Reducing depression stigma using a web-based program

OBJECTIVE This study was designed to investigate the efficacy and feasibility of a web-based depression stigma education tool for healthcare professionals. METHODS A web-based depression stigma program utilizing adult learning theories was developed. Forty-two consecutive subjects were enrolled from University of Maryland staff and graduate students. Primary outcomes were Bogardus Social Distance Scale with a vignette on major depression disorder (BSDS-MDD) and the Depression Stigma Scale (DSS) administered before and after the intervention. RESULTS Internet-based education significantly decreased the level of depression stigma (BSDS-MDD 10.6+/-4.4 versus 7.2+/-4.4, p<0.001; DSS-personal 12.7+/-7.2 versus 7.8+/-5.3, p<0.001; DSS-perceived 21.7+/-5.5 versus 12.4+/-5.5, p<0.001). After the educational intervention the subjects' knowledge about depression significantly improved (pre-test DKS=18.2+/-8.2 versus post-test DKS=20.6+/-4.1, p<0.001). The program was very well accepted by participants. For 100% of participants, it was not difficult to operate the program. CONCLUSIONS Computer-assisted education was effective in reducing the stigma of depression and increasing knowledge about depressive disorder. A web-based intervention has the potential to be used for educating graduate students and university staff about depression and for reducing depression stigmata. Healthcare professionals interacting with people with stigmatizing conditions can benefit from web-based computer education.

[1]  John R. Anderson,et al.  Cognitive principles in the design of computer tutors , 1984 .

[2]  B. Skinner.  The science of learning and the art of teaching. , 1954 .

[3]  U Hegerl,et al.  Public Attitudes Towards Treatment of Depression: Effects of an Information Campaign , 2003, Pharmacopsychiatry.

[4]  J. Finkelstein,et al.  Feasibility of computer-assisted education in patients with multiple sclerosis , 2004 .

[5]  Graham R. Gibbs,et al.  Analyzing Qualitative Data , 2014 .

[6]  Gerhard Falk,et al.  Stigma: How We Treat Outsiders , 2001 .

[7]  Herbert Matschinger,et al.  Public beliefs about schizophrenia and depression: similarities and differences , 2003, Social Psychiatry and Psychiatric Epidemiology.

[8]  B. Skinner,et al.  Principles of Behavior , 1944 .

[9]  Tracey A Davenport,et al.  Monitoring awareness of and attitudes to depression in Australia , 2002, The Medical journal of Australia.

[10]  M. Dew,et al.  Factors affecting help-seeking during depression in a community sample. , 1988, Journal of affective disorders.

[11]  R. Spitzer,et al.  The PHQ-9 , 2001, Journal of General Internal Medicine.

[12]  Joseph Finkelstein,et al.  Testing the Usability of Two Automated Home-Based Patient-Management Systems , 2004, Journal of Medical Systems.

[13]  R G Priest,et al.  Lay people's attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch , 1996, BMJ.

[14]  Roberta M. Volpe,et al.  Multimedia system based on programmed instruction in medical genetics: construction and evaluation , 1998, Int. J. Medical Informatics.

[15]  G. L. Allan,et al.  The implementation of an integrated on-line health education system at RMIT , 1998, Int. J. Medical Informatics.

[16]  John R. Anderson.  The Architecture of Cognition , 1983 .

[17]  Anthony F. Jorm,et al.  Public Beliefs About the Helpfulness of Interventions for Depression: Effects on Actions Taken When Experiencing Anxiety and Depression Symptoms , 2000 .

[18]  Kathleen M Griffiths,et al.  Effect of web-based depression literacy and cognitive–behavioural therapy interventions on stigmatising attitudes to depression , 2004, British Journal of Psychiatry.

[19]  John Sweller,et al.  Cognitive Load During Problem Solving: Effects on Learning , 1988, Cogn. Sci..

[20]  Bruce G. Link,et al.  Reconsidering the social rejection of ex-mental patients: Levels of attitudinal response , 1983, American journal of community psychology.

[21]  Kathleen M Griffiths,et al.  The impact of beyondblue: the national depression initiative on the Australian public's recognition of depression and beliefs about treatments. , 2005, The Australian and New Zealand journal of psychiatry.

[22]  R D Goldney,et al.  Mental health literacy: an impediment to the optimum treatment of major depression in the community. , 2001, Journal of affective disorders.

[23]  G. Hripcsak,et al.  Internet-based home asthma telemonitoring: can patients handle the technology? , 2000, Chest.

[24]  G. Alexopoulos,et al.  Stigma as a barrier to recovery: Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. , 2001, Psychiatric services.

[25]  G Wickström,et al.  The "Hawthorne effect"--what did the original Hawthorne studies actually show? , 2000, Scandinavian journal of work, environment & health.

[26]  Peter Byrne,et al.  Stigma of mental illness and ways of diminishing it , 2000 .

[27]  Joseph Finkelstein,et al.  CO-ED: a development platform for interactive patient education , 2002, International Conference on Computers in Education, 2002. Proceedings..

[28]  K R Dobbin,et al.  Applying learning theories to develop teaching strategies for the critical care nurse. Don't limit yourself to the formal classroom lecture. , 2001, Critical care nursing clinics of North America.

[29]  Olga V. Demler,et al.  The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). , 2003, JAMA.

[30]  L. Spencer,et al.  Qualitative data analysis for applied policy research , 2002 .

[31]  R G Priest,et al.  Changes in public attitudes to depression during the Defeat Depression Campaign , 1998, British Journal of Psychiatry.

[32]  Sylvia Pelayo,et al.  Comparative evaluation of two applications for delivering a multimedia medical course in the French-speaking Virtual Medical University (UMVF) , 2005, Int. J. Medical Informatics.

[33]  M. Ray,et al.  Designing Tailored Web-Based Instruction to Improve Practicing Physicians' Preventive Practices , 2003, Journal of medical Internet research.

[34]  P. Farmer,et al.  Reducing psychiatric stigma and discrimination , 2003, Social Psychiatry and Psychiatric Epidemiology.

[35]  F. W. Denny,et al.  Computer instruction in learning concepts of streptococcal pharyngitis. , 1996, Archives of pediatrics & adolescent medicine.

[36]  R Haghighat,et al.  A unitary theory of stigmatisation: Pursuit of self-interest and routes to destigmatisation , 2001, British Journal of Psychiatry.

[37]  Graham Thornicroft,et al.  Reducing psychiatric stigma and discrimination: evaluation of educational interventions in UK secondary schools , 2003, British Journal of Psychiatry.

[38]  J. Coyne,et al.  Prevalence, nature, and comorbidity of depressive disorders in primary care. , 1994, General hospital psychiatry.

[39]  Daniel Sigulem,et al.  Web-based learning in undergraduate medical education: development and assessment of an online course on experimental surgery , 2004, Int. J. Medical Informatics.

[40]  A. Korten,et al.  “Mental health literacy”: a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment , 1997, The Medical journal of Australia.

[41]  H Orn,et al.  Help-Seeking for Psychiatric Disorders , 1997, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[42]  Goro Tanaka,et al.  Effects of an educational program on public attitudes towards mental illness , 2003, Psychiatry and clinical neurosciences.

[43]  D Nicholas,et al.  Health information: an evaluation of the use of touch screen kiosks in two hospitals. , 2001, Health information and libraries journal.

[44]  Reinhold Haux,et al.  Web-based training: a new paradigm in computer-assisted instruction in medicine , 1999, Int. J. Medical Informatics.