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Promoting Stigma-Free Language in Type 2 Diabetes Care Among Primary Care Clinicians: Randomized Controlled Pilot
Kevin L Joiner1, Alexandra Agapiou2, Alicia Carmichael3
1Department of Health Behavior and Clinical Sciences, School of Nursing, University of Michigan, 426 N Ingalls St, Ann Arbor, MI, 48109, United States, 1 734-647-0127.
JMIR Diabetes
|August 11, 2026
Summary
A diabetes stigma-reduction training module improved primary care clinician attitudes toward stigmatizing language. This pilot study suggests the training is acceptable and beneficial for promoting more person-first communication in diabetes care.
Area of Science:
- Medical Education
- Health Communication
- Diabetes Management
Background:
- Professional organizations recommend person-first, strengths-based, and stigma-free language in diabetes care.
- Interventions to promote stigma-free language among primary care clinicians are limited.
Purpose of the Study:
- To evaluate the acceptability and preliminary effects of a diabetes stigma-reduction training module for primary care clinicians.
- To increase awareness of language used in clinician-patient interactions and explore changes in attitudes and intentions toward avoiding stigmatizing language.
Main Methods:
- A mixed-methods pilot study involving 21 primary care clinicians.
- Participants completed either a stigma-reduction training module or an active control condition.
- Measures included standardized patient encounters, educational videos, self-reflection, Theory of Planned Behavior domains, acceptability surveys, and qualitative interviews.
Main Results:
- Clinicians in the stigma-reduction training module showed significantly greater improvement in attitudes toward avoiding stigmatizing language compared to the control group (P=.001).
- Acceptability ratings for clarity, helpfulness, and recommendation likelihood were higher for the stigma-reduction training module.
- Qualitative findings indicated the module was perceived as actionable, relevant, and useful for self-reflection on language use.
Conclusions:
- A brief, theory-informed diabetes stigma-reduction training module is acceptable and improves clinician attitudes toward stigmatizing language in a simulated setting.
- While intentions showed a positive trend, statistical significance was not reached, warranting cautious interpretation due to sample size and lack of behavioral outcomes.
- Future research should assess the module's impact in larger samples and its translation into sustained changes in clinician language and patient experiences.
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