Recorded versus live social contact interventions to reduce stigma: randomised controlled trial

Background/Objectives: Social contact is known to reduce stigma and social contact-based interventions are being increasingly used in anti-stigma programmes in mental health. Recorded interventions, such as audiovisual DVDs, may act as an indirect form of social contact and may have practical and cost advantages, but little is known about their effectiveness. To compare the effectiveness of a DVD and a live mental health service user intervention and a lecture control, in reducing stigma. We hypothesised that: (i) there will be no difference between the DVD (indirect social contact with people affected by mental illness) and live (direct social contact) delivery modes; and (ii) the interventions with some form of social contact (DVD or live) will be more effective than a control with no social contact (lecture). Methods: Student nurses in their university foundation year were randomly allocated to (i) watch a DVD recording of service users and carers talking about their experiences, (ii) hear a live presentation by a service user and carer, or (iii) attend a lecture on mental health awareness and stigma. Outcomes were measured post-session and at four months follow-up. The primary outcome was stigmatising attitudes (Mental Illness Clinicians’ Attitudes scale, MICA). Secondary stigma-related outcomes were: emotional reactions to people with mental illness (Emotional Reactions to Mental Illness Scale, ERMIS), intended social proximity (Reported and Intended Behaviour Scale, RIBS), knowledge (Social Contact Interventions Leaning Outcomes scale, SCILO), and intended disclosure and intended healthcare seeking (two items only measured at follow up). Participants’ views, process variables and cost comparisons were also assessed. Two sets of comparisons were made following our hypotheses: (1) DVD versus live and (2) social contact with people affected by mental illness (indirect or direct i.e. DVD or live) versus no social contact (lecture). Results: 360 participants were randomised and 216 attended the interventions. Post-session data were collected for all participants and the response rate at four months follow-up was 89% (193/216). Results will be presented on the effectiveness of the interventions, on cost comparisons, on process variables, and on participants’ views. Discussion/Conclusions: The implications of the study findings for decisions about which strategies to use in anti-stigma programmes will be discussed. We will also identify the remaining evidence gaps and make recommendations for future research. Funding: This presentation presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (grant no. RP-PG-0606–1053). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Keywords: Discrimination, social contact, DVD.