Background. Justice-involved adults with co-occurring opioid use disorder (OUD) and mental health disorder (MHD) have complex health needs and underutilize healthcare services and evidence-based interventions to decrease fatal overdose risk, improve mental health symptoms and functioning, and reduce recidivism rates. Stigma and discrimination are commonly cited obstacles to healthcare access and community participation. Combined experiences of criminal-legal system involvements and co-occurring disorders are additionally influenced by other facets of identity and social group memberships, justifying use of an intersectional lens in understanding stigma and discrimination experiences and impacts in this population. However, valid and reliable instruments of intersectional stigma and discrimination have not yet been developed and psychometrically tested among justice-involved adults with co-occurring OUD and MHD. Objective. The objectives of this study were threefold and are presented as three manuscripts. First, a multidimensional measure of intersectional internalized stigma was developed and evaluated among justice-involved adults with co-occurring OUD and MHD (Manuscript 1). Next, the study psychometrically evaluated a recently created measure of intersectional discrimination and examined related health impacts, including psychological distress, active concealment/intentional non-disclosure, and health-related quality of life (Manuscript 2). Finally, internalized stigma, social support, and recovery capital were investigated as potential mediators and moderators of associations between intersectional discrimination and health impacts (Manuscript 3).
Methods. Using a cross-sectional survey design, N=213 participants were recruited from community-based settings (e.g., street outreach, harm reduction organizations, treatment clinics, re-entry programs, community resource fairs) from August 2023 to January 2024. Eligible participants completed thirteen survey modules on sociodemographic characteristics, intersectional stigma and discrimination, personal and interpersonal support mechanisms, and health impacts (i.e., psychological distress, active concealment/intentional non-disclosure, and health-related quality of life). Analytic methods included item reduction techniques, structural equation modeling, and mediation/moderation analyses.
Conclusion. Results help advance the field of intersectional quantitative stigma and discrimination measurement sciences, elucidate health impacts of intersectional stigma and discrimination among justice-involved people with co-occurring disorders, and identify specific opportunities for empowerment-based resources and interventions to help mitigate the negative health impacts of intersectional stigma and discrimination – such as programs to promote recovery capital and social support (e.g., peer recovery programs and recovery-friendly workplaces). / Public Health
| Identifer | oai:union.ndltd.org:TEMPLE/oai:scholarshare.temple.edu:20.500.12613/10323 |
| Date | 05 1900 |
| Creators | Hoadley, Ariel, 0000-0003-1360-0358 |
| Contributors | Bass, Sarah Bauerle, Zisman-Ilani, Yaara, Stahler, Gerald, Martin, Rosemarie Ann, Khanna, Aditya |
| Publisher | Temple University. Libraries |
| Source Sets | Temple University |
| Language | English |
| Detected Language | English |
| Type | Thesis/Dissertation, Text |
| Format | 249 pages |
| Rights | IN COPYRIGHT- This Rights Statement can be used for an Item that is in copyright. Using this statement implies that the organization making this Item available has determined that the Item is in copyright and either is the rights-holder, has obtained permission from the rights-holder(s) to make their Work(s) available, or makes the Item available under an exception or limitation to copyright (including Fair Use) that entitles it to make the Item available., http://rightsstatements.org/vocab/InC/1.0/ |
| Relation | http://dx.doi.org/10.34944/dspace/10285, Theses and Dissertations |
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