Inside this issue:
- Stigma: A Solvable Problem
- Recent Publications
- Join us in these free, upcoming webinars!
- Psychological Reactance and Communication
- Reducing Underage Drinking With Practical Tools That Develop Social and Emotional Skills
- Communication: A Catalyst for Growing Positive Culture
- Moving Beyond Bystander Engagement: Growing Citizenship to Improve Health and Safety
- 2018 Positive Culture Framework Training
- Other Center News
- Our Services
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Stigma: A Solvable Problem
Imagine yourself feeling isolated from a group because of a condition you have. Imagine not seeking treatment or sticking with the treatment you’ve been prescribed because you feel embarrassed or ashamed of having a condition. Unfortunately, for many people these scenarios are a reality, and people with certain conditions may feel isolated or not seek help because of stigma. Stigma is associated with a variety of negative social and health outcomes. At the Center for Health and Safety Culture, we are exploring the concept of stigma with a variety of health and safety issues including traffic safety, violence prevention, gambling, and substance use.
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Researchers have suggested that stigma shows up in prejudice and discriminatory practices at different levels across the social ecology (i.e., individuals, groups, community) and in the structures that we have built (National Academy of Sciences, Engineering, and Medicine, 2016). Stigma is a complex social process that can negatively impact a person’s self-esteem, self-efficacy, and quality of life (Livingston & Boyd, 2010, p. 2155). Regardless of the issue you are working to address, it is important to begin to explore how stigma may be influencing the health and safety outcomes you are seeking.
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Four levels of stigma are often identified in the literature: public stigma, self stigma, courtesy stigma, and structural stigma. Understanding stigma at each of these levels can provide insight and awareness of how stigma might be showing up in your work to influence health and safety. Public, or societal stigma, is the public’s reaction to individuals with a stigmatizing condition (such as substance use, gambling, or a mental health disorder) (Corrigan & Watson, 2002). Public stigma creates a social divide between those that do not have a stigmatized condition and those that do. Self stigma is when a person has a condition and adopts negative beliefs from public stigma (Livingston & Boyd, 2010). It is identifying with and internalizing the stigmatizing beliefs others have created (Corrigan & Watson, 2002). Courtesy stigma, on the other hand, is identified as stigma that is directed toward the family and friends of those with a stigmatized condition (National Academy of Sciences, Engineering, and Medicine, 2016). Family members and friends don’t suffer from a certain condition, but because their loved one does, the family member or friend might feel ashamed, embarrassed, or isolated because of their loved one’s condition. Structural stigma is manifested in policies and procedures that limit the opportunities of people in stigmatized groups (Livingston, Milne, Lan Fang, & Amari, 2011). When leaders adopt laws, policies, and rules based on stigmatized beliefs, they create structural stigma.
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The good news is that we can do something about stigma! Stigma is a social process and social processes can change. Researchers have identified a variety of ways that we can reduce stigma. Four ways are highlighted here.
1. Be cautious of the language and labels used to describe people.
Use person-first language and avoid describing people as their condition (Livingston, Milne, Lan Fang, & Amari, 2011; SAMHSA, 2017).
2. Seek accurate information and counter misinformation.
Gathering accurate information and countering inaccuracies is important to reduce stigma (National Academy of Sciences, Engineering, and Medicine, 2016; Corrigan, Morris, Michaels, Rafacz, & Rüsch, 2012; Griffiths, Carron-Arthur, Parsons, & Reid, 2014). Education is essential.
3. Seek intentional experiences.
Research suggests that people without stigmatized conditions often have little meaningful contact with those who have these conditions. Lack of contact fosters fear and distrust. Experiences can overcome this divide (National Academy of Sciences, Engineering, and Medicine, 2016; Corrigan et al., 2012; Griffiths et al., 2014).
4. Review practices and policies.
Ask those you serve how the practices and policies of your organization might hinder access to services, compliance with treatment, or overall well being. Listening to those responses can be insightful as you review practices and policies. It is easy to get immersed in the work and forget to ask those we serve how practices or policies impact them (Livingston et al., 2011).
Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D., & Rüsch, N. (2012). Challenging the public stigma of mental illness: a meta-analysis of outcome studies.
Psychiatric Services
, 63(10), 963–973.
Corrigan, P., & Watson, A. (2002). Understanding the impact of stigma on people with mental illness.
World Psychiatry
, 1(1).
Griffiths, K. M., Carron-Arthur, B., Parsons, A., & Reid, R. (2014). Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized controlled trials.
World Psychiatry
, 13(2), 161–175.
Livingston, J. D., & Boyd, J. E. (2010). Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis.
Social Science & Medicine
(1982), 71(12), 2150–2161.
Livingston, J., D., Milne, T., Lan Fang, M., & Amari, E. (2011). The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review.
Addiction
, 107, 39-50.
National Academies of Sciences, Engineering, and Medicine. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change. Washington (DC): National Academies Press (US); 2016 Aug 3. 2, Understanding Stigma of Mental and Substance Use Disorders.
SAMHSA’s Center for the Application of Prevention Technologies (2017). Words matter: How language choice can reduce stigma. Retrieved from
http://www.samhsa.gov/capt/
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Recent Publications
Kari Finley, Ph.D., Jay Otto, M.S., and Nic Ward, Ph.D. with the Center for Health and Safety Culture at Montana State University have published an article in the International Journal of Interdisciplinary Civic and Political Studies. The article titled "The Role of Social Capital in Traffic Safety Citizenship" focuses on two traffic safety citizenship behaviors 1) asking a passenger to wear a seat belt and 2) asking a driver to stop texting on a cell phone while driving and explores the role of social capital to facilitate engagement in these behaviors with strangers. Results indicate that social capital may influence engagement in traffic safety citizenship behaviors.
Finley, K., Otto, J., & Ward, N.J. (2018). The Role of Social Capital in Traffic Safety Citizenship.
The International Journal of Interdisciplinary Civic and Political Studies,
13(2), 29-41. doi:10.18848/2327-0071/CGP/v13i02/29-41
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The Center for Health and Safety Culture (CHSC) at Montana State University with Cambridge Systematics contributed to a report recently released by TRB’s National Cooperative Highway Research Program (NCHRP) called “A Strategic Approach to Transforming Traffic Safety Culture to Reduce Deaths and Injuries.” This report provides guidance to traffic safety stakeholders seeking to improve traffic safety culture in their communities. The report is available at
http://www.trb.org/main/blurbs/178272.aspx
.
National Academies of Sciences, Engineering, and Medicine. 2018. A Strategic Approach to Transforming Traffic Safety Culture to Reduce Deaths and Injuries. Washington, DC: The National Academies Press. https://doi.org/10.17226/25286.
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Psychological Reactance and Communication
November 20, 2018 at 11:00 AM (MST)
Speaker: Jay Otto, M.S.
Psychological reactance is a negative reaction triggered by a perception that something or someone is impinging on an individual's freedom and autonomy. Psychological reactance can impede efforts to improve health and safety on a wide variety of issues including traffic safety ("don't tell me to wear a seat belt"), prevention ("don't tell me how to raise my children"), and violence ("don't take my guns if I have been violent"). During this webinar, we will introduce the concept and ways to quiet the negative response.
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Reducing Underage Drinking With Practical Tools That Develop Social and Emotional Skills
December 18, 2018 at 12:00 PM (MST)
Speaker: Annmarie McMahill, M.S.
A recent study found that Montana parents with higher social and emotional parenting skills were over six times more likely to engage in best practices to reduce underage drinking. During this webinar, we will review social and emotional skills, how they are protective for youth, and a project creating practical tools for parents to reduce underage drinking and strengthen social and emotional skills.
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Communication: A Catalyst for Growing Positive Culture
January 16, 2019 at 12:00 PM (MST)
Speaker: Katie Dively, M.S., CHES
Communication includes a variety of methods ranging from mass media campaigns to leveraging the power of individual voices. This webinar will engage participants in developing a deeper understanding of how communication can be used as a catalyst to improve health and safety.
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Moving Beyond Bystander Engagement: Growing Citizenship to Improve Health and Safety
February 12, 2019 at 12:00 PM (MST)
Speaker: Kari Finley, Ph.D.
Safety citizenship requires creating a culture that values "our safety" and empowers early identification of potential risk, being proactive, and bystander engagement. This webinar will introduce safety citizenship, which seeks to involve the majority of people engaging in safe behaviors to influence the smaller group engaging in risky behaviors.
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2018 Positive Culture Framework Training
Nearly 60 people gathered in the historic district of Savannah, Georgia this September for our 2018 Positive Culture Framework Training. Attendees traveled from all corners of the world, from the South Pacific, New York, Canada, and Florida. The annual event provided a foundation for efforts to improve health and safety in which training attendees developed and refined skills in three critical areas: leadership, communication, and the integration of effective strategies; learned how culture influences behavior and how to cultivate cultural transformation; and gained specific next steps for transforming culture.
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In Senior Trainer, Katie Dively’s, words….
“The 2018 Positive Culture Framework training in Savannah was one of our best yet! Attendees traveled from near (Savannah) and far (Hawaii, Palau, and Canada) to learn how to use the framework to improve health and safety. It was exciting to watch such a diverse group of people come together to learn and share their wisdom. Attendees represented a variety of agencies such as, state prevention offices, local hospitals, the U.S. Army, the U.S. Air Force, law enforcement, education, non-profits, and many more. Savannah was a lovely hostess! The historic city provided a little reprieve from the busy day-to-day and an opportunity to reflect and refocus efforts to improve health and safety.”
2019 Training
We plan to host a Positive Culture Framework Training in 2019. The dates and location will be announced soon!
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Other Center News
Since our previous newsletter, we have been a part of many informative and engaging events. Here’s what we have been up to in the past few months:
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Annmarie McMahill presented at the National Prevention Network Conference in Boston, MA on August 28, 2018. Her presentation was titled “Reducing Underage Drinking in Montana with Practical Tools that Develop the Social and Emotional Skills of Parents and Their Children.”
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Dr. Kari Finley presented at the Open Talks Health Conference in Baton Rouge, LA on October 27, 2018. Her presentation was titled “Shhh...I'd Prefer Not to Talk About That Now" - Stigma: A Barrier to Progress.”
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Katie Dively and Kathie Southern presented "Utilizing Communication Strategies to Grow Positive Parenting Behavior and Reduce ACEs" at the 2018 Florida Child Protection Summit on September 5, 2018.
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CHSC staff attended three trainings with topics that included communicating with high stakes and strong emotions (Crucial Conversations), the neurology of feedback, and implicit bias.
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Katie Dively presented the Positive Culture Framework at the 2018 Wisconsin Alcohol Policy Seminar.
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Ph.D. student, Jubaer Ahmed, and his family cooked other staff members a dinner of Bangladeshi cuisine. Thank you Jubaer, Fatima, and your kids for the delicious food and great experience!
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Members of our staff traveled to the following locations for trainings and events:
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Our Services
Our 2.5-day, annual training introduces a framework for improving health and safety using a cultural approach called the Positive Culture Framework. The Positive Culture Framework provides participants with a foundation for efforts to improve health and safety that address a wide variety of health and safety related issues. The training provides background information on the framework as well as guidance on three critical skills: leadership, communication, and integration.
Improving health and safety is an act of leadership – we are leading people to make healthier and safer choices. Changing cultural factors can be challenging, as people often resist questioning their core assumptions. Developing leadership skills increases this effectiveness.
Virtually all efforts to improve health and safety involve communication. Often, communication efforts addressing health and safety have minimal results and sometimes have even made the problem(s) worse. It is very important to ground communication efforts in strong research and to recognize that even conversations are critical communication opportunities.
When we recognize the work of improving health and safety is about impacting many behaviors across the social ecology, we realize that there is no single strategy that will address these complex issues. Accepting that we need a portfolio of strategies means we must also accept the need to actively manage and align these strategies. This management and alignment of strategies is the work of integration. Developing skills in integration means we can foster better resource utilization, reduce competition and foster cooperation, align purpose, and increase the effectiveness of our efforts.
Positive Culture Framework Training participants leave with an understanding of how culture influences behavior, how to cultivate cultural transformation, and specific next steps for implementing this process for transforming culture to achieve community health and safety goals.
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In addition to our Positive Culture Framework Training, we offer separate training in leadership skills, communication skills (social norms marketing), and integration skills.
Communities and organizations often find that ongoing guidance and support from the Center contributes to their success. We offer a trained guide as a personal consultant who is available by phone and email to support efforts to improve health and safety. The guide is available to provide feedback and guidance on leadership development, implementing communication efforts, and managing prevention strategies at the local level, among others.
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We conduct applied research in partnership with community, state, tribal, and national organizations who are seeking to improve health and safety.
We develop assessments, surveys, and evaluation services to better understand cultural factors, facilitate ongoing effectiveness, prioritize potential strategies, and inform future needs.
If you're interested in discussing your community or organization's needs, please
contact us today to get the conversation started.
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