VA HSR&D Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Dr., North Little Rock, AR, USA; Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W Markham St., Little Rock, AR, USA.
VA HSR&D Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Dr., North Little Rock, AR, USA; Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W Markham St., Little Rock, AR, USA.
Psychiatry Res. 2020 Feb;284:112641. doi: 10.1016/j.psychres.2019.112641. Epub 2019 Oct 25.
Stigmatizing attitudes among primary care (PC) providers potentially contribute to poor health outcomes for individuals with serious mental illness (SMI). In this pilot study, our primary aim is to test the feasibility, and preliminary implementation of two interventions (contact and education) to help change provider attitudes and behavior. Participants were 39 primary care providers from two Veterans Affairs medical centers with 19 randomized to the contact intervention and 20 to the education intervention. Both interventions were delivered in a group setting face-to-face. Stigmatizing attitudes were measured using Opening Minds Scale for Health Care Providers, Attribution Questionnaire and Social Distance Scale at baseline, one month and three months. Data were analyzed using repeated measures analysis of variance (ANOVA). Most providers were white, female, nurses, and older than age 50. For each of the three measures of stigmatizing attitudes there was no statistically significant treatment-by-time interaction rejecting our hypothesis that contact intervention will result in significantly greater reduction in stigmatizing attitudes. Qualitative analysis suggests that the contact intervention was perceived as much needed. This study informs future research to reduce provider stigma. Our intervention was modeled on interventions designed for the general public; different interventions may be needed for providers.
初级保健（PC）提供者的污名化态度可能会对严重精神疾病（SMI）患者的健康结果产生不良影响。在这项试点研究中，我们的主要目的是测试两种干预措施（接触和教育）的可行性和初步实施情况，以帮助改变提供者的态度和行为。参与者是来自两个退伍军人事务医疗中心的 39 名初级保健提供者，其中 19 名随机分配到接触干预组，20 名分配到教育干预组。两种干预措施均以面对面的小组形式提供。在基线、一个月和三个月时，使用医疗保健提供者开放思维量表、归因问卷和社会距离量表来衡量污名化态度。使用重复测量方差分析（ANOVA）对数据进行分析。大多数提供者是白人、女性、护士，年龄在 50 岁以上。对于三种污名化态度的衡量标准，都没有统计学上显著的治疗与时间的交互作用，从而拒绝了我们的假设，即接触干预将显著减少污名化态度。定性分析表明，接触干预是非常必要的。这项研究为减少提供者污名化提供了未来的研究信息。我们的干预措施是基于为公众设计的干预措施；可能需要针对提供者的不同干预措施。
