The Effects of Mass Media Photographs on Drug-Related Stigma

A Randomized Experiment to Test the Effects of Mass Media Photographs Related to Drug Use

The aim of this study was to evaluate the effects of exposure to drug-related photos used by the media on emotions, stigma towards people who use drugs, and public health services for this population.

Study Overview

• Status: Completed
• Conditions: Opioid Use Disorder; Substance Use Disorders; Stigma, Social
• Intervention / Treatment: Behavioral: Photo of a person injecting drugs; Behavioral: Photo of EMS responding to an overdose (White); Behavioral: Photo of EMS responding to an overdose (Black); Behavioral: Photo of a person receiving treatment (Jail); Behavioral: Photo of a person receiving treatment (Community); Behavioral: Photo of a person in recovery (White); Behavioral: Photo of a person in recovery (Black); Behavioral: Photo of a family member of an overdose decedent

Detailed Description

This randomized experiment evaluated the impact of drug-related photographs used by the media on stigma towards people who use drugs. A nationally representative sample of US adults was randomized to view different photos used in the media (a person injecting drugs, a person being resuscitated after an overdose, a person receiving treatment, a person in recovery, or a person who had lost a family member to an overdose) and then asked questions about their feelings towards people who use drugs and their acceptance of public health services to address the overdose crisis.

• Study Type: Interventional
• Enrollment (Actual): 3570
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21205
      • Johns Hopkins Bloomberg School of Public Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• participant in existing web-based survey panel (NORC's AmeriSpeak)

Exclusion Criteria:

• not able to complete experiment and survey in English

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

9

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: No exposure control group; This group was not exposed to any drug-related photo.
Experimental: Photo of person injecting drugs; Participants randomized to this arm were exposed to a photo of a person injecting drugs.	Behavioral: Photo of a person injecting drugs; Exposed to a photo of a person injecting drugs
Experimental: Photo of Emergency Medical Services (EMS) responding to an overdose (White); Participants randomized to this arm were exposed to a photo of EMS responding to a white person who had overdosed.	Behavioral: Photo of EMS responding to an overdose (White); Exposed to a photo of EMS responding to an overdose (White)
Experimental: Photo of EMS responding to an overdose (Black); Participants randomized to this arm were exposed to a photo of EMS responding to a Black person who had overdosed.	Behavioral: Photo of EMS responding to an overdose (Black); Exposed to a photo of EMS responding to an overdose (Black)
Experimental: Photo of a person receiving treatment (Jail); Participants randomized to this arm were exposed to a photo of a person receiving methadone treatment in jail.	Behavioral: Photo of a person receiving treatment (Jail); Exposed to a photo of a person receiving treatment (Jail)
Experimental: Photo of a person receiving treatment (Community); Participants randomized to this arm were exposed to a photo of a person receiving methadone treatment in a community setting.	Behavioral: Photo of a person receiving treatment (Community); Exposed to a photo of a person receiving treatment (Community)
Experimental: Photo of a person in recovery (White); Participants randomized to this arm were exposed to a photo of a white person in recovery in their workplace.	Behavioral: Photo of a person in recovery (White); Exposed to a photo of a person in recovery (White)
Experimental: Photo of a person in recovery (Black); Participants randomized to this arm were exposed to a photo of a Black person in recovery in their workplace.	Behavioral: Photo of a person in recovery (Black); Exposed to a photo of a person in recovery (Black)
Experimental: Photo of a family member of an overdose decedent; Participants randomized to this arm were exposed to a photo of a person who had lost a family member to an overdose.	Behavioral: Photo of a family member of an overdose decedent; Exposed to a photo of a family member of an overdose decedent

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Positive and Negative Affect Scale (Angry)	Rating of feeling angry at the present moment. Item from the Positive and Negative Affect Scale. Measured on 5-point Likert scale with 1 indicating "not at all" and 5 indicating "extremely" their feeling angry at the present moment.	Immediately post-exposure to photo intervention
Positive and Negative Affect Scale (Sympathy)	Rating of feeling sympathy at the present moment. Item from the Positive and Negative Affect Scale. Measured on 5-point Likert scale with 1 indicating "not at all" and 5 indicating "extremely" their feeling sympathy at the present moment.	Immediately post-exposure to photo intervention
Positive and Negative Affect Scale (Disgust)	Rating of feeling disgust at the present moment. Item from the Positive and Negative Affect Scale. Measured on 5-point Likert scale with 1 indicating "not at all" and 5 indicating "extremely" their feeling disgust at the present moment.	Immediately post-exposure to photo intervention
Positive and Negative Affect Scale (Pity)	Rating of feeling pity at the present moment. Item from the Positive and Negative Affect Scale. Measured on 5-point Likert scale with 1 indicating "not at all" and 5 indicating "extremely" their feeling pity at the present moment.	Immediately post-exposure to photo intervention
Social Distance Scale (Family)	Rating of willingness to have person with substance use disorder marry into their family. Item from the Social Distance Scale that measures one element of stigma (desire for social distance). Measured on 5-point Likert scale with 1 indicating greater willingness and 5 indicating greater unwillingness to have a person with a substance use disorder marry into the family.	Immediately post-exposure to photo intervention
Social Distance Scale (Neighbor)	Rating of willingness to have person with substance use disorder as a neighbor. Item from the Social Distance Scale that measures one element of stigma (desire for social distance). Measured on 5-point Likert scale with 1 indicating greater willingness and 5 indicating greater unwillingness to have a person with a substance use disorder as a neighbor.	Immediately post-exposure to photo intervention
Social Distance Scale (Work Closely)	Rating of willingness to have person with substance use disorder work closely with them. Item from the Social Distance Scale that measures one element of stigma (desire for social distance). Measured on 5-point Likert scale with 1 indicating greater willingness and 5 indicating greater unwillingness to have a person with a substance use disorder work closely with them.	Immediately post-exposure to photo intervention
Social Distance Scale (close friend)	Rating of willingness to have person with substance use disorder as a close personal friend. Item from the Social Distance Scale that measures one element of stigma (desire for social distance). Measured on 5-point Likert scale with 1 indicating greater willingness and 5 indicating greater unwillingness to have a person with a substance use disorder as a close personal friend.	Immediately post-exposure to photo intervention
Feeling-Thermometer measure of warmth towards people with substance use disorders	Rating of warmth felt toward people with substance use disorder with 0 indicating extremely cold and 100 indicating extremely warm.	Immediately post-exposure to photo intervention
Rating of agreement that recovery is possible	Rating of agreement with statement "Recovery from a drug addiction is possible" on a 5-point Likert scale with 1 indicating strongly agree and 5 indicating strongly disagree.	Immediately post-exposure to photo intervention
Rating of willingness to have a drug treatment program in their neighborhood	Rating of willingness to have a drug treatment program in their neighborhood with 1 indicating greater willingness and 5 indicating greater unwillingness. Measured via survey questionnaire.	Immediately post-exposure to photo intervention
Rating of willingness to have a syringe exchange program in their neighborhood	Rating of willingness to have a syringe exchange program in their neighborhood with 1 indicating greater willingness and 5 indicating greater unwillingness.	Immediately post-exposure to photo intervention
Rating of willingness to have a safe consumption site in their neighborhood	Participant's rating of willingness to have a safe consumption site in their neighborhood with 1 indicating greater willingness and 5 indicating greater unwillingness.	Immediately post-exposure to photo intervention
Number of participants having a family member with a substance use disorder	Personal experience of having a family member with a substance use disorder. Three close-ended response options (Yes, No, Don't know) when asked if the participant has ever had a family member with a substance use disorder.	Immediately post-exposure to photo intervention
Number of participants having a close friend with a substance use disorder	Personal experience of having a close friend with a substance use disorder. Three close-ended response options (Yes, No, Don't know) when asked if the participant has ever had a close friend with a substance use disorder.	Immediately post-exposure to photo intervention
Number of participants having substance use disorder	Personal experience of having a substance use disorder. Three close-ended response options (Yes; No; Don't Know) when asked if the participant has ever had a substance use disorder. Measured via survey questionnaire.	Immediately post-exposure to photo intervention

Collaborators and Investigators

• Sponsor: Johns Hopkins Bloomberg School of Public Health
• Collaborators: Vital Strategies
• Investigators: Principal Investigator: Alene Kennedy-Hendricks, PhD, Johns Hopkins Bloomberg School of Public Health

Study record dates

Study Major Dates

• Study Start (Actual): March 20, 2024
• Primary Completion (Actual): April 8, 2024
• Study Completion (Actual): April 8, 2024

Study Registration Dates

• First Submitted: December 16, 2024
• First Submitted That Met QC Criteria: December 16, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 16, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Narcotic-Related Disorders; Mental Disorders; Chemically-Induced Disorders; Opioid-Related Disorders; Substance-Related Disorders
• Other Study ID Numbers: IRB00026173

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No