Out of the silos

Identifying cross-cutting features of health-related stigma to advance measurement and intervention

Wim H. Van Brakel, Janine Cataldo, Sandeep Grover, Brandon A. Kohrt, Laura Nyblade, Melissa Stockton, Edwin Wouters, Larry Yang

Research output: Contribution to journalArticle

Abstract

Background: Many health conditions perceived to be contagious, dangerous or incurable, or resulting in clearly visible signs, share a common attribute - an association with stigma and discrimination. While the etiology of stigma may differ between conditions and, sometimes, cultural settings, the manifestations and psychosocial consequences of stigma and discrimination are remarkably similar. However, the vast majority of studies measuring stigma or addressing stigma through interventions employ a disease-specific approach. Main body: The current paper opposes this siloed approach and advocates a generic concept of 'health-related stigma' in both stigma measurement and stigma interventions. Employing a conceptual model adapted from Weiss, the current paper demonstrates the commonalities among several major stigmatized conditions by examining how several stigma measurement instruments, such as the Social Distance Scale, Explanatory Model Interview Catalogue, Internalized Stigma of Mental Illness, and Berger stigma scale, and stigma reduction interventions, such as information-based approaches, contact with affected persons, (peer) counselling, and skills building and empowerment, were used successfully across a variety of conditions to measure or address stigma. The results demonstrate that 'health-related stigma' is a viable concept with clearly identifiable characteristics that are similar across a variety of stigmatized health conditions in very diverse cultures. Conclusion: A more generic approach to the study of health-related stigma opens up important practical opportunities - cross-cutting measurement and intervention tools are resource saving and easier to use for personnel working with multiple conditions, allow for comparison between conditions, and recognize the intersectionality of many types of stigma. Further research is needed to build additional evidence demonstrating the advantages and effectiveness of cross-condition approaches to stigma measurement and interventions.

Original languageEnglish (US)
Article number13
JournalBMC Medicine
Volume17
Issue number1
DOIs
StatePublished - Feb 15 2019

Fingerprint

Health
Social Distance
Counseling
Interviews
Research
Power (Psychology)

Keywords

  • cross-cutting approaches
  • disabilities
  • Health-related stigma
  • HIV
  • interventions
  • leprosy
  • measurement
  • mental health
  • neglected tropical diseases
  • tuberculosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Out of the silos : Identifying cross-cutting features of health-related stigma to advance measurement and intervention. / Van Brakel, Wim H.; Cataldo, Janine; Grover, Sandeep; Kohrt, Brandon A.; Nyblade, Laura; Stockton, Melissa; Wouters, Edwin; Yang, Larry.

In: BMC Medicine, Vol. 17, No. 1, 13, 15.02.2019.

Research output: Contribution to journalArticle

Van Brakel, Wim H. ; Cataldo, Janine ; Grover, Sandeep ; Kohrt, Brandon A. ; Nyblade, Laura ; Stockton, Melissa ; Wouters, Edwin ; Yang, Larry. / Out of the silos : Identifying cross-cutting features of health-related stigma to advance measurement and intervention. In: BMC Medicine. 2019 ; Vol. 17, No. 1.
@article{2ff3140a5bed41658f777763d4ab1484,
title = "Out of the silos: Identifying cross-cutting features of health-related stigma to advance measurement and intervention",
abstract = "Background: Many health conditions perceived to be contagious, dangerous or incurable, or resulting in clearly visible signs, share a common attribute - an association with stigma and discrimination. While the etiology of stigma may differ between conditions and, sometimes, cultural settings, the manifestations and psychosocial consequences of stigma and discrimination are remarkably similar. However, the vast majority of studies measuring stigma or addressing stigma through interventions employ a disease-specific approach. Main body: The current paper opposes this siloed approach and advocates a generic concept of 'health-related stigma' in both stigma measurement and stigma interventions. Employing a conceptual model adapted from Weiss, the current paper demonstrates the commonalities among several major stigmatized conditions by examining how several stigma measurement instruments, such as the Social Distance Scale, Explanatory Model Interview Catalogue, Internalized Stigma of Mental Illness, and Berger stigma scale, and stigma reduction interventions, such as information-based approaches, contact with affected persons, (peer) counselling, and skills building and empowerment, were used successfully across a variety of conditions to measure or address stigma. The results demonstrate that 'health-related stigma' is a viable concept with clearly identifiable characteristics that are similar across a variety of stigmatized health conditions in very diverse cultures. Conclusion: A more generic approach to the study of health-related stigma opens up important practical opportunities - cross-cutting measurement and intervention tools are resource saving and easier to use for personnel working with multiple conditions, allow for comparison between conditions, and recognize the intersectionality of many types of stigma. Further research is needed to build additional evidence demonstrating the advantages and effectiveness of cross-condition approaches to stigma measurement and interventions.",
keywords = "cross-cutting approaches, disabilities, Health-related stigma, HIV, interventions, leprosy, measurement, mental health, neglected tropical diseases, tuberculosis",
author = "{Van Brakel}, {Wim H.} and Janine Cataldo and Sandeep Grover and Kohrt, {Brandon A.} and Laura Nyblade and Melissa Stockton and Edwin Wouters and Larry Yang",
year = "2019",
month = "2",
day = "15",
doi = "10.1186/s12916-018-1245-x",
language = "English (US)",
volume = "17",
journal = "BMC Medicine",
issn = "1741-7015",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Out of the silos

T2 - Identifying cross-cutting features of health-related stigma to advance measurement and intervention

AU - Van Brakel, Wim H.

AU - Cataldo, Janine

AU - Grover, Sandeep

AU - Kohrt, Brandon A.

AU - Nyblade, Laura

AU - Stockton, Melissa

AU - Wouters, Edwin

AU - Yang, Larry

PY - 2019/2/15

Y1 - 2019/2/15

N2 - Background: Many health conditions perceived to be contagious, dangerous or incurable, or resulting in clearly visible signs, share a common attribute - an association with stigma and discrimination. While the etiology of stigma may differ between conditions and, sometimes, cultural settings, the manifestations and psychosocial consequences of stigma and discrimination are remarkably similar. However, the vast majority of studies measuring stigma or addressing stigma through interventions employ a disease-specific approach. Main body: The current paper opposes this siloed approach and advocates a generic concept of 'health-related stigma' in both stigma measurement and stigma interventions. Employing a conceptual model adapted from Weiss, the current paper demonstrates the commonalities among several major stigmatized conditions by examining how several stigma measurement instruments, such as the Social Distance Scale, Explanatory Model Interview Catalogue, Internalized Stigma of Mental Illness, and Berger stigma scale, and stigma reduction interventions, such as information-based approaches, contact with affected persons, (peer) counselling, and skills building and empowerment, were used successfully across a variety of conditions to measure or address stigma. The results demonstrate that 'health-related stigma' is a viable concept with clearly identifiable characteristics that are similar across a variety of stigmatized health conditions in very diverse cultures. Conclusion: A more generic approach to the study of health-related stigma opens up important practical opportunities - cross-cutting measurement and intervention tools are resource saving and easier to use for personnel working with multiple conditions, allow for comparison between conditions, and recognize the intersectionality of many types of stigma. Further research is needed to build additional evidence demonstrating the advantages and effectiveness of cross-condition approaches to stigma measurement and interventions.

AB - Background: Many health conditions perceived to be contagious, dangerous or incurable, or resulting in clearly visible signs, share a common attribute - an association with stigma and discrimination. While the etiology of stigma may differ between conditions and, sometimes, cultural settings, the manifestations and psychosocial consequences of stigma and discrimination are remarkably similar. However, the vast majority of studies measuring stigma or addressing stigma through interventions employ a disease-specific approach. Main body: The current paper opposes this siloed approach and advocates a generic concept of 'health-related stigma' in both stigma measurement and stigma interventions. Employing a conceptual model adapted from Weiss, the current paper demonstrates the commonalities among several major stigmatized conditions by examining how several stigma measurement instruments, such as the Social Distance Scale, Explanatory Model Interview Catalogue, Internalized Stigma of Mental Illness, and Berger stigma scale, and stigma reduction interventions, such as information-based approaches, contact with affected persons, (peer) counselling, and skills building and empowerment, were used successfully across a variety of conditions to measure or address stigma. The results demonstrate that 'health-related stigma' is a viable concept with clearly identifiable characteristics that are similar across a variety of stigmatized health conditions in very diverse cultures. Conclusion: A more generic approach to the study of health-related stigma opens up important practical opportunities - cross-cutting measurement and intervention tools are resource saving and easier to use for personnel working with multiple conditions, allow for comparison between conditions, and recognize the intersectionality of many types of stigma. Further research is needed to build additional evidence demonstrating the advantages and effectiveness of cross-condition approaches to stigma measurement and interventions.

KW - cross-cutting approaches

KW - disabilities

KW - Health-related stigma

KW - HIV

KW - interventions

KW - leprosy

KW - measurement

KW - mental health

KW - neglected tropical diseases

KW - tuberculosis

UR - http://www.scopus.com/inward/record.url?scp=85061533237&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061533237&partnerID=8YFLogxK

U2 - 10.1186/s12916-018-1245-x

DO - 10.1186/s12916-018-1245-x

M3 - Article

VL - 17

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

IS - 1

M1 - 13

ER -