Table 2.
Frequency and Potential Effectiveness of Intervention Types (ITs), Behavior Change Techniques (BCTs), and Mechanisms of Action (MOAs) in 28 studies of HIV-related Stigma Reduction among Health Care Workers and Health Systems in the USAa
| Code # | All studies (N = 28) | Studies with experimental designs (N = 9) | |||||||
| Frequency and percent of studies with each code | Improved outcomes reported (potential effectiveness)b | Frequency and percent of studies with each code | Improved outcomes reported (potential effectiveness)b | ||||||
| n | % | Ratio | (%) | n | % | Ratio | (%) | ||
| Intervention Types (ITs) c | |||||||||
| 1. | Education | 28 | 100.0% | 22/28 | (78.6%) | 9 | 100.0% | 4/9 | (44.4%) |
| 5. | Training | 16 | 57.1% | 12/16 | (75.0%) | 6 | 66.7% | 2/6 | (33.3%) |
| 2. | Persuasion | 11 | 39.3% | 9/11 | (81.8%) | 6 | 66.7% | 4/6 | (66.7%) |
| 8. | Enablement | 10 | 35.7% | 7/10 | (70.0%) | 4 | 44.4% | 1/4 | (25.0%) |
| 9. | Modeling | 6 | 21.4% | 4/6 | (66.7%) | 3 | 33.3% | 1/3 | (33.3%) |
| 7. | Environmental restructuring | 5 | 17.9% | 3/5 | (60.0%) | 2 | 22.2% | 0/2 | (0.0%) |
| 4. | Coercion | 2 | 7.1% | 1/2 | (50.0%) | 1 | 11.1% | 0/1 | |
| Behavior Change Techniques (BCTs) c | |||||||||
| 4.1 | Instruction on how to perform a behavior | 23 | 82.1% | 18/23 | (78.3%) | 7 | 77.8% | 3/7 | (42.9%) |
| 6.1 | Demonstration of the behavior | 19 | 67.9% | 15/19 | (78.9%) | 6 | 66.7% | 3/6 | (50.0%) |
| 5.3 | Information about social and environmental consequences | 15 | 53.6% | 11/15 | (73.3%) | 5 | 55.6% | 2/5 | (40.0%) |
| 9.1 | Credible source | 14 | 50.0% | 13/14 | (92.9%) | 3 | 33.3% | 2/3 | (66.7%) |
| 1.2 | Problem-solving | 12 | 42.9% | 11/12 | (91.7%) | 4 | 44.4% | 2/4 | (50.0%) |
| 8.1 | Behavioral practice/rehearsal | 12 | 42.9% | 12/12 | (100.0%) | 3 | 33.3% | 3/3 | (100.0%) |
| 13.2 | Framing/reframing | 10 | 35.7% | 9/10 | (90.0%) | 3 | 33.3% | 2/3 | (66.7%) |
| 3.1 | Social support (unspecified) | 8 | 28.6% | 5/8 | (62.5%) | 3 | 33.3% | 0/3 | (0.0%) |
| 12.2 | Restructuring the social environment | 8 | 28.6% | 7/8 | (87.5%) | 1 | 11.1% | 0/1 | |
| 11.2 | Reduce negative emotions | 7 | 25.0% | 6/7 | (85.7%) | 3 | 33.3% | 2/3 | (66.7%) |
| 2.2 | Feedback on behavior | 5 | 17.9% | 5/5 | (100.0%) | ||||
| 8.2 | Behavior substitution | 4 | 14.3% | 4/4 | (100.0%) | 1 | 11.1% | 1/1 | |
| 1.4 | Action planning | 3 | 10.7% | 2/3 | (66.7%) | 1 | 11.1% | 0/1 | |
| 3.3 | Social support (emotional) | 3 | 10.7% | 2/3 | (66.7%) | 3 | 33.3% | 2/3 | (66.7%) |
| 5.2 | Salience of consequences | 3 | 10.7% | 3/3 | (100.0%) | 3 | 33.3% | 3/3 | (100.0%) |
| 13.3 | Incompatible beliefs | 4 | 14.3% | 3/4 | (75.0%) | 2 | 22.2% | 1/2 | (50.0%) |
| 2.1 | Monitoring of behavior by others without feedback | 2 | 7.1% | 2/2 | (100.0%) | ||||
| 2.7 | Feedback on outcomes (of behavior) | 3 | 10.7% | 3/3 | (100.0%) | ||||
| 4.2 | Information about antecedents | 2 | 7.1% | 1/2 | (50.0%) | 2 | 22.2% | 1/2 | 50.0% |
| 7.1 | Prompts/cues | 2 | 7.1% | 2/2 | (100.0%) | 1 | 11.1% | 1/1 | |
| 8.7 | Graded tasks | 2 | 7.1% | 2/2 | (100.0%) | 1 | 11.1% | 1/1 | |
| 1.1 | Goal setting (behavior) | 1 | 3.6% | 1/1 | |||||
| 1.6 | Discrepancy between current behavior and goal | 1 | 3.6% | 1/1 | |||||
| 1.9 | Commitment | 1 | 3.6% | 1/1 | |||||
| 3.2 | Social support (practical) | 1 | 3.6% | 1/1 | |||||
| 4.4 | Behavioral experiments | 1 | 3.6% | 1/1 | |||||
| 5.1 | Information about health consequences | 1 | 3.6% | 0/1 | |||||
| 5.4 | Monitoring of emotional consequences | 1 | 3.6% | 1/1 | |||||
| 5.6 | Information about emotional consequences | 1 | 3.6% | 0/1 | 1 | 11.1% | 0/1 | ||
| 6.2 | Social comparison | 2 | 7.1% | 1/2 | (50.0%) | 1 | 11.1% | 0/1 | |
| 6.3 | Information about others’ approval | 1 | 3.6% | 1/1 | 1 | 11.1% | 0/1 | ||
| 7.6 | Satiation | 1 | 3.6% | 1/1 | |||||
| 7.7 | Exposure | 1 | 3.6% | 1/1 | |||||
| 9.2 | Pros and cons | 1 | 3.6% | 1/1 | |||||
| 10.3 | Non-specific reward | 1 | 3.6% | 1/1 | |||||
| 10.11 | Future punishment | 1 | 3.6% | 1/1 | |||||
| 12.1 | Restructuring the physical environment | 1 | 3.6% | 1/1 | |||||
| 12.5 | Adding objects to the environment | 1 | 3.6% | 1/1 | |||||
| 13.1 | Identification of self as role model | 1 | 3.6% | 1/1 | |||||
| 13.4 | Valued self-identity | 1 | 3.6% | 1/1 | |||||
| 14.2 | Punishment | 1 | 3.6% | 1/1 | |||||
| 16.3 | Vicarious consequences | 1 | 3.6% | 1/1 | |||||
| Category of BCTs c | |||||||||
| 4. | Shaping knowledge | 24 | 85.7% | 19/24 | (79.2%) | 8 | 88.9% | 4/8 | (50.0%) |
| 6. | Comparison of behavior | 20 | 71.4% | 15/20 | (75.0%) | 7 | 77.8% | 3/7 | (42.9%) |
| 5. | Natural consequences | 16 | 57.1% | 13/16 | (81.3%) | 5 | 55.6% | 3/5 | (60.0%) |
| 1. | Goals and planning | 13 | 46.4% | 11/13 | (84.6%) | 4 | 44.4% | 2/4 | (50.0%) |
| 8. | Repetition and substitution | 13 | 46.4% | 13/13 | (100.0%) | 3 | 33.3% | 3/3 | (100.0%) |
| 9. | Comparison of outcomes | 13 | 46.4% | 12/13 | (92.3%) | 3 | 33.3% | 2/3 | (66.7%) |
| 13. | Identity | 11 | 39.3% | 10/11 | (90.0%) | 4 | 44.4% | 3/4 | (75.0%) |
| 3. | Social support | 10 | 35.7% | 7/10 | (70.0%) | 5 | 55.6% | 2/5 | (40.0%) |
| 12. | Antecedents | 10 | 35.7% | 9/10 | (88.9%) | 1 | 11.1% | 0/1 | |
| 2. | Feedback and monitoring | 7 | 25.0% | 7/7 | (100.0%) | ||||
| 11. | Regulation | 7 | 25.0% | 6/7 | (83.3%) | 3 | 33.3% | 2/3 | (66.7%) |
| 7. | Associations | 3 | 10.7% | 3/3 | (100.0%) | 1 | 11.1% | 1/1 | |
| 10. | Reward and threat | 2 | 7.1% | 2/2 | (100.0%) | ||||
| 14. | Scheduled consequences | 1 | 3.6% | 1/1 | |||||
| 16. | Covert learning | 1 | 3.6% | 1/1 | |||||
| Mechanisms of Action (MOAs) c | |||||||||
| 25. | General Attitudes/Beliefs | 19 | 67.9% | 16/19 | (83.3%) | 7 | 77.8% | 4/7 | (57.1%) |
| 1. | Knowledge | 15 | 53.6% | 13/15 | (86.7%) | 3 | 33.3% | 2/3 | (66.7%) |
| 4. | Beliefs about capabilities | 8 | 28.6% | 7/8 | (87.5%) | 3 | 33.3% | 2/3 | (66.7%) |
| 13. | Emotion | 9 | 32.1% | 7/9 | (77.8%) | 5 | 55.6% | 3/5 | (60.0%) |
| 17. | Attitude toward the Behaviour | 6 | 21.4% | 3/6 | (50.0%) | 4 | 44.4% | 1/4 | (25.0%) |
| 11. | Environmental context and resources | 4 | 14.3% | 4/4 | (100.0%) | ||||
| 21. | Values | 4 | 14.3% | 4/4 | (100.0%) | 1 | 11.1% | 1/1 | |
| 8. | Intentions | 3 | 10.7% | 2/3 | (66.7%) | 2 | 22.2% | 1/2 | (50.0%) |
| 2. | Skills | 2 | 7.1% | 2/2 | (100.0%) | ||||
| 6. | Beliefs about consequences | 2 | 7.1% | 0/2 | (0.0%) | 2 | 22.2% | 0/2 | (0.0%) |
| 12. | Social influences | 2 | 7.1% | 2/2 | (100.0%) | ||||
| 19. | Self-image | 2 | 7.1% | 1/2 | (50.0%) | ||||
| 26. | Perceived susceptibility/Vulnerability | 2 | 7.1% | 1/2 | (50.0%) | ||||
| 3. | Social/Professional role and identity | 1 | 3.6% | 0/1 | |||||
| 5. | Optimism | 1 | 3.6% | 1/1 | 1 | 11.1% | 0/1 | ||
| 7. | Reinforcement | 1 | 3.6% | 0/1 | |||||
| 14. | Behavioural regulation | 1 | 3.6% | 0/1 | 1 | 11.1% | 1/1 | ||
| 16. | Subjective norms | 1 | 3.6% | 0/1 | |||||
aCodes with a frequency of zero are not shown (see Supplementary File 5 for all codes, including codes with zero).
b“Potential effectiveness” refers to the percentage of studies reporting a statistically significant improved outcome among those coded for an IT, BCT, or MOA; potential effectiveness is only shown as a ratio and not a percentage when the denominator is a single study.
cFor definitions of each IT, BCT, and MOA, see Supplementary File 5. BCT categories are not defined per se, but are grouped according to similar BCTs within the Behaviour Change Techniques Taxonomy v.1 [32]