS Behav 2017 Dec;21(12):3431-39. doi: 10.1007/s10461-017-1957-5..
Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Social Stigma
Derose KP, Payan DD, Fulcar MA
Factors contributing to food insecurity among women living with HIV in the Dominican Republic: a qualitative study.
The researchers examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors.
AHRQ-funded; HS000046.
Citation: Derose KP, Payan DD, Fulcar MA .
Factors contributing to food insecurity among women living with HIV in the Dominican Republic: a qualitative study.
PLoS One 2017 Jul 25;12(7):e0181568. doi: 10.1371/journal.pone.0181568.
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Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Patient Safety, Social Stigma, Social Determinants of Health
Turan B, Hatcher AM, Weiser SD
Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes.
The authors present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. Their conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways.
AHRQ-funded; HS013852.
Citation: Turan B, Hatcher AM, Weiser SD .
Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes.
Am J Public Health 2017 Jun;107(6):863-69. doi: 10.2105/ajph.2017.303744.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Stigma
Kennedy-Hendricks A, Barry CL, Gollust SE
Social stigma toward persons with prescription opioid use disorder: associations with public support for punitive and public health-oriented policies.
This study examined social stigma toward individuals with prescription opioid use disorder and tested whether stigma was associated with support for various policy interventions. Respondents expressed high levels of stigma toward individuals with prescription opioid use disorder. Higher levels of stigma were associated with greater support for punitive policies and lower support for public health-oriented policies.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Barry CL, Gollust SE .
Social stigma toward persons with prescription opioid use disorder: associations with public support for punitive and public health-oriented policies.
Psychiatr Serv 2017 May;68(5):462-69. doi: 10.1176/appi.ps.201600056.
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Keywords: Medication, Opioids, Policy, Social Stigma, Substance Abuse
Rice WS, Turan B, Stringer KL
Norms and stigma regarding pregnancy decisions during an unintended pregnancy: development and predictors of scales among young women in the U.S. South.
The researchers sought to create measures of perceived norms and stigma around pregnancy decisions by developing and pre-testing 97 survey items using a mixed methods approach. Their factor analyses revealed four subscales for each pregnancy decision: conditional acceptability, anticipated reactions, stereotypes/misperceptions, and attitudes. Minority women endorsed more negative norms and stigma around adoption.
AHRQ-funded; HS013852.
Citation: Rice WS, Turan B, Stringer KL .
Norms and stigma regarding pregnancy decisions during an unintended pregnancy: development and predictors of scales among young women in the U.S. South.
PLoS One 2017 Mar 22;12(3):e0174210. doi: 10.1371/journal.pone.0174210.
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Keywords: Children/Adolescents, Shared Decision Making, Pregnancy, Social Stigma, Young Adults
Green TC, Case P, Fiske H
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
This study examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists. It found that consumer groups differed in awareness of naloxone and availability at pharmacies, but all groups expressed support for the pharmacist's role and preferences for a universal offer of naloxone based on clear criteria.
AHRQ-funded; HS024021.
Citation: Green TC, Case P, Fiske H .
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
J Am Pharm Assoc 2017 Mar - Apr;57(2s):S19-S27.e4. doi: 10.1016/j.japh.2017.01.013.
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Keywords: Opioids, Provider: Pharmacist, Social Stigma, Substance Abuse
Schnall R, Cho H, Webel A
Predictors of willingness to use a smartphone for research in underserved persons living with HIV.
The purpose of this study was to assess factors associated with persons living with HIV (PLVH) for participation in research using smartphones. It concluded that future mHealth interventions targeting PLWH should take into account the inverse relationship between smartphone use and age, HIV stigma, and social isolation, and other predictor variables.
AHRQ-funded; HS023963.
Citation: Schnall R, Cho H, Webel A .
Predictors of willingness to use a smartphone for research in underserved persons living with HIV.
Int J Med Inform 2017 Mar;99:53-59. doi: 10.1016/j.ijmedinf.2017.01.002.
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Keywords: Human Immunodeficiency Virus (HIV), Patient Self-Management, Social Stigma, Telehealth, Vulnerable Populations
Sulzer SH, Muenchow E, Potvin A
Improving patient-centered communication of the borderline personality disorder diagnosis.
This study aimed to understand how clinicians communicate the diagnosis of borderline personality disorder (BPD) with patients, and compare these practices with patient communication preferences. It found that the majority of clinicians sampled did not actively share the BPD diagnosis with their patients, while the majority of patients wanted to be told that they had the disorder, as well as have their providers discuss the stigma they would face.
AHRQ-funded; HS000032.
Citation: Sulzer SH, Muenchow E, Potvin A .
Improving patient-centered communication of the borderline personality disorder diagnosis.
J Ment Health 2016;25(1):5-9. doi: 10.3109/09638237.2015.1022253.
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Keywords: Communication, Diagnostic Safety and Quality, Behavioral Health, Clinician-Patient Communication, Social Stigma
Earnshaw VA, Rosenthal L, Lang SM
Stigma, activism, and well-being among people living with HIV.
The researchers examined associations between experiences of HIV stigma and HIV activism, and test whether HIV activists benefit from greater well-being than non-activists. Their results suggest that HIV activists reported greater social network integration, greater social well-being, greater engagement in active coping with discrimination, and greater meaning in life than non-activists.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Rosenthal L, Lang SM .
Stigma, activism, and well-being among people living with HIV.
AIDS Care 2016;28(6):717-21. doi: 10.1080/09540121.2015.1124978.
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Keywords: Human Immunodeficiency Virus (HIV), Quality of Life, Depression, Social Determinants of Health, Social Stigma
Kennedy-Hendricks A, McGinty EE, Barry CL
Effects of competing narratives on public perceptions of opioid pain reliever addiction during pregnancy.
The researchers tested the effects of narratives portraying a woman with opioid pain reliever addiction during pregnancy on beliefs about people addicted to opioid pain relievers, perceptions of treatment effectiveness, policy attitudes, and emotional responses. They found that the extent to which narratives portraying successfully treated addiction affected public attitudes depended on the socioeconomic status of the woman portrayed.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, McGinty EE, Barry CL .
Effects of competing narratives on public perceptions of opioid pain reliever addiction during pregnancy.
J Health Polit Policy Law 2016 Oct;41(5):873-916. doi: 10.1215/03616878-3632230.
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Keywords: Opioids, Pain, Pregnancy, Social Stigma, Substance Abuse
Tan JY, Xu LJ, Lopez FY
Shared decision making among clinicians and Asian American and Pacific Islander sexual and gender minorities: an intersectional approach to address a critical care gap.
The authors illustrated how issues at the intersection of Asian American and Pacific Islander (AAPI) and sexual and gender minorities (SGM) identities affect shared decision making processes and health outcomes. They discussed experiences of AAPI SGM that are affected by AAPI heterogeneity, SGM stigma, multiple minority group identities, and sources of discrimination.
AHRQ-funded; HS022433.
Citation: Tan JY, Xu LJ, Lopez FY .
Shared decision making among clinicians and Asian American and Pacific Islander sexual and gender minorities: an intersectional approach to address a critical care gap.
LGBT Health 2016 Oct;3(5):327-34. doi: 10.1089/lgbt.2015.0143.
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Keywords: Shared Decision Making, Disparities, Racial and Ethnic Minorities, Clinician-Patient Communication, Social Stigma
Calabrese SK, Underhill K, Earnshaw VA
Framing HIV Pre-Exposure Prophylaxis (PrEP) for the general public: How inclusive messaging may prevent prejudice from diminishing public support.
The authors examined how public attitudes toward HIV pre-exposure prophylaxis (PrEP) differed based on the social group PrEP was described as benefiting and the moderating effect of prejudice. They found a disparity in support that was stronger among participants reporting greater prejudice and concluded that inclusive framing of PrEP in public discourse may prevent prejudice from undermining implementation efforts.
AHRQ-funded; HS022986.
Citation: Calabrese SK, Underhill K, Earnshaw VA .
Framing HIV Pre-Exposure Prophylaxis (PrEP) for the general public: How inclusive messaging may prevent prejudice from diminishing public support.
AIDS Behav 2016 Jul;20(7):1499-513. doi: 10.1007/s10461-016-1318-9.
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Keywords: Human Immunodeficiency Virus (HIV), Prevention, Public Health, Racial and Ethnic Minorities, Social Stigma
Smith W, Turan JM, White K
Social norms and stigma regarding unintended pregnancy and pregnancy decisions: a qualitative study of young women in Alabama.
The authors sought to describe the presence and manifestations of social norms and stigmas associated with unintended pregnancy and related decision making from the perspective of young women in the southern United States. They found that the community expected young women faced with unintended pregnancies to bear and raise their children, viewing them more positively than women who chose abortion or adoption. They concluded that there's a need to reduce stigma and create a social environment in which young women are empowered to make the best reproductive decisions for themselves.
AHRQ-funded; HS013852.
Citation: Smith W, Turan JM, White K .
Social norms and stigma regarding unintended pregnancy and pregnancy decisions: a qualitative study of young women in Alabama.
Perspect Sex Reprod Health 2016 Jun;48(2):73-81. doi: 10.1363/48e9016.
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Keywords: Shared Decision Making, Pregnancy, Social Stigma, Women, Young Adults
Reid AE, Rosenthal L, Earnshaw VA
Discrimination and excessive weight gain during pregnancy among Black and Latina young women.
The researchers examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. They found that ever experiencing discrimination was associated with a 71 percent increase in the odds of excessive weight gain.
AHRQ-funded; HS022986.
Citation: Reid AE, Rosenthal L, Earnshaw VA .
Discrimination and excessive weight gain during pregnancy among Black and Latina young women.
Soc Sci Med 2016 May;156:134-41. doi: 10.1016/j.socscimed.2016.03.012..
Keywords: Disparities, Obesity: Weight Management, Pregnancy, Racial and Ethnic Minorities, Social Stigma
Smith LR, Earnshaw VA, Copenhaver MM
Substance use stigma: reliability and validity of a theory-based scale for substance-using populations.
The researchers aimed to advance measurement efforts of substance use stigma by drawing on stigma theory to develop and evaluate the Substance Use Stigma Mechanisms Scale (SU-SMS). Their findings support the structural and construct validity of the SU-SMS, suggesting the scale was able to capture enacted, anticipated, and internalized stigma as distinct stigma experiences, also differentiating between two distinct stigma sources, family and healthcare providers. They concluded that the SU-SMS may serve as a valuable tool for better understanding the processes through which substance use stigma serves to undermine key health behaviors and outcomes among persons with substance use disorders.
AHRQ-funded; HS022986.
Citation: Smith LR, Earnshaw VA, Copenhaver MM .
Substance use stigma: reliability and validity of a theory-based scale for substance-using populations.
Drug Alcohol Depend 2016 May 1;162:34-43. doi: 10.1016/j.drugalcdep.2016.02.019.
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Keywords: Behavioral Health, Patient-Centered Outcomes Research, Social Stigma, Substance Abuse
Earnshaw VA, Jin H, Wickersham JA
Stigma toward men who have sex with men among future healthcare providers in Malaysia: would more interpersonal contact reduce prejudice?
This study sought to inform interventions to reduce stigma toward men who have sex with men (MSM) living in countries with strong stigma toward MSM, particularly among healthcare providers. It found that multivariate analyses of variance suggest that medical and dental students who had interpersonal contact with MSM were less prejudiced toward and had lower intentions to discriminate against MSM.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Jin H, Wickersham JA .
Stigma toward men who have sex with men among future healthcare providers in Malaysia: would more interpersonal contact reduce prejudice?
AIDS Behav 2016 Jan;20(1):98-106. doi: 10.1007/s10461-015-1168-x.
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Keywords: Education: Academic, Human Immunodeficiency Virus (HIV), Provider, Clinician-Patient Communication, Social Stigma