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Peer-reviewedCC BY 4.0PLOS One

Stigma reduction as quality health care: A qualitative study of structural level mechanisms to address stigma

  • Carla Treloar1
  • Emily Lenton2
  • Amy Kirwan3
  • Caitlin Douglass4
  • Gemma Nourse5
  • Adrian Farrugia6
  • Kate Seear7
  • Caroline Watts8
  • Mark Stoove
  • Elena Cama
8 affiliations
  1. 1Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
  2. 2Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne, Australia
  3. 3Burnet Institute, Melbourne, Australia
  4. 4School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
  5. 5Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
  6. 6National Drug Research Institute, Curtin University, Melbourne, Australia
  7. 7Deakin Law School, Deakin University, Melbourne, Australia
  8. 8Kirby Institute, UNSW Sydney, Sydney, Australia
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Abstract

The impacts of stigma on health are well-known. Most interventions to reduce stigma focus on education or skills building of health workers and less on organisational or structural approaches. Responding to ongoing efforts to increase the quality of health care, we explore data from semi-structured interviews with 20 key stakeholders to identify and examine stigma reduction opportunities that align with existing practices, policies and structures for strengthening quality in the Australian healthcare system. Analysis focused on the “outer setting” constructs of the Consolidated Framework for Implementation Research to identify and categorise mechanisms that linked to or were determined by governing processes of the (“outer setting”). The necessity to be accredited against national standards was positioned as an over-arching driver of what health systems do and what gets the attention of leaders and executives, and can subsequently impact allocation of resources, including for stigma reduction. Participants’ accounts also raise the possibility of using other more general industrial relations laws to bring greater attention to stigma reduction. Innovative approaches to stigma reduction using macro, structural tools provide a promising opportunity to trial.

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Cite

BibTeXRIS
BibTeX
@article{treloar2026stigma,
  title = {{Stigma reduction as quality health care: A qualitative study of structural level mechanisms to address stigma}},
  author = {Carla Treloar and Emily Lenton and Amy Kirwan and Caitlin Douglass and Gemma Nourse and Adrian Farrugia and Kate Seear and Caroline Watts and Mark Stoove and Elena Cama},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0357633},
  url = {https://doi.org/10.1371/journal.pone.0357633},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Stigma reduction as quality health care: A qualitative study of structural level mechanisms to address stigma
AU  - Carla Treloar
AU  - Emily Lenton
AU  - Amy Kirwan
AU  - Caitlin Douglass
AU  - Gemma Nourse
AU  - Adrian Farrugia
AU  - Kate Seear
AU  - Caroline Watts
AU  - Mark Stoove
AU  - Elena Cama
PY  - 2026
DA  - 2026/09/08
JO  - PLOS One
DO  - 10.1371/journal.pone.0357633
UR  - https://doi.org/10.1371/journal.pone.0357633
AB  - The impacts of stigma on health are well-known. Most interventions to reduce stigma focus on education or skills building of health workers and less on organisational or structural approaches. Responding to ongoing efforts to increase the quality of health care, we explore data from semi-structured interviews with 20 key stakeholders to identify and examine stigma reduction opportunities that align with existing practices, policies and structures for strengthening quality in the Australian healthcare system. Analysis focused on the “outer setting” constructs of the Consolidated Framework for Implementation Research to identify and categorise mechanisms that linked to or were determined by governing processes of the (“outer setting”). The necessity to be accredited against national standards was positioned as an over-arching driver of what health systems do and what gets the attention of leaders and executives, and can subsequently impact allocation of resources, including for stigma reduction. Participants’ accounts also raise the possibility of using other more general industrial relations laws to bring greater attention to stigma reduction. Innovative approaches to stigma reduction using macro, structural tools provide a promising opportunity to trial.
SN  - 1932-6203
ER  -