Table 1.
Characteristics of the included studies.
| Study, year | Country (Setting) |
Stigma label(s) | Age intervention participants (specification) |
Delivery Channelsa |
Contact hours |
Intervention description |
Intervention Components |
RD b |
Results c (measure) |
|---|---|---|---|---|---|---|---|---|---|
| Interventions focused only on children/adolescents | |||||||||
| Ritterbusch (2016) | Colombia (community, health centre) | Mental Illness (substance abuse), Being street-based | Adolescents (People with lived experience) | i | Not reported | Long-term participatory action research including visual research component | Empowerment, Advocacy | 4 | |
| Alemayehu & Ahmed (2008) | Ethiopia (school) | HIV/AIDS | Adolescents (pupils) | Arm 1: l Arm 2: b Arm 2: b Arm 4: b, l |
Half day (arm 1, 2, 3 and 4) | Arm 1: interpersonal dialogue Arm 2: Printed Material Arm 3: short movie Arm 4: combination of all 3 |
Education (all arms) | 2 | All positive (no name) pre-tested questionnaire on blame, coercion, avoidance, sympathetic feelings |
| El-Setouhy & Rio (2003) | Egypt (school) | Filariasis | Children/adolescents (pupils + People living close to them) | a, b | Half day | Comic book read in class and brought home | Education | 3 | |
| Raizada et al. (2004) | India (school) | HIV/AIDS | Adolescents (pupils) | Arm 1: l Arm 2: b Arm 2: b Arm 4: b, l |
Half day (arm 1, 2, 3 and 4) | Arm 1: interpersonal dialogue Arm 2: Printed Material Arm 3: short movie Arm 4: combination of all 3 |
Education (all arms) | 2 | All positive (own: no name) coercive attitude, avoidance, blaming, sympathetic feelings) |
| Interventions focused on children//adolescents and adults | |||||||||
| Yan et al. (2018) | China (school) (+Australia) | Mental Illness (Anorexia) | Adolescents/adults (students) | j | Half day | Social consensus – vignette-based and allocation to in-, out- or neutral group | Social Consensus | 2 | Positive (for in-group) (SDS, Characteristics Scale, Affective Reaction Scale, Severity Scale, Blameworthiness Scale) |
| Lusli et al. (2016) | Indonesia (community, family) | Leprosy | Adolescents/adults (People with lived experience, People Living Close to them, service providers) | f, g | Half day | Rights- and knowledge-based individual, family and group counselling (CBT principles applied, 5 sessions) | IC-CBT, Group Counselling, Care & Support | 1 | Positive SARI Stigma Scale, Participation Scale |
| Jain et al. (2013) | Thailand (community) | HIV/AIDS | Adolescents/adults (People with lived experience + mix) | f, g | Not computable (different dosages) | Campaigns, funfairs, IEC and monthly banking days | Empowerment, Education, Contact | 3 | |
| Dalen (2009) | Uganda (community, schools) | Orphan-hood | Children + adults (mix) | a, l | Not reported | Various: house repair, school fees, counselling/guidance. Income generating activities, awareness raising workshops | Empowerment, Group Counselling, Education | 4 | |
| Geibel et al. (2017) | Bangladesh (health centre) | HIV/AIDS + Sexual Behaviour | Adults (service providers) (impact children) | a | 1–3 days | Sexual and Reproductive Health Rights training, including supplement training on stigma | Training | 3 | |
| Chidrawi et al. (2014) | South Africa (community) | HIV/AIDS | Adolescents/adults (People with lived experience + People living close to them) | f, g, i | 1–2 months (estimate, different dosages) | Community-based intervention with 2-day lecture and activity based workshop, education/contact workshops and implementation of joint projects | Empowerment, Education, Contact | 3 | |
| Zeelen et al. (2010) | South Africa (health centre) | HIV/AIDS | Adolescents/adults (mix) | e | Not reported | Edutainment: storyteller uses dialogue between animals as metaphor to create openness in waiting room of clinic | Education | 4 | |
| Creel et al. (2011) | Malawi (community) | HIV/AIDS | Adolescents/adults/elderly (mix) | Arm 1: c Arm 2: c, i | Half day (both arms) | Both arms: radio diary (PWLE telling about everyday life). 2nd arm includes group discussion. | Education, Contact (arm 1 and 2) | 1 | Positive (adapted, no name) fear, shame, blame and judgement, willingness to disclose |
| Elafros et al. (2013) | Zambia (health centre) | Mental Illness (epilepsy) | Adolescents/adults (People with lived experience) | a, i | 1–3 days | Monthly peer support groups to share life experiences, for medical questions clinical officer present | Empowerment, Self-Help | 3 | |
| O’Leary et al. (2007) | Botswana (community) | HIV/AIDS | Adolescents + Adults (mix) | C | Not reported | Edutainment: story line on HIV stigma within the soap “the bold and the beautiful” | Education | 2 | Positive (no name) stigma scale on attitudes and intent |
| Interventions focused only on adults | |||||||||
| Li et al. (2018) | China (health centre) | Mental Illness (schizo-phrenia) | Adults (People with lived experience) | A | 1–3 days | Psychoeducation (7 modules), Social Skills Training (6 modules), CBT (3 steps) | IC-CBT, Empowerment | 1 | Positive DISC, ISMI |
| Maulik et al. (2017) | India (community) | Mental Illness | Adults (mix) | b, c, d | Not computable (different dosages) | Multi-media anti-stigma campaign sharing (interactive) information and testimonies | Education, Contact | 3 | |
| Lyons et al. (2017) | Senegal (community, health centre) | Sexual behaviour (MSM/FSW) | Adults (vulnerable population + service providers) | g, j, l | Not computable (different dosages) | Integrated intervention: community intervention, clinical and web-based referral system | Empowerment, Training, Policy | 3 | |
| Lohiniva et al. (2016) | Egypt (health centre) | HIV/AIDS | Adults (service providers) | l | 1–3 days | Hospital-based inter-active training programme (5 modules) | Training | 2 | Positive (own) Stigma Score Fear- and value-based stigma |
| Nyblade et al. (2018) | India (Health centre) | HIV/AIDS | Adults (Service Providers) | g, i, j | Half day | Blended learning approach combining tablet and in-person sessions | Training | 3 | |
| Kutcher et al. (2016) | Tanzania (school) | Mental Illness | Adults (service providers) | a | 1–3 days | Training teachers on the African Guide mental health literacy curriculum (6 modules) | Training | 3 | |
| Pulerwitz et al. (2015) | Vietnam (community, health centre) | HIV/AIDS | Adults (service providers) | a, g (both arms) | 1–3 days (arms 1 and 2) (estimate) | Staff training, hospital policy development and supplies provision (1st arm: focus on fear, 2nd arm: more intense training + focus on value/social stigma) | Training, Policy (arm 1 and 2) | 2 | Both positive (adapted) Stigma score Enacted Stigma, Social Stigma, Fear-based stigma |
| Li et al. (2014) | China (health centre) | Mental Illness | Adults (service providers) | A | 0,5 day–1 day | Mental health training course (2 parts) | Training | 3 | |
| Nyamathi et al. (2013) | India (community, family) | HIV/AIDS | Adults (People with lived experience) | a, f | 1–3 days | Empowering, educational and support intervention (Asha-Life) | IC, CBR, Empowerment | 2 | Positive (adapted, no name) Internalised stigma, Disclosure Avoidance Scale |
| Li et al. (2013) | China (health centre) | HIV/AIDS | Adults (service providers) | d, f | 1–3 days | Behavioural and structural change training programme (4 sessions) through popular opinion leaders + 3 refresher | Training | 1 | Positive (adapted, no name) Prejudice (own) providers’ avoidance intent |
| Augustine et al. (2012) | India (health centre) | Leprosy | Adults (People with lived experience) | a | 1–2 weeks | Social Skills training (10 day sessions) with role plays and videos | Empowerment | 3 | |
| Nambiar et al. (2011) | India (health centre) | HIV/AIDS | Adults (People with lived experience, People living close to them, service providers) | c, e | 1–3 days | Educational radio and theatre programme with messages, testimonies and Q&As on the radio | Empowerment | 2 | Positive (adapted, no name) Felt, disclosure and enacted stigma |
| Macq et al. (2008) | Nicaragua (health centre, family) | TB | Adults (People with lived experience + service providers) | a | Not computable | Municipal teams implementing self-identified patient-centred packages including TB clubs and home visits | Self-Help, HCT, Training | 2 | Positive (Rosenberg scale) as determinant for Internalised social stigma |
| Lapinski & Nwulu (2008) | Nigeria (community) | HIV/AIDS | Adults (general population) | b | Half day | Edutainment: fictional story of relatable character contracting HIV, phase of rejection and then acceptance | Education | 2 | Neutral (items adopted) Coercive policies attitudes scale, avoidance scale, blame scale |
| Finkelstein et al. (2007) | Russia (school) | Mental Illness | Adults (students) | Arm 1: j Arm 2: b |
Not reported | 1st arm: short interactive educational messages on stigma 2nd arm: brochures on stigma | Training (arm 1 and 2) | 2 | Both positive (CAMI, SDS) |
| Wu et al. (2008) | China (health centre) | HIV/AIDS | Adults (service providers) | a | Half day | Interactive training programme, including testimonies, role plays and group discussions | Training | 2 | Positive (No name) Attitudes towards PLWHA |
| Apinundecha et al. (2007) | Thailand (community) | HIV/AIDS | Adults (People with lived experience + People living close to them + mix) | d, f, i | Not reported | Participatory community action research with leader engagement, information-sharing and cooperation | Empowerment, Education, Contact, Popular Opinion Leader | 2 | Positive (adapted, no name) Community and family stigma towards PLWHA, PLWHA perceptions of stigma, PLWHA self-stigma, Community stigma towards family of PLWHA |
| Cross & Choudary (2005) | Nepal (community) | Leprosy | Adults (People with lived experience) | g | Not reported | Stigma Eliminating Programme: empowerment through self-care, livelihood and contribution to community development | Empowerment, Self-Help | 2 | Positive Participation Scale |
| Doosti-Irani et al. (2017) | Iran (community) | Diabetes | Adults (People with lived experience + People living close to them + service providers + mix) | k | Not reported | Variety of community, family and organisational activities, such as diabetes walking tour, use of media, conference, contact, changing diabetes centre policies | Empowerment, Care & Support, Policy, Contact, Education, Advocacy | 4 | |
| Rai et al. (2018) | Nepal (health centre) | Mental Illness | Adults (People with lived experience) | g | 1–2 weeks | Participatory research training where service users use PhotoVoice as advocacy and empowerment tool, and provide input into mhGAP training | Empowerment, Training | 4 | |
| Ahuja et al. (2017) | India (school) | Mental Illness | Adults (students) | e, g, i | Half day | One-time education and contact moment, with PowerPoint, dance drama and information from person with lived experience | Education, Contact | 3 | |
| Hofmann-Broussard et al. (2017) | India (community) | Mental Illness | Adults (service providers) | a, f, g | 4–7 days | Manual-based mental health training (12 modules), face-to-face with person with lived experience (recovery) | Training | 2 | Positive (own) Attitudes |
| Cornish (2006) | India (community) | Sexual Behaviour (sex work) | Adults (People with lived experience) | a, g | Not reported | Community intervention: education sessions to PWLE, collective action, meet politicians/academics at press conferences | Empowerment, Self-Help, Advocacy | 4 | |
| Logie et al. (2019) | Swaziland/Lesotho (family + health centre + community) | Sexual Behaviour (LGTBQI) | Adults (students + service providers + mix) | e | Half day | Edutainment: theatre intervention with 3 skits on LGBT stigma, active audience involvement in identifying proper way forward | Education | 4 | |
| Shilling et al. (2015) | Chile (health centre) | Mental Illness | Adults (People with lived experience) | a, i | 1–3 days | Recovery-oriented 10 session constructivist psychoeducation/group sessions (Tree of Life) | Group Counselling | 4 | |
| Shah et al. (2014) | India (health centre) | HIV/AIDS | Adults (Students) | a, g | Half day | PowerPoint and group discussions and shared experience from PWLE | Training | 2 | Positive (no name) intent to discriminate, attitudes towards PLWHA, endorsing coercion, blame |
| Catalani et al. (2013) | India (community) | HIV/AIDS | Adults (vulnerable population) | b (both arms) | Half day (both arms) | Storytelling on HIV stigma through movie (arm 1: feature film, arm 2: illustrated video) | Education, Contact | 2 | Both positive (FGD) attitudes, fear of casual contact |
| Dadun et al. (2017) | Indonesia (community) | Leprosy | Adults ((People with lived experience + People living close to them + mix) | Arm 1: a, g, i Arm 2: a, f, g Arm 3: a, f, g, i |
Not reported | Socio-Economic: loans, business training (arm 1 and 2) Counselling: skills building, peer services (arm 2 and 3) Contact: contact, dialogue interaction (arm 1 and 3) |
Arm 1: Contact, Empowerment Arm 2: Group Counselling, Empowerment Arm 3: Group Counselling, Contact |
1 | All three Positive SARI, EMIC, SDS |
| Monteiro (2014) | Botswana (school) | Mental Illness | Adults (students) | I | 1–2 weeks | Psychopathology course using a didactic approach, incorporation of unplanned self- and peer-disclosure | Training | 4 | |
| Go et al. (2017) | Vietnam (community) | HIV/AIDS + Mental Illness (substance abuse) | Adults (People with lived experience | Arm 1; a Arm 2: b, f Arm 3: a, b, f |
Arm 1: half day (estimate) Arm 2: 1 day (estimate) Arm 3: 1–3 day (estimate) |
Arm 1: Individual and Group Counselling, including PLC Arm 2: Community-wide programme, showing fictional video + follow up sessions Arm 3: combination of 1 and 2 |
Arm 1: IC, Group Counselling Arm 2: Contact, Education Arm 3: combination of arm 1 and 2 |
1 | All three neutral HIV Stigma, IDU Stigma |
| Sermrittirong et al. (2014) | Thailand (community + health centre + family) | Leprosy | Adults (mix + service providers) | Arm 1: a, f Arm 2: a, f Arm 3: f |
Not computable (arm 1, 2 and 3) | Arm 1: formal health care system Arm 2: local volunteers Arm 3: self-help groups |
Arm 1: HCTs, Training, Education Arm 2: IC, Care & Support, Training, Education Arm 3: Self-Help, Empowerment, Education |
2 | 1.neutral 2. positive 3. positive EMIC |
| Francis & Hemson (2006) | South Africa (school) | HIV/AIDS | Adults (students) | i | Half day (estimate) | Participatory visual arts with dialogue | Education | 4 | |
| Uys et al. (2009) | Lesotho, Malawi, South Africa, Swaziland, Tanzania (health centre) | HIV/AIDS | Adults (service providers + People with lived experience) | a, g | 2 weeks–1 month | Information-based and empowerment training based on education and contact | Empowerment, Training | 3 | |
| Tshabalala & Visser (2011) | South Africa (health centre) | HIV/AIDS | Adults (People with lived experience) | a | 1–3 days | 8 CBT sessions, addressing self-worth, guilt, positive reframing, coping skills | IC-CBT | 2 | Positive serithi internalised stigma scale, enacted stigma |
| ÜÇOk et al. (2006) | Turkey (health centre) | Mental Illness (schizo-phrenia) | Adults (service providers) | a | Half day | PowerPoint presentation and interactive discussion | Training | 3 | |
| Altindag et al. (2006) | Turkey (school) | Mental Illness (schizo-phrenia) | Adults (students) | a, b, g | 1 day | Lecture, PLWE sharing personal story and an autobiographical film | Training | 2 | Positive (questions based on SDS) attitude towards care and management of people living with schizophrenia) |
| Finkelstein et al. (2008) | Russia (school) | Mental Illness | Adults (students) | Arm 1: j Arm 2: b |
Not reported | Arm 1: self-paced short educational stigma messages, fictional story, triggering emotions Arm 2: Factual stigma brochures |
Training (both arms) | 2 | Both positive CAMI |
| Bayar et al. (2009) | Turkey (health centre) | Mental Illness | Adults (service providers) | j | Half day | Instructive email about stigma on beliefs, occurrence, negative effects and potential actions | Training | 2 | Positive (no scale identified) |
| Koen et al. (2010) | South Africa (community) | HIV/AIDS | Adults (People with lived experience) | a, f | 1–3 days | 8 sessions group counselling about HIV/AIDS, voluntary counselling and testing, stigma and manifestations, coping, disclosure | Group Counselling | 4 | |
| Peters et al. (2015) | Indonesia (community) | Leprosy | Not specified (mix) | g, i | 0,5–1 day (estimate) | Contact intervention, including testimonies and contact events | Education, Contact | 1 | Positive SDS, EMIC, 6QQ |
| Shamsaei et al. (2018) | Iran (health centre) | Mental illness (caregivers) | Adults (People with lived experience) | a | 1 day | In-person education (4 sessions) to provide information about MI, role of family, experiences in stigma and coping skills | Empowerment | 2 | Positive (own questionnaire) |
| Interventions with non-specified age group | |||||||||
| Prinsloo & Greeff (2016) | South Africa (community) | HIV/AIDS | Not specified (People with lived experience + People living close to them) | g, h | Not computable (different dosages) | Community intervention: door-to-door, community workshops, psychodrama, peer support, active PWLE involvement | Self-Help, Empowerment, Contact | 3 | |
| Dharitri et al. (2015) | India (community) | Mental Illness | Not specified (mix) | b, e, l | 1–2 weeks (estimate, different dosages) | Community education intervention including psychoeducation | Education | 3 | |
| Neema et al. (2012) | Uganda (health centre) | HIV/AIDS | Not specified (People with lived experience) | l | Not reported | Edutainment/Creativity intervention in a clinic’s waiting room | Policy | 3 | |
| Raju et al. (2008) | India (community, health centre) | Leprosy | Not specified (mix) | a, d, f | Not reported | Community-based intervention, with a stigma reduction organising committee initiating activities | Care & Support, CBR + Contact, Education | 3 | |
| Boulay et al. (2008) | Ghana (religious site) | HIV/AIDS | Not specified (mix) | c, d | Not reported | National mass media messages and community-level IEC, complemented at congregational level messages of compassion | Education, popular opinion leader | 3 | |
| Arole et al. (2002) | India (community + health centre) | Leprosy | Not specified (People with lived experience + mix) | Arm 1: a, f Arm 2: a |
Not computable (arm 1 and 2) | Arm 1: Integrated community-based primary health care, including case detection Arm 2: Integration of leprosy with other conditions |
Arm 1: CBR, Policy Arm 2: Policy |
2 | Both positive (no name: qualitative) |
a. Delivery Channels: a (professionals), b (printed material/movie-based), c (mass media), d (local leaders), e (local actors), f (lay community workers/members), g (people with lived experience), h (people living close to them), i (research team), i (web-based), k (mix of channels), i (not reported).
b. RD (Research Design): 1 = RCT including comparisons, 2 = pre-post with control, 3 = pre-post without control, 4 = qualitative/anecdotal.
c. Results: only results of research designs 1 and 2 have been captured.