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Table 3 Interventions used across conditions to address public stigma (attitudes and behavior)

From: Out of the silos: identifying cross-cutting features of health-related stigma to advance measurement and intervention

Author Country Condition Target group N Evidence of effectiveness Comments
Information-based approaches
Masuda et al. [107] USA Psychological disorders College students 95 (43 + 52) The CAMI scores for the educational workshop lowered at post-intervention and 1-month follow-up among participants with higher levels of psychological flexibility (scored 67 or higher on the Acceptance and Action Questionnaire) CAMI administered at beginning and end of workshop, and at 1-month follow-up
Boulay et al. [108] Ghana HIV General public 2746, 2926 Attitudes related to a punitive response to PLHA both improved over time and were positively associated with exposure to the program’s campaign; overall, respondents exposed to the campaign were 45% more likely than those not exposed to be willing to care for a HIV-infected relative, and 43% more likely to believe that an HIV-infected female teacher should be allowed to continue teaching  
Peters et al. [109] Indonesia Leprosy Community in an endemic district 213 and 375 Knowledge about leprosy increased and that negative attitudes reduced significantly; at baseline, 87% considered leprosy curable and 31% thought leprosy was still contagious after treatment; this had improved after the contact event to 98% and 7%, respectively Post-intervention result measured after 3 months
Contact
Peters et al. [109] Indonesia Leprosy Community in an endemic district 213 and 375 The EMIC and SDS stigma scores reduced both among those attending ‘contact events’ (effect sizes 0.75 and 0.81, respectively) and in the wider community (effect size 0.47 and 0.54) Contact was through testimonies on video plus a live testimony given at ‘contact events’ with community groups; post-intervention results were measured on average 1–1.5 years after the contact events
Corrigan et al. [110] USA Mental illness College students 257 Participants in the contact intervention group showed significant reduction in avoidance and segregation factors with the Attribution Questionnaire at post-intervention and 1-week follow-up; participants in contact condition also showed significant reduction in pity and improvement in power from pre- to post-intervention Contact through video was used; measures administered pre-test, post-test, 1-week follow-up
Paxton [137] ? HIV Young people 1230 HIV-positive speakers were effective in decreasing fear and stigmatization among the audience; meeting HIV-positive people decreased fear and prejudice, reinforced messages about protective behavior and increased the belief that HIV is preventable; the improved attitudes remained significant over 3 months  
Uys et al. [71] Lesotho, Malawi, South Africa, Swaziland, Tanzania HIV Nurses
PLHA
41 PLHA
134 nurses
PLHA involved in the intervention teams reported less stigma and increased self-esteem; nurses in the intervention teams and those in the target group reported no reduction in stigma or increases in self-esteem and self-efficacy, but their HIV testing behavior increased significantly A pre- and post-test was done to measure stigma, self-esteem and self-efficacy; the post-test was conducted within 1 month after the intervention
Yiu et al. [111] Hong Kong HIV Nursing students 89 In both the knowledge-only group and the knowledge-contact group, significant improvement in AIDS knowledge, stigmatizing attitudes, fear of contagion, willingness to treat, and negative affect were found at post-test; the effects on AIDS knowledge, fear of contagion, willingness to treat, and negative affect were sustained at follow-up for both groups
Intergroup comparisons at post-test showed that the effectiveness of the knowledge-contact program was significantly greater than the knowledge program in improving stigmatizing attitudes; no significant difference between the two groups was found at follow-up
 
Change agents/ Popular opinion leaders
Kelly et al. [114] USA HIV Gay men 8 cities In the four intervention cities a statistically significant reduction was found in the mean frequency of unprotected anal intercourse during the previous 2 months and a significant increase in the mean percentage of occasions of anal intercourse protected by condoms  
Cross & Choudhury [76] Nepal Leprosy Community 152 SHG participants The Stigma Elimination Programme had a significant impact at community level and is recognized as a positive force by district level officials of Her Majesty’s Government of Nepal; as direct effects of SHG activity, 1060 people have had some basic education, many people now have access to clean water, some have the benefits of improved sanitation and others have improved physical access to amenities, over 200 people are now generating income from their own micro enterprises  
Young et al. [77] Peru HIV Community 1327 POL, 1722 comparison HIV-related stigma significantly reduced from baseline to 12-month follow-up and from baseline to 24-month follow-up among participants in the POL intervention 5 stigma items assessed at baseline, 12-month, and 24-month follow-up
Li et al. [78] China HIV Healthcare workers 1750 POL Reduced prejudicial attitudes (estimated difference = – 2.40; p < 0.001), reduced avoidance intent towards people living with HIV (estimated difference = – 1.10; p < 0.001), and increased institutional support in the hospitals (estimated difference = 0.39; p = 0.003) at 6 months after controlling for service providers’ background factors and clinic-level characteristics The intervention effects (6 months) were sustained and strengthened at 12 months
  1. CAMI Community Attitudes toward the Mentally Ill, EMIC Explanatory Model Interview Catalogue, POL popular opinion leaders, PLHA people living with HIV and AIDS, SDS Social Distance Scale, SHG self-help group