Background The ongoing substance use crisis continues to disproportionately impact rural communities with limited access to behavioral health services and high stigma surrounding substance use disorder (SUD). Las Animas and Huerfano rural Colorado counties show high rates of youth substance use, mental health concerns, and overdose risk compared to state averages. This project highlights the participatory co-design, implementation, and pilot evaluation of Change the Narrative, a community-informed multicomponent digital public health educational anti-stigma campaign developed to reduce substance use and mental health stigma and increase access to care.
Methods Using participatory design and Boot Camp Translation-like methodology, a coalition of public health organizations, healthcare providers, and community members collaborated to develop culturally responsive evidence-based educational materials for stigma reduction. Mixed-methods evaluation, stakeholder feedback, and social media analytics help assess feasibility, acceptability, engagement, access, and preliminary impact.
Results Over 15 community and health service organizations participated in campaign development and dissemination. More than 60 community members, including youth, adults, providers, and coalition members, participated in iterative testing and evaluation activities. Over 50 co-designed and iteratively enhanced materials focused on the impact of substance use, prevention and access, dismantling stereotypes and stigma, seeing the whole person, recovery, and hope. Components included: a) printed outreach materials distributed across hospitals, restaurants, park, schools, other community venues); b) prevention action-focused educational website; c) youth-centered social media (Instagram, Tiktok). Preliminary findings demonstrated acceptability of messaging and shifts in community perceptions.
Implications
This project supports the feasibility of community-engaged digital campaigns to reduce stigma and strengthen substance use prevention and mental health resources in rural communities. Youth-informed messaging, social media engagement, and culturally responsive resources may improve outreach, build community capacity, and advance health equity. Results highlight the importance of partnerships between local public health workforces and communities to develop evidence-based, community-driven prevention interventions.
