Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Amsterdam, The Netherlands.
Research and Development Department, War Child, Amsterdam, The Netherlands.
PLoS One. 2023 Oct 31;18(10):e0292064. doi: 10.1371/journal.pone.0292064. eCollection 2023.
Stigmatisation impedes health and quality of life. Evidence regarding stigma reduction interventions is, albeit growing, limited. There is a gap in the availability and evidence of interventions for reducing stigma among children and adolescents, especially in low- and middle-income countries. This paper describes the process that led to a stigma reduction intervention impacting children and adolescents in low- and middle-income countries, following previously conducted formative research.
In this study, we conducted (i) online stakeholder consultations (FGD) (n = 43), including a survey assessing intervention acceptability, appropriateness, feasibility and scalability (n = 16); and (ii) preliminary field-testing of intervention content online and in a refugee settlement in Uganda.
Stakeholder consultation showed the initial version of STRETCH (Stigma Reduction to Trigger Change for Children), albeit positively received, required adaptations. We made adjustments to i) take into account implementation duration, intervention flexibility and intersectionality; (ii) strengthen the involvement of individuals, including adolescents/youth, with lived stigma experience; (iii) target people close to individuals with lived stigma experience; and (iv) address feasibility and sustainability concerns. Preliminary field-testing simplified STRETCH while adding a community outreach component and revisiting the intervention setup, to ensure STRETCH can also be applied from a modular perspective.
We conducted a process to develop a child-focused multi-component stigma reduction intervention, with intended applicability across stigmas and settings. This paper provides an overview of the intervention development process, generating intervention-specific learnings with generic value. STRETCH aims to reduce stigmatisation at the implementing organisation, create community-wide reflection and stigma reduction demand, and reduce stigmatisation among various target groups.
污名化会影响健康和生活质量。尽管减少污名化的证据在不断增加，但仍然有限。在为儿童和青少年减少污名化提供干预措施方面，尤其是在中低收入国家，存在着可及性和证据方面的差距。本文描述了在先前进行的形成性研究之后，为中低收入国家的儿童和青少年减少污名化而进行的干预措施的制定过程。
在这项研究中，我们进行了（i）在线利益相关者磋商（焦点小组讨论）（n=43），包括一项评估干预措施可接受性、适当性、可行性和可扩展性的调查（n=16）；以及（ii）在乌干达的一个难民营中在线和现场初步测试干预内容。
利益相关者磋商表明，尽管最初版本的 STRETCH（通过减少儿童的污名化来触发改变）得到了积极的反馈，但仍需要进行调整。我们对其进行了调整，以考虑到（i）实施时间、干预灵活性和交叉性；（ii）加强具有污名化经历的个人，包括青少年/年轻人的参与；（iii）针对与具有污名化经历的个人关系密切的人；以及（iv）解决可行性和可持续性问题。初步现场测试简化了 STRETCH，同时增加了社区外联部分，并重新考虑了干预设置，以确保 STRETCH 也可以从模块化的角度进行应用。
我们开展了一个制定以儿童为重点的多组分减少污名化干预措施的过程，旨在在各种污名和环境中具有适用性。本文概述了干预措施的制定过程，产生了具有普遍价值的干预措施特定经验。STRETCH 的目的是减少实施组织的污名化，在社区范围内引起反思和减少污名化需求，并减少各个目标群体的污名化。
