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Public Health/Global Health

Poster Session 1

(217) Assessing healthcare worker stigma toward pregnant persons with opioid use disorder

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Anthony Kendle, MD (he/him/his)

Assistant Professor
University of South Florida Morsani College of Medicine
Tampa, FL, United States

Coauthor(s)

Katherine Pressman, MD

University of South Florida Morsani College of Medicine
Tampa, FL, United States
MC

Margaret Cornwall, BS

University of South Florida Morsani College of Medicine
Tampa, FL, United States
MK

Marcia Kneusel, RN

University of South Florida Morsani College of Medicine
Tampa, FL, United States
Tanner G. Wright, MD

Assistant Professor
University of South Florida Morsani College of Medicine
Tampa, FL, United States

Objective: Stigma toward pregnant people with opioid use disorder (OUD) is a significant barrier to treatment and quality care. We aimed to assess the degree of stigma that exists among healthcare workers who care for these families in hospital settings.

Study Design: This is a cross-sectional analysis of survey responses from healthcare workers at a single tertiary care center. We collected participant demographics as well as responses to the modified Attribution Questionnaire 9 (mAQ-9) to assess stigma toward pregnant people with OUD. Participants were randomized to two versions of the mAQ-9: a pregnant person with OUD receiving methadone (“MOUD”) or a pregnant person with continued, active heroin use (“Active Use”). The questionnaire assesses 9 stereotypes using a nine Likert scale items of agreement, such that higher scores indicate more stigma. Mean mAQ-9 scores were compared between groups using a two-sided t-test. A p-value of < 0.05 was considered significant.

Results: A total of 294 participants completed the survey, with 144 in the “MOUD” group and 150 in the “Active Use” group. The mean mAQ-9 score for all participants was 28.3 (range of scores 9-72). Mean mAQ-9 score was higher for the Active Use group compared to the MOUD group among all participants (31.2 vs. 25.3, p< 0.001) and among nurse participants (32.5 vs. 25.1, p< 0.001). Clinical Support Staff had the highest mean scores for both groups whereas mid-level providers had the lowest mean scores. Healthcare workers in pediatric units had higher mean mAQ-9 scores compared to those in obstetric units (29.6 vs 25.8, p=0.006). Pity was the stereotype most implicated in stigma toward pregnant people with OUD. Of all respondents, 22% felt a pregnant person with OUD should be forced into treatment.

Conclusion: Healthcare workers hold stigma toward pregnant people with OUD, especially toward those with active opioid use in pregnancy. Stigma is greatest among clinical support staff and nurses, and workers in pediatric units have higher degrees of stigma. This supports a role for anti-stigma efforts to improve care for pregnant people with OUD.