Fear Of Stigma Research Articles

Mental health stigma experiences among caregivers and service users in South Africa: a qualitative investigation.

The study aimed to understand the nature and context of mental health stigma among people living with a mental health condition and the subsequent effect on their caregivers. Semi-structured qualitative face to face interviews were conducted by trained mental healthcare professionals with mental health service users (n = 26) and caregivers (n = 24) in private rooms at a tertiary health facility, where service users were admitted. Following transcription and translation, data was analysed using framework analysis. There was limited knowledge about their mental health diagnosis by service users and generally low mental health literacy among service users and caregivers. Mental health service users reported experiences of stigma from their own families and communities. Caregivers reported withholding the patient’s diagnosis from the community for fear of being stigmatised, and this fear of stigma carries the risk of negatively affecting care treatment-seeking. Limited mental health knowledge, coupled with a high prevalence of perceived family and community stigma among caregivers and service users, impedes the capacity of caregivers to effectively cope in supporting their family members living with mental illness. There is a need for interventions to provide psychoeducation, reduce community stigma, and support coping strategies for caregivers and people with mental health conditions.

Barriers to timely disclosure of HIV serostatus: A qualitative study at care and treatment centers in Dar es Salaam, Tanzania

Disclosure of Human Immunodeficiency Virus (HIV) status is important to prevent the spread of HIV and maintain the health of people living with HIV, their spouses, and the community. Despite the benefits of disclosure, many people living with HIV delay disclosing their status to those close to them thereby increasing the risk for disease transmission. This study aimed to determine the barriers to timely disclosure of HIV serostatus for people living with HIV in Dar es Salaam, Tanzania, and identify what motivated disclosure. A qualitative descriptive study using in-depth individual interviews was conducted with10 participants attending HIV care and treatment centers in Dar es Salaam. The participants were people living with HIV who had delayed disclosing their serostatus for more than one month after diagnosis. Data was analyzed using qualitative content analysis. Three categories emerged from the analysis: Barriers hindering timely disclosure, motivation for disclosure of serostatus, and consequences of delayed disclosure. Barriers to timely disclosure included denial of one's status, the fear of stigmatization, fear of being separated or divorced, the need to protect loved ones, and lack of adequate knowledge about the disease. Reasons that motivated disclosure included gaining social support, preventing disease transmission and wanting to be at peace. Timely disclosure is hindered by stigma because HIV is negatively perceived by the public. People living with HIV prefer not to disclose to avoid the negative consequences of disclosure, especially because of fear of being discriminated against and losing their social status, which plays a major role in social status in Tanzania. Trust and adequate counseling from health care workers helps prompt disclosure.

The Lived Experience of a Newly Diagnosed Older Person With HIV in Ukraine.

Low- and middle-income countries are home to 80% of older people with HIV (OPWH). Ukrainian OPWH experience higher mortality and decreased antiretroviral therapy (ART) initiation than younger patients, but there is little data examining OPWH's perspectives around new diagnosis and impact on care. In this study, we examined accounts of 30 newly diagnosed OPWH in Ukraine, exploring challenges faced in the peri-diagnosis period. Themes emerged representing the longitudinal coping process: OPWH (1) viewed themselves as low risk before diagnosis; (2) experienced HIV diagnosis as a traumatic event challenging their self-image; (3) used disclosure to seek support among a small circle of family, friends, or health care providers; (4) avoided disclosure to outsiders including primary care providers for fears of stigma and breaches in confidentiality; (5) viewed age as an asset; and (6) used HIV diagnosis as starting point for growth. These findings highlight the need for age-specific programming to increase HIV knowledge and coping, increase screening, and improve long-term planning.

Exploring men\u2019s use of mental health support offered by an Australian Employee Assistance Program (EAP): perspectives from a focus-group study with males working in blue- and white-collar industries

BackgroundMen continue to be overrepresented in the Australian suicide statistics despite wide scale public health initiatives to improve men’s mental health literacy and to increase their help-seeking behaviour. Employee Assistance Programs (EAP) deliver free and confidential mental health support; however, their services are underutilised by men. In the absence of contemporary literature that explores end-user experiences of EAPs, we asked men from blue- and white-collar employment settings about the barriers and enablers to using EAP services and explored differences between employment settings.MethodsForty-four men participated in this qualitative study: 32 from one white-collar employer and 12 from one blue-collar employer. Two qualified mental health professionals facilitated five first-round and three second-round focus groups and one interview with white-collar workers, and two focus groups and three interviews with blue-collar workers. Data were thematically analysed using a framework approach.ResultsFour of the six main themes were barriers: no need for EAP—alternative supports; uncertainty of EAP services; scepticism and distrust of EAP; and societal and workplace cultures. Elements of enduring barriers to EAP use were contained within sub-themes. These included lack of knowledge about EAPs, issues of trustworthiness and confidentiality, and fear of stigma and career jeopardy. Enablers comprised the need for attractive, reliable messaging and proactive connections and service delivery. Differences within sub-themes for white-collar and blue-collar groups reflected the corporate nature of work and workplace culture for white-collar participants, and workers’ communication and practical problem resolution preferences for blue-collar workers.ConclusionSome elements identified in the barriers to EAP use are more entrenched than were previously estimated and these need to be a priority for action to increase confidence in EAP services by end-users. EAPs that have a visible and proactive presence in the workplace, that tailor their marketing and service delivery to different workgroups, that provide a competitive advantage to its service users, and more confidently conveys independence from its client organisations may help to increase men’s interest in accessing EAP support services. Further initiatives that reduce the stigma surrounding mental health and help-seeking both in society and the workplace are needed.

Black and ethnic minority carers perceptions on mental health services and support in the United Kingdom: a systematic review

Purpose The purpose of this study was to examine and synthesise the empirical evidence on the perceptions of Black and Ethnic Minority (BAME) carers views on mental health (MH) services and support offered in the UK. Design/methodology/approach A comprehensive search conducted by searching Medline, Cumulated Index to Nursing and Allied Health Literature and Psychology and Behavioural Sciences Collection served to identify relevant studies that explored the perceptions of BAME carers on MH services. Other key sources and reference list of identified journal articles were searched to ascertain that this review contains all relevant studies and captured studies not indexed in the databases. Using the Critical Appraisal Skills Programme tool, 20 relevant studies published between 1996 and 2020 retrieved were and reviewed. From the reviewed papers five themes emerged which summarised the perception of BAME carers views on MH services and support services offered in the UK. Findings Critical appraisal of 20 studies that met the ascribed inclusion criteria was undertaken. A total of 18 studies were of qualitative design, one used a quantitative approach and one was a systematic review. Several themes addressing the participants’ views were identified from the studies. The core themes central to these studies were: awareness and utilization of available MH services, language barriers to accessing MH services, positive experience whilst in contact with MH services, negative experience whilst in contact with MH services and difficulties in seeking help. Research limitations/implications One of the review criteria was to focus on peer-reviewed articles; grey literature was exempted from the search for relevant studies. Although a systematic literature review was conducted, there is the possibility that some appropriate studies were not identified. This could be because of different use of key terms in some of the studies. Papers that identified and acknowledged BAME MH carers and MH services were focused on, which resulted in 20 eligible studies for synthesis. Originality/value This review revealed the perception of BAME carers on MH services and available support offered. It highlighted that a significant number of BAME carers had limited understanding of the range of available MH services and support on offer within the UK. The review highlighted that fear of stigmatisation, discrimination in conjunction with the formulaic nature of MH services, delayed at best and inhibited at worst BAME Carers from accessing support from MH services, which consequentially had detrimental effects on service users receiving the timely appropriate support needed (Mermon et al., 2016). It is, therefore, a recommended imperative that MH services are deliberate in their endeavour to be inclusive, culturally embracing and accessible, if the MH needs of diverse ethnic minority groups within the UK are to be met appropriately.

Public health nurses' perceptions on promotive and risk factors for children's mental health: A qualitative interview study.

To describe promotive and risk factors for children's mental health at the individual, interpersonal, organizational, community and public policy levels of the socioecological environment. A descriptive qualitative interview study. Data were collected in Finland during autumn 2019 via semi-structured interviews. Participants (n=23) comprised public health nurses who worked in child health clinics and school healthcare. Data were analyzed using inductive content analysis. Several promotive and risk factors were identified to have affected children's mental health. Intra-family factors were the most important in the opinion of public health nurses, and they were most concerned about family related risk factors. In addition, the descriptions of nurses revealed that children are in a socially unequal position in terms of their place of residence. It was also uncovered that there were fewer social and healthcare and leisure services in small municipalities, the distances to services were longer, which was perceived to complicate the use of services, and the fear of stigma was greater. According to public health nurses, factors at the individual, interpersonal, organizational, community and public policy levels of the socioecological environment affect children's mental health and overall well-being. Consequently, the promotion of children's mental health should be emphasized at every level of the society, considering the whole family. This study indicated the importance of considering factors that affect children's mental health at all levels of the socioecological environment. The results can be reflected in the relation of the socioecological model of health promotion and used in planning the work of nurses in primary healthcare and other relevant nursing settings to emphasize promotive and preventive work.

‘To reveal or to conceal’- Disclosure strategies in parents of children with epilepsy in India

Purpose: Disclosure of epilepsy is a relevant but under-researched topic in epilepsy research. This study was done to assess the disclosure strategies in parents of CWE in a developing country with conservative culture. The study also assessed the influence of demographic factors and seizure characteristics on the choice of disclosure. Enablers and barriers behind disclosure and the consequences after disclosure were evaluated. Methods: A cross-sectional analytical, self-report survey was done in 284 parents of CWE with the help of a semi-structured questionnaire over a 7-month period in the paediatric epilepsy clinic. Disclosure was considered present if epilepsy was revealed to two or more of the five target groups (extended family, school, friends, neighbours, and peers of children). Separate set of questions was given for reasons behind their choice and consequences after disclosure. For continuous variables, unpaired T test or Mann – Whitney U test between group and for categorized variables, Pearson's Chi square test or Fisher's exact test was used. Results: 92.96 % of 284 subjects disclosed their child's epilepsy while 7.04% concealed. Demographic factors and seizure characteristics did not influence the disclosure choice. Most parents revealed to the extended family followed by teachers. Type of seizure was the commonest information revealed. The main reason behind disclosure was better acceptance of the child followed by safety while main barrier was considering epilepsy as private grief. 92.8% felt their children were better accepted after disclosure. Conclusion: Disclosure practices have improved in parents of CWE in India and well-being and safety of the child has overridden the fear of stigma and discrimination. This could be the first major step to bring epilepsy out of the shadows at national and global levels.

Understanding the Role of Social Media-Based Mental Health Support Among College Students: Survey and Semistructured Interviews.

BackgroundMental illness is a growing concern within many college campuses. Limited access to therapy resources, along with the fear of stigma, often prevents students from seeking help. Introducing supportive interventions, coping strategies, and mitigation programs might decrease the negative effects of mental illness among college students.ObjectiveMany college students find social support for a variety of needs through social media platforms. With the pervasive adoption of social media sites in college populations, in this study, we examine whether and how these platforms may help meet college students’ mental health needs.MethodsWe first conducted a survey among 101 students, followed by semistructured interviews (n=11), of a large public university in the southeast region of the United States to understand whether, to what extent, and how students appropriate social media platforms to suit their struggle with mental health concerns. The interviews were intended to provide comprehensive information on students’ attitudes and their perceived benefits and limitations of social media as platforms for mental health support.ResultsOur survey revealed that a large number of participating students (71/101, 70.3%) had recently experienced some form of stress, anxiety, or other mental health challenges related to college life. Half of them (52/101, 51.5%) also reported having appropriated some social media platforms for self-disclosure or help, indicating the pervasiveness of this practice. Through our interviews, we obtained deeper insights into these initial observations. We identified specific academic, personal, and social life stressors; motivations behind social media use for mental health needs; and specific platform affordances that helped or hindered this use.ConclusionsStudents recognized the benefits of social media in helping connect with peers on campus and promoting informal and candid disclosures. However, they argued against complete anonymity in platforms for mental health help and advocated the need for privacy and boundary regulation mechanisms in social media platforms supporting this use. Our findings bear implications for informing campus counseling efforts and in designing social media–based mental health support tools for college students.

Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis

BackgroundWomen living with HIV (WLH) lack evidence-based information about reproductive options while managing pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination influence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproductive decision-making process for WLH in developed countries.MethodsA systematic review with qualitative research synthesis was conducted through searches in 10 electronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfispo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country was operationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis.ResultsTwenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinformation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process influenced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difficult to manage.ConclusionWLH encounter reproductive decision-making with knowledge deficits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could benefit from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical practice guidelines need to be tailored for the family planning and sexual health needs of WLH.

People newly diagnosed with HIV during the COVID-19 pandemic: A focus group study on the associated early biopsychosocial reactions

Aim Currently, HIV and COVID-19 are among the global health threats, and being newly diagnosed with HIV during the COVID-19 pandemic may be distressing. Therefore, this study explored the early biopsychosocial reactions to a new HIV-positive diagnosis among people newly diagnosed with HIV during the COVID-19 pandemic. Methods Twenty-five PLWH participated in focus group discussions (FGDs). The FGDs were conducted in the same modalities with three groups for an average of two hours until data saturation occurred. Data were thematically analyzed after which there were three rigorous phases of analysis validation. Results Five themes were created—“Concerns about HIV care being disrupted by the COVID-19 pandemic,” “HIV-positive status was blamed on the COVID-19 pandemic,” “Expecting an HIV-positive diagnosis reduced negative reactions (e.g., psychological distress),” “Fear of stigmatization,” and “Suicidal ideation and body ache.” Conclusion The implications of findings for theory and practice are discussed.

Qualitative assessment of the impact of socioeconomic and cultural barriers on uptake and utilisation of tuberculosis diagnostic and treatment tools in East Africa: a cross-sectional study

ObjectivesEarly diagnosis and timely treatment are key elements of a successful healthcare system. We assessed the role of socioeconomic and cultural norms in accelerating or decelerating uptake and utilisation of...

Perceptions of donor-conceived families: a survey study on the perspectives of teachers

Research regarding donor-conceived families has mainly focused on processes within the family unit. Research on social factors affecting the family from outside is rare. Focusing on individuals’ difficulties without acknowledging external social factors is, however, misleading when the subjects studied belong to a stigmatised group. As openness about donor conception is increasingly encouraged, donor-conceived families will interact more with their social networks. Yet uncertainty around the societal perceptions of their family building, alongside fear of stigma, can make parents insecure about disclosure. This survey study assessed awareness, knowledge, attitudes and behaviour regarding donor-conceived families among 151 Belgian and 67 Swedish school teachers. Teachers had a basic awareness of donor-conceived families, yet limited understanding of the implications of donor conception for the families. While an open attitude towards donor-conceived families existed, the value of privacy affected interactions. Differences were observed in relation to the different forms of donor-conceived families. Implications for practice are discussed.

Factors that influence enrollment in syringe services programs in rural areas: a qualitative study among program clients in Appalachian Kentucky

BackgroundEnrolling sufficient number of people who inject drugs (PWID) into syringe services programs (SSP) is important to curtail outbreaks of drug-related harms. Still, little is known about barriers and facilitators to SSP enrollment in rural areas with no history of such programs. This study’s purpose was to develop a grounded theory of the role of the risk environment and individual characteristics of PWID in shaping SSP enrollment in rural Kentucky.MethodsWe conducted one-on-one semi-structured interviews with 41 clients of 5 SSPs that were established in rural counties in Appalachian Kentucky in 2017–2018. Interviews covered PWID needs, the process of becoming aware of SSPs, and barriers and facilitators to SSP enrollment. Applying constructivist grounded theory methods and guided by the Intersectional Risk Environment Framework (IREF), we applied open, axial and selective coding to develop the grounded theory.ResultsStigma, a feature of IREF’s meso-level social domain, is the main factor hampering SSP enrollment. PWID hesitated to visit SSPs because of internalized stigma and because of anticipated stigma from police, friends, family and healthcare providers. Fear of stigma was often mitigated or amplified by a constellation of meso-level environmental factors related to healthcare (e.g., SSPs) and social (PWID networks) domains and by PWID’s individual characteristics. SSPs mitigated stigma as a barrier to enrollment by providing low threshold services in a friendly atmosphere, and by offering their clients program IDs to protect them from paraphernalia charges. SSP clients spread positive information about the program within PWID networks and helped their hesitant peers to enroll by accompanying them to SSPs. Individual characteristics, including child custody, employment or high social status, made certain PWID more susceptible to drug-related stigma and hence more likely to delay SSP enrollment.ConclusionsFeatures of the social and healthcare environments operating at the meso-level, as well as PWID’s individual characteristics, appear to enhance or mitigate the effect of stigma as a barrier to SSP enrollment. SSPs opening in locations with high stigma against PWID need to ensure low threshold and friendly services, protect their clients from police and mobilize PWID networks to promote enrollment.

Disclosure Experiences and Challenges Among Children and Adolescents Living with HIV/AIDS in Nigeria-A Review of the Literature

Context: Disclosure of HIV positive infection status in children and Adolescents is multifaceted and should take into consideration their age, psychosocial maturity, cultural and clinical context. This study was conducted to examine disclosure experiences and challenges among children and ALWHA in Nigeria. Evidence Acquisition: We conducted narrative review of relevant literatures by searching PubMed, Google scholar and Medscape using predetermined keywords. Results: Findings are presented under themes of process of disclosure and age of disclosure, reasons and challenges of disclosure, reactions and responses to disclosure, consistent with various authors. This study shows that the mean age and reasons for HIV positive status disclosure are variable. Disclosure was mostly executed at home and mostly carried out by parents or caregivers of HIV-infected children. Reactions of children and ALWHA upon disclosure was mainly negative and ranged from feeling of anger to expression of shock to feeling of sadness and to crying. Barriers to HIV-positive status disclosure among caregivers were perceived sense immaturity and age of the child, fear of stigma, fear of child’s inability to cope, fear of blaming the parents and refusal to take antiretroviral (ARV) drugs. While caregivers highlighted several factors that affect disclosure of HIV status to children and adolescents, this study reveals both positive and negative impact on their emotions. Conclusions: It is of note that approach to disclosure is critical, therefore caregivers and healthcare workers should be properly trained and supported with resources required to effectively carry out disclosure. There is need for continuous research to understand and develop age and culture specific approaches to disclosure in children and adolescents in Nigeria.

Feasibility of collecting and processing of COVID-19 convalescent plasma for treatment of COVID-19 in Uganda.

IntroductionEvidence that supports the use of COVID-19 convalescent plasma (CCP) for treatment of COVID-19 is increasingly emerging. However, very few African countries have undertaken the collection and processing of CCP. The aim of this study was to assess the feasibility of collecting and processing of CCP, in preparation for a randomized clinical trial of CCP for treatment of COVID-19 in Uganda.MethodsIn a cross-sectional study, persons with documented evidence of recovery from COVID-19 in Uganda were contacted and screened for blood donation via telephone calls. Those found eligible were asked to come to the blood donation centre for further screening and consent. Whole blood collection was undertaken from which plasma was processed. Plasma was tested for transfusion transmissible infections (TTIs) and anti-SARS CoV-2 antibody titers. SARS-CoV-2 testing was also done on nasopharyngeal swabs from the donors.Results192 participants were contacted of whom 179 (93.2%) were eligible to donate. Of the 179 eligible, 23 (12.8%) were not willing to donate and reasons given included: having no time 7(30.4%), fear of being retained at the COVID-19 treatment center 10 (43.5%), fear of stigma in the community 1 (4.3%), phobia for donating blood 1 (4.3%), religious issues 1 (4.4%), lack of interest 2 (8.7%) and transport challenges 1 (4.3%). The median age was 30 years and females accounted for 3.7% of the donors. A total of 30 (18.5%) donors tested positive for different TTIs. Antibody titer testing demonstrated titers of more than 1:320 for all the 72 samples tested. Age greater than 46 years and female gender were associated with higher titers though not statistically significant.ConclusionCCP collection and processing is possible in Uganda. However, concerns about stigma and lack of time, interest or transport need to be addressed in order to maximize donations.

An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial

BackgroundA cancer diagnosis can cause severe emotional distress and affect quality of life as well as social relationships. The transition from inpatient to outpatient treatment is burdened by stressful uncertainties and a gap of psycho-oncological care. In addition, further barriers, such as information deficits or fear of stigmatization, might hinder cancer patients to use psycho-oncological face-to-face interventions. Online interventions can be a low-threshold adjunct to existing face-to-face services. This study aims to evaluate the effect of the online self-help program epos (emotion-based psycho-oncological online self-help) on improving symptoms of anxiety and depression in German-speaking cancer patients. MethodsA randomized controlled trial (RCT) is carried out in a parallel group design. N = 325 patients will be enrolled in the trial, randomly assigned to an intervention and a control group. While the intervention group has access to nine modules of epos, the control group gets access to an informational website. Participants will complete online questionnaires at baseline (T0), after the intervention (T1) and three-month follow-up (T2). Primary outcome is a combined measure of depression and anxiety. Secondary outcomes include psychological distress, anxiety, depression, quality of life, emotional control, posttraumatic growth, and satisfaction with epos. Participants are at least 18 years old, have a cancer diagnosis, currently receive cancer treatment or aftercare, have sufficient German language competence, and have access to the Internet. Exclusion criteria are severe mental comorbidities (i.e. severe depression, suicidality) or somatic comorbidities (i.e. visual disabilities). DiscussionThe results of this study will provide information about acceptability, feasibility, and efficacy of epos in improving symptoms of depression and anxiety in cancer patients and thus contribute to the research on web-based interventions. If found efficacious, epos will improve psycho-oncological care in cancer patients in transition from inpatient to outpatient care and in those who struggle to find adequate psycho-oncological support due to other (perceived) barriers.

Barriers to and facilitators of South Asian immigrant adolescents’ access to sexual and reproductive health services in Canada: A qualitative study

Data on immigrant access to sexual and reproductive health (SRH) services in Canada typically focus on adult populations generally but not adolescents specifically. To fill this gap, this study explored South Asian immigrant adolescents’ perceptions of barriers and facilitators for SRH care and services in Edmonton, Alberta, Canada. In this qualitative descriptive study, researchers conducted six focus group semi-structured interviews with South Asian immigrant adolescents who live in Edmonton, Canada. Barriers included fear of stigma and judgment, lack of information about the healthcare system, lack of privacy and youth-friendly SRH services, lack of comprehensive sexuality education, lack of trust of online SRH information, and language barriers. Facilitators included SRH information classes at school, parental support, and provision of free services. South Asian immigrant adolescents expressed their need for more inclusive and relevant sexual health education, more support from parents and teachers with adequate and evidence-based SRH information and effective communication strategies to enhance communication with adolescents, and more youth-driven integrated health promotion programs to allow them to make informed choices. Their voices and perspectives are useful in informing inclusive and youth-centered sexual health education at home, in school, and in the community.

Self-Medication Practices and Associated Factors in the Prevention and/or Treatment of COVID-19 Virus: A Population-Based Survey in Nigeria.

Background: The anxiety caused by the emergence of the novel coronavirus disease (COVID-19) globally has made many Nigerians resort to self-medication for purported protection against the disease, amid fear of contracting it from health workers and hospital environments. Therefore, this study aimed to estimate the knowledge level, causes, prevalence, and determinants of self-medication practices for the prevention and/or treatment of COVID-19 in Nigeria.Methods: A web-based cross-sectional survey was conducted between June and July 2020 among the Nigerian population, using a self-reported questionnaire. Statistical analysis of descriptive, bivariate, and multivariate analyses was done using STATA 15.Results: A total of 461 respondents participated in the survey. Almost all the respondents had sufficient knowledge about self-medication (96.7%). The overall prevalence of self-medication for the prevention and treatment of COVID-19 was 41%. The contributing factors were fear of stigmatization or discrimination (79.5%), fear of being quarantine (77.3%), and fear of infection or contact with a suspected person (76.3%). The proximal reasons for self-medication were emergency illness (49.1%), delays in receiving hospital services (28.1%), distance to the health facility (23%), and proximity of the pharmacy (21%). The most commonly used drugs for self-medication were vitamin C and multivitamin (51.8%) and antimalarials (24.9%). These drugs were bought mainly from pharmacies (73.9%). From the multivariable logistic regression model, males (OR: 0.79; 95% CI: 0.07–0.54), and sufficient knowledge on SM (OR: 0.64; 95% CI: 0.19–0.77) were significantly associated with self-medication.Conclusion: The key finding of this study was the use of different over-the-counter medications for the prevention (mainly vitamin C and multivitamins) and treatment (antibiotics/antimicrobial) of perceived COVID-19 infection by Nigerians with mainly tertiary education. This is despite their high knowledge and risk associated with self-medication. We suggest that medication outlets, media and community should be engaged to support the rational use of medication.

Precautionary Behavior Practices and Psychological Characteristics of COVID-19 Patients and Quarantined Persons.

Background: since the coronavirus disease (COVID-19) was first reported in 2019, South Korea has enforced isolation of patients with confirmed cases of COVID-19, as well as quarantine for close contacts of individuals diagnosed with COVID-19 and persons traveling from abroad, in order to contain its spread. Precautionary behavior practices and psychological characteristics of confirmed and quarantined persons were investigated for planning pandemic recovery and preparedness. Methods: this study was conducted with 1716 confirmed patients and quarantined persons in Daegu and Busan, regions where a high number of cases were confirmed during the early stage of the COVID-19 outbreak in South Korea. We collected online survey data from 23 April to 20 May 2020, in Daegu, and 28 April to 27 May 2020, in Busan, in cooperation with Daegu and Busan Infectious Disease Control Centers and public health centers in the regions. COVID-19 symptoms, pre-cautionary behavior practices, psychological states, and the need for improvement in isolation/quarantine environments were examined using an online survey. Results: compared to patients infected with coronavirus, quarantined persons engaged in more hygiene-related behaviors (e.g., hand washing, cough etiquette, and proper mask-wearing) and social distancing. COVID-19 patients had a strong fear of stigma, while quarantined persons had a strong fear of contracting COVID-19. Study participants responded that it was necessary to provide financial support and adequate information during isolation/quarantine. Conclusions: the study highlights the importance of precautionary behavior to prevent COVID-19 infection and the need to provide support (both psychological and financial) to patients and quarantined persons, to reinforce effective communication, social solidarity, and public health emergency preparedness (PHEP) in a pandemic situation.

Speaker Abstracts

The Deaf community consists of a diverse group of individuals with varied languages (i.e. American Sign Language, English, etc.), community affiliations (i.e. Deaf culture, general community, etc.), and sociocultural norms (Anderson et al., 2018). Despite evidence of higher rates of victimization, behavioral health disorders, and hazardous drinking among Deaf individuals, they remain one of the most understudied populations in behavioral health research (Anderson et al., 2018;Fellinger et al., 2012). Significant disparities exist in access to and utilization of behavioral health services among Deaf individuals due to limited access to health information, fear and mistrust in healthcare settings, cultural and linguistic oppression, fear of stigmatization within the Deaf community, communication barriers, and a lack of culturally appropriate services (Barnett et al., 2011;Fellinger et al., 2012). CBT for Treatment Seeking (CBT-TS) has shown promise as an intervention to promote the use of treatment services among hearing individuals (Stecker et al., 2012), but it is unknown whether the intervention would be effective with Deaf individuals and what modifications might be necessary to increase its accessibility and applicability. This paper will present an ongoing project funded by an NIAAA diversity supplement [R01AA026815-03S1] to adapt CBT-TS for Deaf individuals using the ADAPT-ITT model, a pragmatic framework for adapting evidence-based interventions (Wingood & DiClemente, 2008). The first part of this project involves elicitation interviews with members of the new target population regarding their attitudes and beliefs about treatment, facilitators and barriers to treatment seeking, and the impact of COVID-19 on treatment seeking. The second part involves soliciting feedback of the materials, content, and delivery of CBT-TS from the target population and key stakeholders in the community via a pretesting methodology called “theater testing.” Finally, data from the elicitation interviews and the theater testing sessions will be combined to produce an adapted version of CBT-TS for Deaf individuals. This paper will present background information about behavioral health disparities among Deaf individuals and the rationale, plan, progress, and initial data of the ongoing project. An adaptation of CBT-TS for Deaf individuals would benefit a historically underserved community with potentially higher rates of hazardous drinking and behavioral health disorders and lower rates of treatment use.