Date of Award


Document Type

Restricted Access Thesis

Degree Name

Master of Arts in Nursing (MAN)



First Advisor

Joyce P. Miller, DNP, RN

Second Advisor

Kathleen Clark, DNP, RN

Third Advisor

Anna Bosch, MPH


People marginalized by drug use experience increased morbidity and mortality. Community-based networks of care developed and endorsed by people who use drugs demonstrate a beneficial impact on health outcomes and the reduction of harm, morbidity, and mortality. In contrast, clinical health and medical services are seen as a risk environment by people marginalized by drug use, which demonstrates ineffective patterns of access and results in poor health outcomes. There must be a paradigm shift within clinical health and medical services to overcome structural barriers and stigma embedded in care settings in proximity to drug use. Educational and reflective offerings that integrate health practices increase capacity and offset bias and the marginalization of drug use in care settings. Through an educational module based on Madeleine Leininger’s Theory of Culture Care Diversity and Universality, caregivers across a major metropolitan area of the Midwest will increase their capacity to have dialogue and information sharing with people who use drugs. The goal of the module is to increase knowledge and comfort levels in initiating and engaging in open conversations with people marginalized by drug use about the conditions and healthways in which individual episodes of drug use occur. Feedback through pre and post surveys is collected, and responses are made available to attendees for reflection and future learning. People marginalized by drug use must receive more integrated care in clinical health and medical settings to advance their health and wellness and prolong life.


SC 11.MAN.2024.Keaveny.S