2026 Theses Doctoral

Developing and Pilot Testing the S.C.O.R.E. Framework for Addressing Substance Use Disorders

Grier, Stephanie

This study presents the development and inaugural implementation of the S.C.O.R.E. training program, focusing on its formative evaluation and the pilot testing of participant assessments and feedback. S.C.O.R.E., which stands for Self-Assessment, Care, Objectivity, Relatability, and Expertise, offers a structured framework designed to enhance self-awareness regarding stigma and self-efficacy in patient-centered care amongst aspiring health professionals who care for individuals with substance use disorders (SUD).

A cohort of nursing students (N=25), aged 20 to 22 years, engaged in S.C.O.R.E. e-learning and pre-post testing. The findings indicate the potential for reducing stigma-related thoughts and behaviors while improving self-efficacy in patient-centered care. Stigma has been linked to health disparities, with research demonstrating a correlation between stigma and non-adherence to treatments and appointments. Notably, around 16% of individuals with SUD have refrained from seeking treatment due to concerns about societal judgment.

Findings from the S.C.O.R.E. training demonstrated significant improvements in students' stigma perceptions and in their self-efficacy in providing patient-centered care. Specifically, there were changes in students' beliefs regarding the importance of sympathy and understanding (t(48) = -2.41, p < .05), and in the ability to distinguish between personal beliefs and professional responsibilities (t(48) = -1.93, p < .05). These results underscore the importance of stigma training and coaching in patient-centered care practices.