A theory-informed, arts-based intervention to change community attitudes of people who inject drugs released from prison

Introduction

Community attitudes contribute to stigma and social exclusion of people with incarceration and injecting drug use histories. Interventions that positively impact community attitudes are important to strengthen policy efforts to reduce recidivism and support positive health and social outcomes.

Method

A narrative script on the theme of "exhaustion” was produced using data from an interview study of post-release experiences. Members of the general public were recruited via a Qualtrics panel for a three-armed randomised controlled trial: (1) control (no intervention); (2) neutral intervention (plain English description of the theme); (3) narrative intervention (scripted performance by a person with lived experience). Surveys administered at baseline, post-intervention (for arms 2 and 3) and three-month follow-up measured perceptions of the target group through four key dimensions of stigma (Attitudes, Social Distance, Opinions, and Empathy). Qualitative interviews were conducted with 24 participants in arm 3 to further investigate responses to the narrative intervention. 

Results: 

1,071 participants completed all phases of the trial. At post-intervention, scores indicated more positive perceptions among participants in the neutral and narrative intervention arms than the control arm, and these effects were mostly larger [c1] for the narrative intervention arm. At three-month follow-up, scores for the neutral intervention arm indicated more positive perceptions than the control arm on the Opinions scale, while the narrative intervention arm recorded more positive perceptions than the control arm on both Opinions and Attitudes scales. Qualitative data indicated that participants who reported not being influenced by the narrative intervention perceived that people who inject drugs should be held accountable for lacking control of their drug use. 

Discussions and Conclusions: 

Research-informed, co-designed, arts-based interventions can positively impact public perceptions of a highly stigmatized group. However, the effects of the interventions attenuated over time suggesting need for further interventions with attention to perceptions of controllability of drug use. 

 
 [c1]TIM - or should this be “more positive”  ??