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Implicit Stigma Recognition and Management for Health Professionals

Abstract

Objective

Stigma against individuals with mental illness has disastrous consequences for patient outcomes. Better approaches to reducing stigma in health care professionals are required. Implicit stigma education is an emerging area of research that may inform the design and implementation of stigma reduction programs. In this “in brief report,” the authors describe the evaluation of a novel implicit stigma reduction workshop for health professionals.

Methods

The authors conducted a realist evaluation using a longitudinal multiple case study approach. Once a conceptual model was established, three case studies were conducted on physicians and nurses (n = 69) at an academic health sciences center. Within each case, pre- and post-attitudinal scales and qualitative data from semi-structured interviews were used. Consistent with realist evaluation principles, context-mechanism-outcome configuration patterns were analyzed.

Results

An implicit stigma recognition and management workshop produced statistically significant changes in participant attitudes in two out of three contexts. The qualitative evaluation described the perceptions of sustainable changes in perspective and practice. The degree to which individual participants learned with and worked among inter-professional teams influenced outcomes.

Conclusions

Implicit stigma recognition and management is a useful educational strategy for reducing stigma among health professionals. Once stigma is recognized, curricular interventions may promote behavioral change by encouraging explicit alternative behaviors that are sustained through social reinforcement within inter-professional teams.

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Acknowledgments

The authors would like to thank Saad Chahine for his assistance with this evaluation.

Funding

This work was supported by grants from the Academic Medical Organization of Southwestern Ontario, London Health Sciences Centre Children’s Health Foundation, and Associated Medical Services.

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Correspondence to Javeed Sukhera.

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This work describes a project evaluation, and was therefore exempt from ethics review board approval.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Sukhera, J., Miller, K., Scerbo, C. et al. Implicit Stigma Recognition and Management for Health Professionals. Acad Psychiatry 44, 59–63 (2020). https://doi.org/10.1007/s40596-019-01133-8

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Keywords

  • Stigma
  • Education
  • Implicit bias
  • Realist