Ashworth Madison, Thunström Linda, Clancy Grace L, Thompson Robin A, Johnson David, Fletcher Ernest
Fletcher Group, Inc., 601 Meyers Baker Road, London, KY 40741, United States.
University of Wyoming, Department of Economics, 1000 E. University Ave., Laramie WY 82070, United States.
Addict Behav Rep. 2024 Mar 19;19:100541. doi: 10.1016/j.abrep.2024.100541. eCollection 2024 Jun.
Individuals with substance use disorder (SUD) and recovery support services often face significant social stigma, especially in rural areas. One method of addressing stigma is through education and personal recovery stories. It is unclear if such messages will work similarly across rural and non-rural areas.
We conduct an exploratory analysis of data from a national randomized controlled trial (N = 2,721) to determine if there are differences in the effectiveness of messages at reducing stigma across rurality. Specifically, we test four interventions to reduce stigma: education about the effectiveness of recovery housing and three versions of a personal recovery story that varied social distance and delivery medium (identified written story, anonymous written story, and video).
We find that messages may not have the same effect across rurality, with non-rural participants in the identified and anonymous written recovery story groups having lower stigma scores and only rural participants exposed to the anonymous written story having lower stigma scores compared to their counterparts in the control group. Further, non-rural participants exposed to both written story treatments had higher positive feelings towards those in recovery compared to the control group, but only rural participants in the anonymous written story group had higher positive feelings compared to the control group.
Our results suggest that messages may have different effects on stigma across rurality and that rural participants' beliefs may be particularly hard to change. Future research should examine what types of stigma reduction interventions are most effective in rural areas.
患有物质使用障碍（SUD）的个体及康复支持服务常常面临严重的社会污名，尤其是在农村地区。应对污名的一种方法是通过教育和个人康复故事。目前尚不清楚此类信息在农村和非农村地区的效果是否相似。
我们对一项全国随机对照试验（N = 2721）的数据进行探索性分析，以确定减少污名的信息在农村和非农村地区的效果是否存在差异。具体而言，我们测试了四种减少污名的干预措施：关于康复住房有效性的教育以及个人康复故事的三个版本，这三个版本在社会距离和传播媒介方面有所不同（确定身份的书面故事、匿名书面故事和视频）。
我们发现信息在农村和非农村地区的效果可能不同，在确定身份和匿名书面康复故事组中的非农村参与者污名得分较低，与对照组相比，只有接触匿名书面故事的农村参与者污名得分较低。此外，与对照组相比，接触两种书面故事治疗的非农村参与者对康复者有更高的积极感受，但只有匿名书面故事组中的农村参与者与对照组相比有更高的积极感受。
我们的结果表明，信息对农村和非农村地区污名的影响可能不同，农村参与者的观念可能特别难以改变。未来的研究应探讨哪种类型的减少污名干预措施在农村地区最有效。
