"YOU’LL BE TREATED LIKE A P.O.S.” EXAMINING DISCLOSURE OF DRUG USE TO HEALTHCARE PROFESSIONALS USING A REASONED ACTION APPROACH

Author

Kyle Miller, Southern Illinois University CarbondaleFollow

Date of Award

5-1-2022

Degree Name

Doctor of Philosophy

Department

Health Education

First Advisor

McDaniel, Justin

Abstract

The purpose of this qualitative study was to identify salient beliefs about disclosing drug use to healthcare providers among a convenience sample of adults who use drugs in the United States. This study differs from previous research by using the Reasoned Action Approach as the theoretical framework which allows the intention to disclose to be explored. A sample of 5 adults were recruited from Bluelight.org, with ages above 35 years for all participants. Primary drugs differed among the sample with two participants using primarily opioids, heroin as the primary drug for one participant, and stimulants as the primary drug for two participants. Data was collected using an open-ended web survey. Content analysis was performed on the data using a pragmatic worldview. Data was analyzed using the Reasoned Action Approach concepts relating to behavioral beliefs, normative beliefs, and control beliefs. Among the sample, advantages to disclosing drug use included improved healthcare and finding help while disadvantages primarily included discrimination and stigmatization. When asked about normative referents that would encourage disclosure, family and healthcare providers were provided most. However, those who would discourage disclosure were people who know the consequence, pain patients, and support groups. Stigma and discrimination appeared again as response to a question about groups or people who would be least likely to disclose. When asked about factors that would increase the likelihood of disclosure, being listened to without consequences and a variety of healthcare provider qualities (e.g., caring, trustworthy, etc.) were provided most often. Factors that would decrease the likelihood of disclosure were less conclusive and diminished health/healthcare was the only salient belief identified. The findings of this study align with previous literature on the consequences of stigma and discrimination while also providing a base of literature for future research on the topic using the Reasoned Action Approach.