Acceptability and Feasibility of a Social Contact Based Intervention for Reduction of Public Stigma Against Persons...

Opioid Use Disorder (OUD) is a major public health issue, exacerbated by public stigma that hinders treatment-seeking and social integration. This study aimed to adapt and validate a social-contact-based intervention to reduce public stigma against individuals with OUD in India, ensuring cultural relevance and feasibility.

The study followed a two-phase approach: adaptation and validation using the ADAPT framework and Delphi method with 14 multi-disciplinary experts and people with lived experience (PWLE), and pre-experimental, open-label pilot study assessing feasibility, acceptability, and preliminary impact on stigma. Participants (n = 30) attended a 60- to 90-min session combining an educational component with direct social contact with PWLE. Stigma was assessed using a validated questionnaire at baseline, 48 hr, and 3 months. Correlation analysis was done between total stigma and domain-wise scores.

The intervention achieved a 90% session completion rate, with 69.2% of approached individuals consenting to participate. Acceptability measures indicated high engagement, with 90% of participants rating the session as useful, although 36.6% found it challenging to reconcile with pre-existing beliefs. Stigma scores significantly improved at 48 hr post-intervention in the Attribution Blame domain (p = .002) and Attribution Exoneration domain (p = .079, trend toward significance). Partial attenuation of stigma reduction effects was observed at 3 months. The Total Stigma Score was significantly correlated with Punishment (r = .733, p < .001), Social Threat (r = .681, p < .001), and Attribution Blame (r = .609, p < .001). Attribution Exoneration negatively correlated with Punishment (r = -.373, p < .05).

This study demonstrates the feasibility and acceptability of a culturally adapted, social-contact-based intervention for reducing public stigma against OUD. Shifting blame perceptions may help reduce punitive attitudes.