Bitta Mary A, Baariu Judy, Grassi Simone, Kariuki Symon M, Lennox Belinda, Newton Charles R J C
Clinical Research-Neurosciences, KEMRI/Wellcome Trust Research Program, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya; and Department of Psychiatry, University of Oxford, Oxford, UK.
Clinical Research-Neurosciences, KEMRI/Wellcome Trust Research Program, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya.
BJPsych Open. 2023 Nov 13;9(6):e215. doi: 10.1192/bjo.2023.587.
Globally, stigma associated with mental, neurological and substance use (MNS) disorders is rampant and a barrier to good health and overall well-being of people with these conditions. Person-centred digital approaches such as participatory video may reduce stigma, but evidence on their effectiveness in Africa is absent.
To evaluate the effectiveness of participatory video in reducing mental health-related stigma in a resource-limited setting.
We evaluated the effectiveness of using participatory video and face-to-face interaction between people with MNS disorders and a target audience in lowering stigma among 420 people living in Kilifi, Kenya. Changes in knowledge, attitudes and behaviour (KAB) were measured by comparing baseline scores with scores immediately after watching the participatory videos and 4 months after the intervention. Sociodemographic correlates of stigma scores were examined using multivariable linear regression models.
Compared with baseline, KAB scores significantly improved at both time points, suggesting reduced stigma levels. At 4 months, the changes in scores were: knowledge (β = 0.20, 95% CI 0.16-0.25; < 0.01), liberal attitude (β = 1.08, 95% CI 0.98-1.17; < 0.01), sympathetic attitude (β = 0.52, 95% CI 0.42-0.62; < 0.01), tolerant attitude (β = 0.72, 95% CI 0.61-0.83; < 0.01) and behaviour (β = 0.37, 95% CI 0.31-0.43; < 0.01). Sociodemographic variables were significantly correlated with KAB scores; the correlations were not consistent across the domains.
Participatory video is a feasible and effective strategy in improving knowledge, attitudes and intended behaviour in a resource-limited setting. Further studies are required to understand the mechanisms through which it lowers stigma and to examine long-term sustainability and the effectiveness of multicomponent interventions.
在全球范围内，与精神、神经和物质使用（MNS）障碍相关的污名化现象猖獗，是影响患有这些疾病的人的健康和整体幸福感的障碍。以个人为中心的数字方法，如参与式视频，可能会减少污名化，但在非洲缺乏关于其有效性的证据。
评估参与式视频在资源有限的环境中减少与心理健康相关的污名化的有效性。
我们评估了使用参与式视频以及MNS障碍患者与目标受众之间的面对面互动，对肯尼亚基利菲420名居民中降低污名化的效果。通过比较基线分数与观看参与式视频后立即以及干预后4个月的分数，来衡量知识、态度和行为（KAB）的变化。使用多变量线性回归模型检查污名分数的社会人口统计学相关因素。
与基线相比，两个时间点的KAB分数均显著提高，表明污名化水平降低。在4个月时，分数变化为：知识（β = 0.20，95%可信区间0.16 - 0.25；<0.01）、开明态度（β = 1.08，95%可信区间0.98 - 1.17；<0.01）、同情态度（β = 0.52，95%可信区间0.42 - 0.62；<0.01）、宽容态度（β = 0.72，95%可信区间0.61 - 0.83；<0.01）和行为（β = 0.37，95%可信区间0.31 - 0.43；<0.01）。社会人口统计学变量与KAB分数显著相关；各领域的相关性不一致。
参与式视频是在资源有限的环境中改善知识、态度和预期行为的可行且有效策略。需要进一步研究以了解其降低污名化的机制，并检验多成分干预措施的长期可持续性和有效性。
