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Table 3 Included studies (n = 35) and associated interventions (n = 29) by year of publication

From: Implementation science and stigma reduction interventions in low- and middle-income countries: a systematic review

Study Intervention
First Author Citation Year Design Study Type Imp. Stage Study Population Imp. Outcome(s) Imp. Outcome Score Other Outcome(s) Key Findings Description Name Country Stigmatizing Condition TIDieR Score
el-Setouhy [43] 2003 CS; PPwoC Type 1 Pi Co Ac 40% S Children liked the comic book and its contents and found this book easy to understand Comic book for Egyptian schoolchildren n/s Egypt LF 55%
Norr [44] 2004 Qual; PPwC Eff Pi Co Su 0% S O Leaders continued to offer intervention post-funding Peer group intervention n/s Botswana HIV; STDs 64%
Witter [45] 2004 Qual; Econ Type 1 Sc Co Pa Ac Ad C Fe Su 20% S H O Acceptable and effective tool with low costs, though participants still cannot bear cost; hard to keep momentum and extend coverage Book of family background, memories, hopes Memory Book Uganda HIV 55%
Lawoyin [46] 2007 Qual; PPwoC Type 1 Pi Co Ac 20% S Satisfaction with content and appreciation for social support Life skills education n/s Nigeria HIV 64%
Boulay [47] 2008 CS Type 1 Sc Co Pe 50% S 51% of men and 53% of women recalled hearing or seeing the slogan; broadcast media reached the greatest number of men and women Mass media, promotional materials, training for local religious leaders Reach Out, Show Compassion Ghana HIV 55%
Finkelstein [48] 2008 Qual; iRCT Type 1 Pi Co Ac Fe 40% S Students liked how program worked; none had problems operating the program Content, user interface, and learning process could be improved Anti-stigma computer program and print materials Computer Assisted Education system Russia MH 36%
Khumalo-Sakutukwa [49] 2008 cRCT; QI/QA Type 1 Pi Co Pr Fi Pe 40% SD 4-fold increase in testing in intervention vs. control communities; 95% adherence to intervention Community mobilization, community HIV voluntary counselling and testing, and post-test support services Project Accept Tanzania, Zimbabwe, South Africa, Thailand HIV 91%
Lapinski [50] 2008 Qual; CS; iRCT Type 1 Pi Co Ac Ap 40% S SD Enjoyment was high and men and women did not differ in their enjoyment of the film or perception of credibility Film Starting Over Nigeria HIV 55%
Pappas-DeLuca [51] 2008 CS Type 1 Sc Co Pe 75% S SD O Nearly one half reported listening each week, 15% for 1 year or longer, and 19% talking to someone about Makgabaneng in past 3 months Serial radio drama Makgabaneng Botswana HIV 64%
Zeelen [52] 2010 Qual Imp Pi Pa Pr Ac Fe 25%   Storytelling seen as useful; some listeners distracted by other people; some had to see provider and missed story message Clinic waiting room storytelling n/s South Africa HIV 55%
Gurnani [53] 2011 M&E Imp Sc Co Po Pe 50% SD O Increase in FSW population reached from 40% to 85%; 61.5% of police force received training; crisis management teams supported 92% of rights violations in redress Advocacy, legal empowerment, police and media sensitization n/s India HIV 45%
Watt [54] 2011 Qual Type 1 Pi Co Pa Ac Fi 60% S SD H O Patients judged usefulness 4.76 out of 5; intervention was delivered as intended in the manual – all 20 sectionscovered in each session Support group for antiretroviral therapy patients Zinduka Tanzania HIV 64%
Denison [55] 2012 CS; Econ Type 1 Sc Co C 60% S O Total annual cost of US $501,516; average annual cost per school of US $8222; Adolescent Sexual and Reproductive Health Life Skills Education pillar had highest cost (US $2197) Volunteer peer educators, youth resource center, extracurricular activities, community events, teacher training School HIV/AIDS Education Program Zambia HIV 64%
Rice [56] 2012 cRCT Type 1 Pi Co Pe 100% S O Rise in communication about intervention messages in the intervention Chinese markets was at first moderate and then substantial Training market vendors, community-popular opinion leaders n/s China HIV; STDs 64%
Al-Iryani [57] 2013 Qual Type 1 Pi Co Pr Po Ac Fe 60% SD 76.6% of students considered intervention beneficial; program was acceptable because it was framed as ‘life skills’, did not take away from academics, and was supported by school staff School peer education program n/s Yemen HIV 73%
Catalani [58] 2013 Qual; PPwoC Type 1 Pi Co Ac 75% S Storyline seemed believable and possible; participants responded positively to each medium Film Prarambha India HIV 64%
Li [59] 2013 cRCT Type 1 Pi Pr Ac 20%   Approach accepted by providers; messages were relevant to provider self-interests Training providers as popular opinion leaders n/s China HIV 73%
Li [60] 2013 cRCT Type 1 Pi Pr Fe 0% S Intervention appropriately covered key issues relevant to provider daily practice
Murray [61] 2013 Qual; PPwoC Type 1 Pi Co Pa Pr Po Ap 100% SD H Preference for treatment that serves both children and adolescents; treatment that addressed traumatic grief; cross-cultural appropriateness and/or flexibility to adapt; and evidence of effectiveness Psychosocial therapy for orphans and vulnerable children Trauma-Focused Cognitive Behavioral Therapy Zambia MH 100%
Murray [62] 2013 QI/QA; PPwoC Type 1 Pi Pa Fi 40% S SD H Treatment conducted with fidelity due to close monitoring built into Apprenticeship model
Murray [63] 2014 Qual Type 1 Pi Co Pa Pr Ac Fe 75%   Counselors liked structure and flexibility, reported positive changes in clients, and discussed cultural adaptation around activities and language; children and caregivers stated positive changes attributed to trauma-focused cognitive behavioral therapy
French [64] 2014 Qual Type 1 Pi Co Pa Ac 75% S Taking on projects was difficult but empowering Training people living with HIV and peers to conduct community projects n/s South Africa HIV 55%
French [65] 2015 Qual Type 1 Pi Co Pa Ac Fe 20% S Some struggled with their projects; many found projects challenging and exhausting, yet interesting and exciting
Shah [66] 2014 PPwC Type 1 Pi Co Ac Fe 60% S Both sessions rated highly; few participants said materials made them uncomfortable; most felt that they could be honest about their beliefs and behaviors Stigma reduction curriculum for nurses n/s India HIV 64%
Lusli [67] 2015 Qual Type 1 Pi Pr Ap Fe 50% SD Effective communication skills were important; physically disabled counsellors had challenges making contact and providing counselling; distance between clients was challenging Rights-based counselling of people with leprosy by peer and lay counsellors Stigma Assessment and Reduction of Impact: Counselling Indonesia Lepr. 73%
Lusli [68] 2016 Qual; cRCT Type 1 Pi Co Pa Ac Fe 50% S SD O Participants appreciated counselling; counsellors needed intense supervision; not easy to manage client conditions and characteristics; peer counselors were preferred; family counselling preferred overall, but integrating family, individual, and group counselling was best approach
Peters [69] 2015 Qual; cRCT Type 1 Pi Co Fe 0% S SD Challenges related to convincing key of value of contact event, logistics (weak audio system, inappropriate venue, too many people and limited time), audience (tired, less involved), and Stigma Assessment and Reduction of Impact team (cancelations, delayed) Contact events using testimonies, participatory videos, and comics Stigma Assessment and Reduction of Impact: Contact and Video Indonesia Lepr. 64%
Peters [70] 2016 Qual Type 1 Pi Pa Ac Ap Fe 25% S Support of video process; some participants had physical limitations and needed additional technical training in videography
Salmen [71] 2015 Qual Type 1 Pi Co Pa Ac 50% S O Participants found testimonials and role-modeling to be encouraging and gave them courage to disclose, though some concerns about group testing and disclosure process were expressed Microclinic of neighbors, relatives, and friends trained to provide psychosocial, nutritional, and adherence support n/s Kenya HIV 64%
Figueroa [72] 2016 CS Type 1 Sc Co Pe 50% S O Almost two-thirds (63%) of the control group said that they had heard of TT; exposure to TT was higher among those in the intervention group Facilitated community dialogues and radio magazines Tchova Tchova Histórias de Vida: Diálogos Comunitários Mozambique HIV 55%
Tekle-Haimanot [73] 2016 Qual; PPwoC Type 1 Pi Pr Ap 60% S Providers suggested comic be distributed among school children and felt it was easy to read and understand, well presented and illustrated for a non-medical person Comic book for Ethiopian schoolchildren We’ll Make It Ethiopia Epil. 55%
Tora [74] 2016 Qual Type 1 Pi Co Pa Fi 0% S O Weaknesses observed during training and household education sessions; some educators provided superficial presentations, improper use of supplementary examples, and incomplete messages Lay health educator-delivered educational modules and booster sessions Inherited susceptibility education module Ethiopia Pod. 82%
Wilson [75] 2016 Qual; PPwoC Type 1 Pi Co Pa Pr Ac Fe 50% H O DVD players did not have high volume; few electrical outlets; participants identified with the Salvadorian patients and understood video content; short duration of video not disruptive to TB clinic schedules Educational video n/s El Salvador TB 64%
Lyons [76] 2017 CS; Coh Type 1 Pi Co Ac Fe 40% S H 63.9% of MSM and 82.5% of FSW agreed that the workshops were effective in addressing stigma; 68.0% of MSM and 81.6% of FSW self-reported that the workshops helped them think about how to cope with stigma Peer-led group sessions, training health workers, and web-based referral system n/s Senegal HIV 64%
Oduguwa [77] 2017 PPwC Type 1 Pi Co Ac 40% O Most participants liked the program because it increased their awareness about mental illness; some noted that hearing about mental illness created fear; majority affirmed that the program benefited them, the school, and the family Mental health awareness training n/s Nigeria MH 64%
  1. Designs: CS cross-sectional, Coh cohort, M&E monitoring and evaluation, PPwC non-randomized pre/post study with control, PPwoC non-randomized pre/post study without control, iRCT individual randomized controlled trial, cRCT cluster randomized controlled trial, Qual qualitative, QI/QA quality improvement/quality assurance
  2. Study types: Eff effectiveness, Type 1 type 1 hybrid effectiveness-implementation, Imp implementation
  3. Implementation stages: Pi pilot/once-off implementation, Sc sustained implementation at scale
  4. Study populations: Co community members, Pa patients, Pr providers, Po policy-makers
  5. Implementation outcomes: Ac acceptability, Ap appropriateness, Ad adoption, C costs, Fe feasibility, Fi fidelity, P penetration, S sustainability
  6. Other outcomes: S stigma, SD service delivery, H patient health, O other outcome
  7. Stigmatizing conditions: Epil epilepsy, Lepr leprosy, LF lymphatic filariasis, MH mental health, Pod podoconiosis, STD sexually transmitted disease, TB tuberculosis
  8. FSW female sex worker, MSM men who have sex with men, n/s not specified, TT Tchova Tchova Histórias de Vida