02704nas a2200217 4500000000100000008004100001100001800042700001400060700001300074700001200087700001400099700001500113700001400128700001100142245012300153856007800276300000700354490000700361520210400368022001402472 2019 d1 avan Brakel WH1 aCataldo J1 aGrover S1 aKohrt B1 aNyblade L1 aStockton M1 aWouters E1 aYang L00aOut of the silos: identifying cross-cutting features of health-related stigma to advance measurement and intervention. uhttps://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-018-1245-x a130 v173 a

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.

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