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Table 1 Study and intervention characteristics, stigma drivers, evaluation methods, and quality assessment score

From: Stigma in health facilities: why it matters and how we can change it

First author, publication year, country, health condition Intervention population, sample size Stigma reduction approaches, duration Brief intervention description Stigma drivers targeted Evaluation methods, quality score, effect on stigma
Aggarwal [103], 2013, USA, MI Students, 250 PL, C; 2 h Panel presentation and discussion Attitudes, knowledge of stigma QE/NC, 14/27, decreased
Bamgbade [104], 2017, USA, MI Students, 120 I, PL, C; 2.5 h over 2 days Presentations, videos, discussion and active-learning exercises Attitudes, fear, knowledge of condition, knowledge of stigma QE/NC, 15/27, decreased
Bamgbade [105], 2016, USA, MI Students, 120 I, PL, C; 2.5 h over 2 days Presentations, videos, discussion and active-learning exercises Attitudes, knowledge of condition, knowledge of stigma QE/NC, 16/27, mixed
Batey [74], 2016, USA, HIV HCPs and PLHIV, 38 I, SB, PL, C, E; 1.5 day Workshop HCPs: attitudes, fear, knowledge of stigmaPLHIV: coping QE/NC and qualitative, 13/27, mixed
Beaulieu [106], 2017, Canada, MI HCPs, 111 I, PL, C; 3 3.5-h sessions over 2 months Training modules led by consumer Unclear RCT, 22/27, Mixed
Bingham [107], 2018, New Zealand, MI Students, 45 SB, PL, C; 12 h over 3 weeks Guided clinical practice and discussion focused on attitudes and beliefs Attitudes, fear, ability to manage condition QE/NC, 10/27, mixed
Clarke [71], 2015, UK, MI HCPs, 100 I, SB; 2 days over 2 weeks Workshop Attitudes, knowledge of condition, ability to manage condition RCT and qualitative, 18/27, mixed
Economou [108], 2017, Greece, MI Students, 678 I, SB, C; 120 h over 4 weeks Lectures and clinical placement Knowledge of condition, ability to manage condition, unclear QE/NC, 18/27, decreased
Feeney [65], 2013, Ireland, substance abuse Students, 119 SB, PL, C; 6 weeks Clinic posting, patient presentations, discussion, assignments Knowledge of condition, ability to manage condition RCT and qualitative, 20/27, decreased
Fernandez [66], 2016, Malaysia, MI Students, 102 I, PL, C; 3 h Lecture, video or face-to-face presentation, discussion Fear, knowledge of condition, knowledge of stigma RCT, 17/27, decreased
Flanagan [67], 2016, USA, MI, substance abuse HCPs, 27 C, PL; 1 h Multimedia in-person performance by people living with a mental disorder Fear, knowledge of stigma RCT, 20/27, decreased
Friedrich [109], 2013, England, MI Students, 1452 I, SB, PL, C; n/a Lecture, testimonials, discussion, role-play providing clinical care Knowledge condition, knowledge of stigma, ability to manage condition QE/C, 15/27, mixed
Geibel [75], 2016, Bangladesh, HIV HCPs, 300 I, SB, PL; 3 days Workshop with lectures, discussion, participatory activities, & role-play providing clinical care Attitudes, fear, knowledge of condition, knowledge of stigma, ability to manage condition QE/NC, 15/27, decreased
Gulati [110], 2014, India, MI Students, 135 SB, C; 2 weeks Clinic posting Ability to manage condition Post, with control; 16/27; mixed
Happell [68], 2014, Australia, MI Students, 201 SB, C; 12 weeks Lecture delivered by stigmatized individual Ability to manage condition QE/C, 14/27, decreased
Hawke [89], 2014, Canada, MI HCPs, students, clients, 137 C, PL; 50 min Video performance and discussion Knowledge of the condition QE/NC and qualitative, 15/27, decreased
Iheanacho [111], 2014, Nigeria, MI Students, 82 I, SB, PL; 4 days lLctures, discussions, role-play providing clinical care Knowledge of the condition QE/NC, 15/27, mixed
Itzhaki [112], 2017, Israel, MI Students, 101 I, SB, PL, C; 70 h over academic semester Lectures, contact w/people with mental health disorders, skill building exercised, video on coping Fear, knowledge of condition, ability to manage condition QE/NC, 14/27, decreased
Jarvie [90], 2013, Canada, MI Students, 49 PL, C; 2.5 h Comedy show and discussion Unclear QE/NC, 16/27, mixed
Jaworsky [91], 2016, Canada, MI Students, 67 SB, C; 2 h Observed provision of HIV testing with PLHIV and testimonies Ability to manage condition QE/NC and qualitative, 14/27, decreased
Knaak [58], 2013, Canada, MI HPCs and students, 58 I, PL, C; 2 h Pamphlet, video screening of a play, discussion Knowledge of condition QE/NC, 13/27, decreased
Knaak [69], 2015, Canada, MI HCPs, 230 I, SB, PL, C; 1 day Workshop with lectures, skills training and testimonials Attitudes, knowledge of condition, ability to manage condition QE/NC, 13/27, decreased
Li [61], 2015, China, HIV HCPs, 1760 I, PL, S; 12 months Participatory training of champions from each hospital and provided universal precaution materials Attitudes, fear, knowledge of condition, knowledge of stigma, ability to manage condition RCT, 21/27, decreased
Li [62], 2013, China, HIV HCPs, 1760 I, PL, S; 12 months Participatory training of champions from each hospital and provided universal precaution materials Attitudes, fear, knowledge of condition, knowledge of stigma, ability to manage condition RCT, 22/27, decreased
Li [63], 2013, China, HIV HCPs, 1760 I, PL, S; 12 months Participatory training of champions from each hospital and provision of universal precaution materials Attitudes, fear, knowledge of condition, knowledge of stigma, ability to manage condition RCT, 23/27, decreased
Li [60], 2013, China, HIV HCPs, 1760 I, PL, S; 12 months Participatory training of champions from each hospital and provided universal precaution materials Attitudes, fear, knowledge of condition, knowledge of stigma, ability to manage condition RCT, 24/27, decreased
Li [63], 2013, China, HIV HCPs, 1760 I, PL, S; 12 months Participatory training of champions from each hospital and provided universal precaution materials Attitudes, fear, knowledge of condition, knowledge of stigma, ability to manage condition RCT, 24/27, decreased
Li [61], 2015, China, MI HCPs, 77 I, SB, C; 85 h Lectures, clinical placement, Knowledge of condition, knowledge of stigma, ability to manage condition QE/C, 18/27, decreased
Li [92], 2014, China, MI HCPs, 99 I, PL, C; 1 day Discussion and activities Knowledge of condition, knowledge of stigma QE/NC, 14/27, decreased
Lohiniva [93], 2016, Egypt, MI HCPs, 347 I, SB, PL, C; 25 h over 4 months Lectures, discussions, activities, training on universal precautions Knowledge of condition, fear, knowledge of stigma QE/C, 15/27, decreased
Lyons [113], 2015, Australia, MI Students, 151 baseline, 161 follow-up I, SB, C; 8 weeks Lectures and clinical clerkship Knowledge of condition, ability to manage condition QE/NC, 15/27, decreased
MacCarthy [114], 2013, Canada, MI HCPs, n/a I, SB, PL; 1 day Live or video lectures, discussion, and role-play service provision Knowledge of condition, ability to manage condition QE/NC, 7/27, decreased
Mak [72], 2015, Hong Kong, HIV Students, 88 I, PL, or C; 1.5 h Lecture and interactive game or in-person sharing session lead by PLHIV Attitudes, knowledge of condition, knowledge of stigma QE/NC, 17/27, decreased
Marzan-Rodriquez [115], 2016, Puerto Rico, HIV Students, 20 I, SB, PL; 9 h over 3 days Lectures, discussion, activities Attitudes, knowledge of condition, knowledge of stigma Process and qualitative, n/a
Michaels [116], 2014, USA, MI HCPs, 131 I, PL; 3 h Discussion, activities, video performance Knowledge of condition, knowledge of stigma RCT, 16/27, decreased
Morawska [117], 2013, Australia, MI, substance abuse HPCs, educators, clients, 458 I, SB; 2 days Workshop Knowledge of condition, ability to manage condition QE/NC, 13/27, decreased
Moxam [118], 2016, Australia, MI Students, 79 PL, C; 5 days Immersive camp outside of clinical setting Unclear QE/C, 15/27, decreased
Muzyk [119], 2017, USA, MI Students, 74 I, PL; 6 sessions over 2 weeks Discussion-based lectures with small group activities Attitudes, knowledge of condition, knowledge of stigma QE/NC, 12/27, mixed
Ng [27], 2017, Malaysia, MI HCPs, 206 I, C; 5 min Video Fear, knowledge of condition QE/NC, 17/27, decreased
Odeny [60], 2013, Kenya, HIV PLHIV, 295 S; 12 months Integration of HIV care with primary health care services Institutionalized procedures Repeated cross-sectional surveys, 17/27, mixed
Papish [70], 2013, Canada, MI Students, 90 I, SB, PL, C; 4 weeks Lecture, discussion, observed clinical care provision, videos, presentations Attitudes, knowledge of condition, ability to manage condition RCT, 21/27, decreased
Pulerwitz [64], 2015, Vietnam, HIV Health facility staff, HCPs, 795 I, SB, PL, C; 1.5–2 days Discussion, participatory activities, universal precaution skills building, development of a code of practice Attitudes, fear, knowledge of condition, knowledge of stigma QE/NC, 20/27, decreased
Shah [76], 2014, India, HIV Students, 99 I, PL, C; 2 h over 2 weeks Lectures, discussion, testimony Attitudes, fear, knowledge of condition, knowledge of stigma QE/C and process, 17/27, decreased
Shen [120], 2014, China, MI Students, 325 SB, C; 8 week Clinical clerkship Ability to manage condition QE/C, 14/27, decreased
Uebel [59], 2013, South Africa, HIV HCPs and PLHIV, n/a S; n/a Integration of HIV care into primary health care Institutionalized procedures Process and Qualitative, n/a
Wakeman [121], 2017, USA, substance abuse HCPs, 149 I, S; 1 year Addition of services to improve care for substance abuse and an educational curriculum for providers Knowledge about condition, unclear QE/NC, 15/27, mixed
Winkler [73], 2017, Czech Republic, MI Students, 60 I, PL, C; leaflet: n/a; in-person: 45 min; video: 7 min Brochure, seminar discussion, or video Attitudes, knowledge about condition, knowledge about stigma RCT, 22/27, mixed
  1. Abbreviations: C contact, E empowerment, HCPs health care providers, HIV human immunodeficiency virus, I information-based, MI mental illness, PL participatory learning, PLHIV people living with HIV, QE/C quasi-experimental with a control group, QE/NC quasi-experimental with no control group, RCT randomized controlled trial, S structural, SB skills building; students, students receiving healthcare training