School of Psychological Science, University of Bristol, 12a Priory Road, Clifton, Bristol, UK; Bristol Medical School, University of Bristol, Canynge Hall, Clifton, Bristol, UK; London School of Hygiene and Tropical Medicine, Department of Public Health, Environments and Society, Faculty of Public Health and Policy, 15-17 Tavistock Place, London, UK.
University of Bath, Department of Psychology, Addiction and Mental Health Group, Bath, UK.
Int J Drug Policy. 2024 Oct;132:104543. doi: 10.1016/j.drugpo.2024.104543. Epub 2024 Sep 3.
People who use drugs face entrenched stigma, which fosters shame, restricts service access, and exacerbates inequalities. The use of mass media in anti-stigma interventions offers an opportunity to challenge stigmatising attitudes at scale. There are, however, inconsistencies in messaging approaches used in mass media anti-stigma interventions, and how authors conceptualise and measure 'stigma'.
This scoping review maps literature on the development and/or evaluation of mass media interventions intended to reduce stigma towards people who use drugs. We systematically searched seven databases for reports about: (i) people who use drugs, (ii) stigma, (iii) mass media. We charted data about intervention (i) subjects and recipients, (ii) format, (iii) authors, (iv) content; and (v) conceptualisation and measurement of stigma. We narratively synthesised findings with qualitative content analyses.
From 14,256 records, we included 49 reports about 35 interventions. 25/35 were from the last five years and 19/35 were from the United States. Intended recipients included the public and/or specified sub-populations, often including healthcare workers. Most interventions were intended to reduce stigma towards people with patterns of drug use perceived to be problematic, as opposed to people who use drugs in general. Interventions ranged from single pieces of media to complex multi-format campaigns. People who use(d) drugs contributed to 22/35 interventions. Professionals working in medical disciplines co-authored 29/35 interventions. Intervention content often had a medical focus, describing dependence as a 'disease' or medical issue, and emphasised the benefits of recovery. Other interventions, however, criticised medical framings. In some interventions drug use and people who use drugs were described in markedly negative terms. 'Stigma' was often under-theorised, and measurement approaches were inconsistent, with 42 instruments used to measure phenomena associated with stigma across 19 quantitative evaluations.
We found inconsistencies in approaches to reduce and measure stigma, potentially reflecting different motivations for intervention development. The primary motivation of many interventions was seemingly to promote drug service engagement and recovery.
吸毒者面临根深蒂固的污名，这助长了羞耻感，限制了服务的获取，并加剧了不平等。大众媒体在反污名干预中的应用提供了一个机会，可以大规模挑战污名化态度。然而，大众媒体反污名干预中使用的信息传递方法以及作者对“污名”的概念化和衡量方法存在不一致之处。
本范围界定综述绘制了旨在减少对吸毒者污名的大众媒体干预措施的制定和/或评估的文献。我们系统地在七个数据库中搜索了有关以下方面的报告：（i）吸毒者，（ii）污名，（iii）大众媒体。我们记录了有关干预措施的数据：（i）对象和接受者，（ii）形式，（iii）作者，（iv）内容；以及（v）污名的概念化和衡量。我们使用定性内容分析对发现进行了叙述性综合。
从 14256 条记录中，我们纳入了 49 份关于 35 项干预措施的报告。35 项中的 25 项来自过去五年，19 项来自美国。预期的接受者包括公众和/或特定的亚人群，通常包括医疗保健工作者。大多数干预措施旨在减少对被认为有问题的吸毒模式的人的污名，而不是对一般吸毒者的污名。干预措施范围从单一媒体到复杂的多格式活动。22/35 项干预措施涉及吸毒者。从事医学专业的专业人员共同撰写了 35 项干预措施中的 29 项。干预措施的内容通常侧重于医学，将依赖描述为“疾病”或医学问题，并强调康复的好处。然而，其他干预措施批评了医学框架。在一些干预措施中，吸毒者和吸毒者被描述为明显负面的术语。“污名”往往没有理论化，衡量方法也不一致，在 19 项定量评估中使用了 42 种工具来衡量与污名相关的现象。
我们发现减少和衡量污名的方法存在不一致之处，这可能反映了干预措施制定的不同动机。许多干预措施的主要动机似乎是促进吸毒者服务的参与和康复。
