304 - Decreasing Neonatal Intensive Care Unit (NICU) healthcare providers stigma toward pregnant and post-partum persons with opioid use disorder.

Publication Number: 304.4561

Jenny Gutwein, Tampa General Hospital Children's Medical Center, Tampa, FL, United States; Kristin Kosyluk, University of South Florida, Tampa, FL, United States; Marcia Kneusel, University of South Florida, Tampa, FL, United States; Mykenzie King, University of South Florida, Land O Lakes, FL, United States; Margaret Cornwall, USF Health Morsani College of Medicine, Allentown, PA, United States; Tanner Wright, USF Health Morsani College of Medicine, Tampa, FL, United States; Anthony Kendle, University of South Florida, Tampa, FL, United States; Serena Bhaskar, University of South Florida, Safety Harbor, FL, United States

Background: Stigma toward pregnant and parenting people with opioid use disorder (OUD) is a significant barrier to treatment and quality care. It is well documented that stigma is a major contributor to adverse pregnancy, childhood, and family outcomes in the setting of perinatal substance use, there are limited studies that address ways to systematically reduce stigma in the healthcare system. We hypothesized that education and interaction with individuals with lived experience will reduce objective measures of stigma toward pregnant persons and parents with OUD among a cohort of NICU bedside nurses.

Objective: To decrease stigma held by neonatal nurses toward persons with OUD during the perinatal period.

Design/Methods: The experimental study intervention consisted of two 10-minute education sessions about stigma and OUD in pregnancy followed by a 45-minute small group interaction with persons with lived experience of OUD. The intervention was provided to NICU nurses during required educational blocks. Selected scales from a validated survey—Shatterproof Addiction Stigma Index (SASI)-- were used to quantify levels of stigma toward prenatal OUD. Participants completed identical surveys pre- & post-intervention. Statistical analysis was completed using independent samples t-tests to examine the difference in outcomes.

Results: Survey data was available for 150 pre- and 105 post-intervention surveys for NICU nurses. Compared with the pre-intervention block, responses from the post-intervention block surveys showed significant reductions in social distance in social and workplace settings (23.5 vs 21.5, p < 0.001), significant improvements in recognition of an opioid use disorder as a physical illness and chronic medical illness comparable to other chronic illnesses (like diabetes, arthritis, or heart disease) (2.4 vs 2.8, p < 0.001), significant reductions in the endorsement of harmful stereotypes (including the belief that a pregnant person with a substance use disorder who is participating in medication for opioid use disorder/medication for addiction treatment (MOUD/MAT) is violent, unpredictable, untrustworthy, and incompetent) (9.6 vs 8.8, p< 0.001), and significant improvements in the belief that MOUD/MAT is an effective treatment for OUD and should be available to people who want it (6.1 vs 6.7, p < 0.001).

Conclusion(s): These findings support a combination of education and contact as an effective intervention for reducing stigma and improving attitudes towards pregnant and parenting people with OUD among NICU nurses.

Figure 1. Shatterproof Addiction Stigma Index (SASI) Scores from Pre- and Post- Intervention Survey Responses
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 responses. Asterisk indicates statistical significance (p <0.05).