Randomized study of different anti-stigma media.

OBJECTIVE We designed our study to assess if computer-assisted anti-stigma interventions can be effective in reducing the level of psychiatric stigma in a sample of special education university students. METHODS We enrolled 193 graduate students. They had two study visits with an interval of 6 months. The participants were randomly distributed into three study groups: 76 students read anti-stigma printed materials (reading group, RG), and 69 studied an anti-stigma computer program (program group, PG), and 48 students were in a control group (CG) and received no intervention. We used the Bogardus scale of social distance (BSSD), the community attitudes toward the mentally ill (CAMI) questionnaire, and the psychiatric knowledge survey (PKS) as the main outcome measures. RESULTS After the intervention BSSD, CAMI and PKS scores significantly improved both in RG and PG. After 6 months in RG two out of three CAMI subscales and PKS scores were not different from the baseline. In PG all stigma and knowledge changes remained significant. CONCLUSIONS This study demonstrated that computers can be an effective mean in changing attitudes of students toward psychiatric patients. PRACTICE IMPLICATIONS A computer-mediated intervention has the potential for educating graduate students about mental disease and for reducing psychiatric stigma.

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

[2]  Bruce G. Link,et al.  Measuring mental illness stigma. , 2004, Schizophrenia bulletin.

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

[4]  M. Sprangers,et al.  Exploring the black box of a decision aid: what information do patients select from an interactive Cd-Rom on treatment options in breast cancer? , 2007, Patient education and counseling.

[5]  Joseph Finkelstein,et al.  Introducing Handheld Computing for Interactive Patient Education , 2002, AMIA.

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

[7]  G H Guyatt,et al.  Intention-to-treat principle. , 2001, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[8]  W. Rössler,et al.  Do mental health professionals stigmatize their patients? , 2006, Acta psychiatrica Scandinavica. Supplementum.

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

[10]  G. Thornicroft,et al.  Discrimination in health care against people with mental illness , 2007, International review of psychiatry.

[11]  Patrick W. Corrigan,et al.  Will Filmed Presentations of Education and Contact Diminish Mental Illness Stigma? , 2007, Community Mental Health Journal.

[12]  S. Lawrie Stigmatisation of psychiatric disorder , 1999 .

[13]  Mustafa Ozkan,et al.  Effects of an antistigma program on medical students’ attitudes towards people with schizophrenia , 2006, Psychiatry and clinical neurosciences.

[14]  M J Dear,et al.  Scaling community attitudes toward the mentally ill. , 1981, Schizophrenia bulletin.

[15]  Fred Ferguson Interactive Web technology provides significant advantages in oral health education. , 2006, School nurse news.

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

[17]  Richard A. Van Dorn,et al.  Treatment engagement and violence risk in mental disorders , 2006, British Journal of Psychiatry.

[18]  T. Tsuda,et al.  Effects of a one‐hour educational program on medical students' attitudes to mental illness , 2001, Psychiatry and clinical neurosciences.

[19]  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.

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

[21]  Anthony F Jorm,et al.  Mental health literacy , 2000, British Journal of Psychiatry.

[22]  R. H. Franke,et al.  The Hawthorne experiments: First statistical interpretation. , 1978 .

[23]  P. Corrigan,et al.  EXAMINING TWO ASPECTS OF CONTACT ON THE STIGMA OF MENTAL ILLNESS , 2004 .

[24]  W. Bria,et al.  Influence of an Interactive Computer-Based Inhaler Technique Tutorial on Patient Knowledge and Inhaler Technique , 2007, The Annals of pharmacotherapy.

[25]  K. Chung Changing the Attitudes of Hong Kong Medical Students Toward People With Mental Illness , 2005, The Journal of nervous and mental disease.

[26]  J. Finkelstein The Feasibility and Patient Acceptance of Computer-assisted Asthma Education in the Emergency Department , 2003 .

[27]  Websites as a mode of delivering mental health information: perceptions from the Australian public , 2007, Social Psychiatry and Psychiatric Epidemiology.

[28]  Joseph Finkelstein,et al.  Acceptance of Telemanagement is High in Patients With Inflammatory Bowel Disease , 2006, Journal of clinical gastroenterology.

[29]  Joseph Finkelstein,et al.  Reducing depression stigma using a web-based program , 2007, Int. J. Medical Informatics.

[30]  H. Christensen,et al.  Effects of a Cognitive‐Behavioural Internet Program on Depression, Vulnerability to Depression and Stigma in Adolescent Males: A School‐Based Controlled Trial , 2006, Cognitive behaviour therapy.

[31]  H. Soygür,et al.  The impact of antistigma education on the attitudes of general practitioners regarding schizophrenia * , 2006, Psychiatry and clinical neurosciences.

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

[33]  A. Gumley,et al.  Young people with intellectual disabilities attending mainstream and segregated schooling: perceived stigma, social comparison and future aspirations. , 2006, Journal of intellectual disability research : JIDR.

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

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

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

[37]  H. Fabrega Does a Clerkship Affect Students' Views of Psychiatric Patients? , 1995, The Journal of nervous and mental disease.

[38]  R. Jones,et al.  Labels and Stigma in Special Education , 1972, Exceptional children.

[39]  A. Korten,et al.  Attitudes Towards People with a Mental Disorder: A Survey of the Australian Public and Health Professionals , 1999, The Australian and New Zealand journal of psychiatry.

[40]  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.

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

[42]  B. Zalar,et al.  Psychiatric Education: Does It Affect Stigma? , 2007, Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry.

[43]  C. Winters Learning disabilities, crime, delinquency, and special education placement. , 1997, Adolescence.

[44]  G. Vaughan,et al.  ‘Like Minds, Like Mine’: A New Zealand Project to Counter the Stigma and Discrimination Associated with Mental Illness , 2004 .

[45]  Joseph Finkelstein,et al.  A Comparison of Two Models of Web-based Education in Older Adults , 2005, AMIA.

[46]  P. Corrigan,et al.  Changing mental illness stigma as it exists in the real world , 2007 .

[47]  P W Corrigan,et al.  Familiarity with and social distance from people who have serious mental illness. , 2001, Psychiatric services.

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

[49]  Joseph Finkelstein,et al.  Feasibility of Computer-Assisted Tai Chi Education , 2005, AMIA.

[50]  J. Coid Dangerous patients with mental illness: increased risks warrant new policies, adequate resources, and appropriate legislation , 1996, BMJ.