Table 3.
Included studies (n = 35) and associated interventions (n = 29) by year of publication
| Study | Intervention | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Author Citation | Year | Design | Study Type | Imp. Stage | Study Population | Imp. Outcome(s) | Imp. Outcome Score | Other Outcome(s) | Key Findings | Description | Name | Country | Stigmatizing Condition | TIDieR Score |
| el-Setouhy [43] | 2003 | CS; PPwoC | Type 1 | Pi | Co | Ac | 40% | S | Children liked the comic book and its contents and found this book easy to understand | Comic book for Egyptian schoolchildren | n/s | Egypt | LF | 55% |
| Norr [44] | 2004 | Qual; PPwC | Eff | Pi | Co | Su | 0% | S O | Leaders continued to offer intervention post-funding | Peer group intervention | n/s | Botswana | HIV; STDs | 64% |
| Witter [45] | 2004 | Qual; Econ | Type 1 | Sc | Co Pa | Ac Ad C Fe Su | 20% | S H O | Acceptable and effective tool with low costs, though participants still cannot bear cost; hard to keep momentum and extend coverage | Book of family background, memories, hopes | Memory Book | Uganda | HIV | 55% |
| Lawoyin [46] | 2007 | Qual; PPwoC | Type 1 | Pi | Co | Ac | 20% | S | Satisfaction with content and appreciation for social support | Life skills education | n/s | Nigeria | HIV | 64% |
| Boulay [47] | 2008 | CS | Type 1 | Sc | Co | Pe | 50% | S | 51% of men and 53% of women recalled hearing or seeing the slogan; broadcast media reached the greatest number of men and women | Mass media, promotional materials, training for local religious leaders | Reach Out, Show Compassion | Ghana | HIV | 55% |
| Finkelstein [48] | 2008 | Qual; iRCT | Type 1 | Pi | Co | Ac Fe | 40% | S | Students liked how program worked; none had problems operating the program Content, user interface, and learning process could be improved | Anti-stigma computer program and print materials | Computer Assisted Education system | Russia | MH | 36% |
| Khumalo-Sakutukwa [49] | 2008 | cRCT; QI/QA | Type 1 | Pi | Co Pr | Fi Pe | 40% | SD | 4-fold increase in testing in intervention vs. control communities; 95% adherence to intervention | Community mobilization, community HIV voluntary counselling and testing, and post-test support services | Project Accept | Tanzania, Zimbabwe, South Africa, Thailand | HIV | 91% |
| Lapinski [50] | 2008 | Qual; CS; iRCT | Type 1 | Pi | Co | Ac Ap | 40% | S SD | Enjoyment was high and men and women did not differ in their enjoyment of the film or perception of credibility | Film | Starting Over | Nigeria | HIV | 55% |
| Pappas-DeLuca [51] | 2008 | CS | Type 1 | Sc | Co | Pe | 75% | S SD O | Nearly one half reported listening each week, 15% for 1 year or longer, and 19% talking to someone about Makgabaneng in past 3 months | Serial radio drama | Makgabaneng | Botswana | HIV | 64% |
| Zeelen [52] | 2010 | Qual | Imp | Pi | Pa Pr | Ac Fe | 25% | Storytelling seen as useful; some listeners distracted by other people; some had to see provider and missed story message | Clinic waiting room storytelling | n/s | South Africa | HIV | 55% | |
| Gurnani [53] | 2011 | M&E | Imp | Sc | Co Po | Pe | 50% | SD O | Increase in FSW population reached from 40% to 85%; 61.5% of police force received training; crisis management teams supported 92% of rights violations in redress | Advocacy, legal empowerment, police and media sensitization | n/s | India | HIV | 45% |
| Watt [54] | 2011 | Qual | Type 1 | Pi | Co Pa | Ac Fi | 60% | S SD H O | Patients judged usefulness 4.76 out of 5; intervention was delivered as intended in the manual – all 20 sectionscovered in each session | Support group for antiretroviral therapy patients | Zinduka | Tanzania | HIV | 64% |
| Denison [55] | 2012 | CS; Econ | Type 1 | Sc | Co | C | 60% | S O | Total annual cost of US $501,516; average annual cost per school of US $8222; Adolescent Sexual and Reproductive Health Life Skills Education pillar had highest cost (US $2197) | Volunteer peer educators, youth resource center, extracurricular activities, community events, teacher training | School HIV/AIDS Education Program | Zambia | HIV | 64% |
| Rice [56] | 2012 | cRCT | Type 1 | Pi | Co | Pe | 100% | S O | Rise in communication about intervention messages in the intervention Chinese markets was at first moderate and then substantial | Training market vendors, community-popular opinion leaders | n/s | China | HIV; STDs | 64% |
| Al-Iryani [57] | 2013 | Qual | Type 1 | Pi | Co Pr Po | Ac Fe | 60% | SD | 76.6% of students considered intervention beneficial; program was acceptable because it was framed as ‘life skills’, did not take away from academics, and was supported by school staff | School peer education program | n/s | Yemen | HIV | 73% |
| Catalani [58] | 2013 | Qual; PPwoC | Type 1 | Pi | Co | Ac | 75% | S | Storyline seemed believable and possible; participants responded positively to each medium | Film | Prarambha | India | HIV | 64% |
| Li [59] | 2013 | cRCT | Type 1 | Pi | Pr | Ac | 20% | Approach accepted by providers; messages were relevant to provider self-interests | Training providers as popular opinion leaders | n/s | China | HIV | 73% | |
| Li [60] | 2013 | cRCT | Type 1 | Pi | Pr | Fe | 0% | S | Intervention appropriately covered key issues relevant to provider daily practice | |||||
| Murray [61] | 2013 | Qual; PPwoC | Type 1 | Pi | Co Pa Pr Po | Ap | 100% | SD H | Preference for treatment that serves both children and adolescents; treatment that addressed traumatic grief; cross-cultural appropriateness and/or flexibility to adapt; and evidence of effectiveness | Psychosocial therapy for orphans and vulnerable children | Trauma-Focused Cognitive Behavioral Therapy | Zambia | MH | 100% |
| Murray [62] | 2013 | QI/QA; PPwoC | Type 1 | Pi | Pa | Fi | 40% | S SD H | Treatment conducted with fidelity due to close monitoring built into Apprenticeship model | |||||
| Murray [63] | 2014 | Qual | Type 1 | Pi | Co Pa Pr | Ac Fe | 75% | Counselors liked structure and flexibility, reported positive changes in clients, and discussed cultural adaptation around activities and language; children and caregivers stated positive changes attributed to trauma-focused cognitive behavioral therapy | ||||||
| French [64] | 2014 | Qual | Type 1 | Pi | Co Pa | Ac | 75% | S | Taking on projects was difficult but empowering | Training people living with HIV and peers to conduct community projects | n/s | South Africa | HIV | 55% |
| French [65] | 2015 | Qual | Type 1 | Pi | Co Pa | Ac Fe | 20% | S | Some struggled with their projects; many found projects challenging and exhausting, yet interesting and exciting | |||||
| Shah [66] | 2014 | PPwC | Type 1 | Pi | Co | Ac Fe | 60% | S | Both sessions rated highly; few participants said materials made them uncomfortable; most felt that they could be honest about their beliefs and behaviors | Stigma reduction curriculum for nurses | n/s | India | HIV | 64% |
| Lusli [67] | 2015 | Qual | Type 1 | Pi | Pr | Ap Fe | 50% | SD | Effective communication skills were important; physically disabled counsellors had challenges making contact and providing counselling; distance between clients was challenging | Rights-based counselling of people with leprosy by peer and lay counsellors | Stigma Assessment and Reduction of Impact: Counselling | Indonesia | Lepr. | 73% |
| Lusli [68] | 2016 | Qual; cRCT | Type 1 | Pi | Co Pa | Ac Fe | 50% | S SD O | Participants appreciated counselling; counsellors needed intense supervision; not easy to manage client conditions and characteristics; peer counselors were preferred; family counselling preferred overall, but integrating family, individual, and group counselling was best approach | |||||
| Peters [69] | 2015 | Qual; cRCT | Type 1 | Pi | Co | Fe | 0% | S SD | Challenges related to convincing key of value of contact event, logistics (weak audio system, inappropriate venue, too many people and limited time), audience (tired, less involved), and Stigma Assessment and Reduction of Impact team (cancelations, delayed) | Contact events using testimonies, participatory videos, and comics | Stigma Assessment and Reduction of Impact: Contact and Video | Indonesia | Lepr. | 64% |
| Peters [70] | 2016 | Qual | Type 1 | Pi | Pa | Ac Ap Fe | 25% | S | Support of video process; some participants had physical limitations and needed additional technical training in videography | |||||
| Salmen [71] | 2015 | Qual | Type 1 | Pi | Co Pa | Ac | 50% | S O | Participants found testimonials and role-modeling to be encouraging and gave them courage to disclose, though some concerns about group testing and disclosure process were expressed | Microclinic of neighbors, relatives, and friends trained to provide psychosocial, nutritional, and adherence support | n/s | Kenya | HIV | 64% |
| Figueroa [72] | 2016 | CS | Type 1 | Sc | Co | Pe | 50% | S O | Almost two-thirds (63%) of the control group said that they had heard of TT; exposure to TT was higher among those in the intervention group | Facilitated community dialogues and radio magazines | Tchova Tchova Histórias de Vida: Diálogos Comunitários | Mozambique | HIV | 55% |
| Tekle-Haimanot [73] | 2016 | Qual; PPwoC | Type 1 | Pi | Pr | Ap | 60% | S | Providers suggested comic be distributed among school children and felt it was easy to read and understand, well presented and illustrated for a non-medical person | Comic book for Ethiopian schoolchildren | We’ll Make It | Ethiopia | Epil. | 55% |
| Tora [74] | 2016 | Qual | Type 1 | Pi | Co Pa | Fi | 0% | S O | Weaknesses observed during training and household education sessions; some educators provided superficial presentations, improper use of supplementary examples, and incomplete messages | Lay health educator-delivered educational modules and booster sessions | Inherited susceptibility education module | Ethiopia | Pod. | 82% |
| Wilson [75] | 2016 | Qual; PPwoC | Type 1 | Pi | Co Pa Pr | Ac Fe | 50% | H O | DVD players did not have high volume; few electrical outlets; participants identified with the Salvadorian patients and understood video content; short duration of video not disruptive to TB clinic schedules | Educational video | n/s | El Salvador | TB | 64% |
| Lyons [76] | 2017 | CS; Coh | Type 1 | Pi | Co | Ac Fe | 40% | S H | 63.9% of MSM and 82.5% of FSW agreed that the workshops were effective in addressing stigma; 68.0% of MSM and 81.6% of FSW self-reported that the workshops helped them think about how to cope with stigma | Peer-led group sessions, training health workers, and web-based referral system | n/s | Senegal | HIV | 64% |
| Oduguwa [77] | 2017 | PPwC | Type 1 | Pi | Co | Ac | 40% | O | Most participants liked the program because it increased their awareness about mental illness; some noted that hearing about mental illness created fear; majority affirmed that the program benefited them, the school, and the family | Mental health awareness training | n/s | Nigeria | MH | 64% |
Designs: CS cross-sectional, Coh cohort, M&E monitoring and evaluation, PPwC non-randomized pre/post study with control, PPwoC non-randomized pre/post study without control, iRCT individual randomized controlled trial, cRCT cluster randomized controlled trial, Qual qualitative, QI/QA quality improvement/quality assurance
Study types: Eff effectiveness, Type 1 type 1 hybrid effectiveness-implementation, Imp implementation
Implementation stages: Pi pilot/once-off implementation, Sc sustained implementation at scale
Study populations: Co community members, Pa patients, Pr providers, Po policy-makers
Implementation outcomes: Ac acceptability, Ap appropriateness, Ad adoption, C costs, Fe feasibility, Fi fidelity, P penetration, S sustainability
Other outcomes: S stigma, SD service delivery, H patient health, O other outcome
Stigmatizing conditions: Epil epilepsy, Lepr leprosy, LF lymphatic filariasis, MH mental health, Pod podoconiosis, STD sexually transmitted disease, TB tuberculosis
FSW female sex worker, MSM men who have sex with men, n/s not specified, TT Tchova Tchova Histórias de Vida