A total of 572 respondents participated in this study (overall response rate = 9%). Most respondents were students (
n = 428; 75%), followed by faculty (
n = 107; 19%) and staff (
n = 32; 6%) (Table
1). Most respondents were female (
n = 372; 76%), the highest degree completed was a 4-year college degree (
n = 308; 52%), 31 years old on average (Standard Deviation [SD]: 12.2 years), not Hispanic, Latino or Spanish origin (
n = 473; 96%), and white (
n = 336; 69%) (Table
1). Most respondents were from the college of pharmacy (
n = 214; 43%), followed by medicine (
n = 101; 21%), nursing (
n = 74; 15%), health professions (
n = 50; 10%), dentistry (
n = 29; 6%), and graduate health sciences (
n = 24; 5%) (Table
1).
Table 1
Respondent Characteristics
Role |
Faculty | 107 | 19 |
Staff | 32 | 6 |
Student | 428 | 75 |
Age (years) | 31 (SD: 12) |
Sex |
Male | 114 | 23 |
Female | 372 | 76 |
Prefer not to answer | 6 | 1 |
Hispanic, Latino, or Spanish Origin |
Yes | 19 | 4 |
No | 473 | 96 |
Race |
White | 336 | 69 |
Black or African American | 75 | 15 |
Asian Indian | 27 | 6 |
Some other race* | 51 | 10 |
College |
Dentistry | 29 | 6 |
Graduate Health Sciences | 24 | 55 |
Health Professions | 50 | 10 |
Medicine | 101 | 21 |
Nursing | 74 | 15 |
Pharmacy | 214 | 43 |
SUD perceptions
Most respondents reported knowing someone with a SUD (n = 340; 60%), and, of those, nearly all participants had interacted with someone with a SUD (n = 333; 99%) and did so on a weekly basis (n = 126; 38%), followed by monthly (n = 98; 30%), quarterly (n = 55; 17%), annually (n = 46; 14%), or never (n = 4; 1%). Those interactions most commonly occurred in a personal setting (n = 311; 53%), followed by a professional setting (n = 188; 32%) or another type of setting, such as in the general public or community service events (n = 6; 1%). Of respondents who reported interacting with a person with a SUD, many reported experiencing challenges interacting with that person (n = 276; 48%). The most common cited challenge was difficulty communicating (n = 211; 37%), followed by lack of trust on the part of the individual (n = 186; 33%), overall uncomfortability (n = 110; 19%), inadequate amount of time to spend with person (n = 80; 14%), overall feeling of being unprepared (n = 59; 10%), or another reason (n = 23; 4%).
When asked about their perceptions of SUDs, most respondents answered that they viewed a SUD as a mental health condition (
n = 463; 81%), followed by a biological disease (
n = 326; 57%), a consequence of the family or community where one lives (
n = 328; 57%), a personal choice (
n = 214; 37%), a moral failing (
n = 42; 7%), or were not sure (
n = 39; 7%) (Table
2). Staff more commonly than faculty or students perceived SUDs as a moral failing or personal choice whereas faculty and students more commonly perceived it as a biological disease or mental health condition (Table
2). Most respondents felt very or somewhat comfortable continuing a friendship with someone in their college that has a SUD (
n = 327; 60%), with faculty significantly more likely than staff to feel comfortable continuing the relationship, H(2) = 16.82,
p < 0.001 (main effect), post hoc Dunn’s test, z = -4.10,
p < 0.001. Few respondents reported being very likely or likely to avoid a colleague that has a SUD (
n = 66; 12%), with students significantly more likely than faculty to avoid a colleague, H(2) = 13.52,
p = 0.001 (main effect), post hoc Dunn’s test, z = 3.60,
p < 0.001.
Table 2
Faculty, Staff, and Student Perceptions of SUD.*
Faculty | 4 | 4 | 20 | 19 | 63 | 59 | 45 | 42 | 73 | 68 |
Staff | 4 | 13 | 12 | 38 | 9 | 28 | 13 | 41 | 20 | 63 |
Student | 29 | 7 | 155 | 36 | 218 | 51 | 232 | 54 | 321 | 75 |
Perceptions of stigma in health professional training
Respondents were also asked about their perceptions of stigma in health professional training. Most respondents strongly agreed, agreed, or somewhat agreed that they felt comfortable engaging with someone with a SUD (n = 505; 94%). When asked if they perceive people with SUDs similar to a people with other disease states, such as high blood pressure, most strongly agreed, agreed, or somewhat agreed that they did (n = 425; 79%), and only a few disagreed (n = 97; 18%) or strongly disagreed (n = 13; 2%). Faculty were significantly more likely than students to perceive people with SUDs similarly to people with other disease states, H(2) = 8.37, p = 0.015 (main effect), post hoc Dunn’s test, z = -2.85, p = 0.004.
Most respondents agreed that they believe their college emphasizes learning about SUDs (strongly agree, n = 98, 18%; agree, n = 175, 33%; somewhat agree, n = 140, 26%). Most respondents also agree that their college promotes an accurate perception of SUDs (strongly agree, n = 85, 16%; agree, n = 206, 39%; somewhat agree, n = 163, 31%). Also, most respondents reported that they believe their college fosters respect for people with SUDs (strongly agree, n = 101, 19%; agree, n = 209, 39%; somewhat agree, n = 155, 29%).
Faculty, staff, and students were also probed about whether they believe people in those roles at their institution hold negative perceptions of people with SUDs. Most respondents agreed that they believe most faculty at their college do not hold negative perceptions of people with SUDs (strongly agree, n = 75, 14%; agree, n = 192, 36%; somewhat agree, n = 173, 33%; disagree, n = 81, 15%; strongly disagree, n = 11, 2%), H(2) = 21.34, p < 0.001, with students significantly more likely than faculty (z = 4.03, p < 0.001) and students significantly more likely than staff (z = 2.70, p = 0.007) to believe this. Most respondents agreed that they believe most staff at their college do not hold negative perceptions of people with SUDs (strongly agree, n = 59, 11%; agree, n = 198, 37%; somewhat agree, n = 186, 35%; disagree, n = 75, 14%; strongly disagree, n = 14, 2%), H(2) = 22.05, p < 0.001. Post hoc testing with Dunn’s test showed students were significantly more likely than staff (z = 2.01, p = 0.045) and, separately, faculty (z = 4.45, p < 0.001) to believe this. Most respondents agreed that they believe most staff at their college do not hold negative perceptions of people with SUDs (strongly agree, n = 30, 6%; agree, n = 163, 31%; somewhat agree, n = 210, 39%; disagree, n = 114, 21%; strongly disagree, n = 16, 3%). No findings were significant.
Most respondents overall reported that they never or rarely heard faculty, staff, or students express negative comments about people with SUDs (faculty, never = 345, 67%; rarely = 121, 23%; staff, never = 353, 68%, rarely = 112, 22%; students, never = 211, 41%, rarely = 167, 32%). Some respondents reported that they sometimes (n = 118, 23%) or often heard students express negative comments (n = 21, 4%). Very few respondents report hearing faculty or staff express negative comments sometimes or often (faculty, sometimes = 45, 9%; often = 6,1%; staff, sometimes = 44, 9%; often = 7, 1%).
Stigma experiences at my own institution
Respondents were prompted to reflect on how hearing negative comments would make them feel, and most agreed that it would make them feel uncomfortable (n = 455; 88%). Most respondents also agreed to some degree that they have felt uncomfortable about the negative comments they have heard at their College about people with SUDs (strongly agreed, n = 39, 8%; agreed, n = 177, 34%; somewhat agreed n = 122, 24%). Most respondents reporting feeling confident in thinking and expressing their own opinions about people with SUDs (n = 475; 92%) and feel empowered to take action to address comments that may make them feel uncomfortable about people with SUDs (n = 439; 85%). Most even agreed that they have taken action to address comments that made them feel uncomfortable (strongly agree, n = 52, 10%; agree, n = 141, 27%; somewhat agree, n = 144, 28%; disagree, n = 153, 26%; strongly disagree, n = 26, 4%). When respondents were asked to reflect on whether they heard faculty, staff, or students express negative comments about people with SUDs, most reported they never or rarely heard negative comments from all three groups.