29 - Decreasing Neonatal Intensive Care Unit (NICU) Healthcare Providers Stigma Long-term Toward Pregnant and Postpartum Persons with Opioid Use Disorder (OUD).

Publication Number: 4028.29

Jenny Gutwein, Tampa General Hospital Children's Medical Center, Tampa, FL, United States; Tanner Wright, USF Health Morsani College of Medicine, Tampa, FL, United States; Marcia Kneusel, University of South Florida, Tampa, FL, United States; Anthony Kendle, University of South Florida, Tampa, FL, United States; Kristin Kosyluk, University of South Florida, Tampa, FL, United States; Margaret Cornwall, USF Health Morsani College of Medicine, Tampa, FL, United States

Background: Stigma toward perinatal OUD is a significant barrier to treatment and quality care. While it is well documented that stigma is a major contributor to adverse pregnancy and family outcomes in the setting of perinatal substance use, there are limited studies that address ways to reduce stigma in the healthcare system. We hypothesized that education and shared lived experience of those with OUD will reduce objective measures of stigma in NICU bedside nurses toward perinatal OUD long-term.

Objective: To evaluate the lasting effects of education and shared lived-experience on reducing stigma held by neonatal nurses toward perinatal OUD, as measured by a six-month follow-up survey.

Design/Methods: A prior experimental study intervention consisting of two education sessions followed by a small group interaction with persons with lived experience of OUD demonstrated a reduction in stigma via a post-intervention validated survey, the Shatterproof Addiction Stigma Index (SASI). A six month identical follow-up survey was completed to determine if the intervention had lasting anti-stigma effects. Statistical analysis was completed using one way ANOVAs.

Results: In the prior study survey data was available from 150 nurses at pre-intervention and 105 nurses for the post-intervention survey. Fifty-seven of the nurses completed the same validated survey at the six month mark post intervention. Pre and post-intervention surveys showed decreased desired social distance in the workplace and social settings from pregnant people with OUD from pre- (M= 23.5, SD= 5.0) to post-intervention (M=21.5; SD= 5.0), which was maintained in the six month survey (M=20.3, SD= 4.8) (F=10.7, p<.001). Stigma toward the use of medications for opioid use disorder (MOUD) by pregnant people decreased, from pre- (M= 8.3, SD= 2.1) to post-intervention (M=7.6; SD= 2.0). Nurses exhibited more favorable attitudes towards MOUD for pregnant people, which was maintained at the six month survey (M=7.8, SD= 2.0) (F=3.7, p=0.03). Nurses reported feeling more similar to pregnant people with OUD across all time points, a meaningful finding since greater perceived similarity is linked to reduced stigma.

Conclusion(s): Current research lacks evidence of stigma-reducing interventions that are sustainable and remain effective without reinforcement. Following a short-term benefit from a combination of education and lived experience shared through contact with those with perinatal OUD this study shows the ability of this intervention to reduce stigma and improve attitudes towards perinatal OUD among NICU nurses six month post intervention, without reinforcement.

1) Reduced Desired Distance from OUD in Social & Workplace Settings 2) Decreased Stigma toward MOUD in Pregnant Persons
The Y-axis denotes score from SASI items. X-axis represents different domains of stigma and corresponding range of scores based on survey items. Bars represent mean scores for pre and post-intervention followed by six month follow up responses.