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Public stigma has been revealed to have multidimensional negative impacts on people with schizophrenia (PWS). However, evidence-based stigma reduction program is inadequate in Hong Kong. Intervention with theory basis and structured sessions is even rarer.
In the current study, a randomized controlled trial will be conducted to examine the effectiveness of a one-day intervention grounded on the inter-group contact theory targeting at reducing college students’ stigma towards PWS.
Methods
A two-arm randomized controlled trial was conducted among college students in Hong Kong. College students aging 18 and above and could communicate in Chinese were recruited. Trained PWS serving as peer specialists in local community mental health institutions joined the one-day intervention. Participants’ knowledge of schizophrenia, changes of stigmatizing attitude and social distance towards PWS were measured before and after each session of the intervention. One-month and three-month follow-up tests were also conducted to examine the long-term effectiveness. Three sessions with different contact levels (zero contact, moderate contact with limitation and instruction given by the intervention, and intimate contact comprising free interaction and cooperative task) were designed for the intervention group. Although, there were also three sessions in the control group, no direct contact with PWS was introduced. The whole intervention was finished within 6 hours.
Results
Valid responses were collected from 37 participants in total. Results indicated significant improvement on knowledge of schizophrenia, stigmatizing attitude and social distance towards PWS with moderate to large effect sizes (Cohen’s d = 0.52 to 1.05).
Results revealed that different levels of contact with PWS had different functions on the reduction of stigma components. Zero contact with correct knowledge contributed the most on participants’ knowledge improvement, and direct contact may be effective for attitude and intended behavior changes.
By examining the changing trend at each measuring points, we could further demonstrate that the changing of participants attitudes towards PWS was an incremental process. However, significant changes only occurred after session 2, which indicated that contact was a compulsory element to be included in the stigma reduction program.
And compared with the design of watching artworks created by PWS, the direct contact and cooperative task design in the intervention group brought about greater understanding and reduced hostile attitudes towards PWS. This further supported our assumption that direct contact was the key element to improve stigmatizing attitude and shorten the social distance between college students and PWS.
Conclusion and Implications
The findings provided evidence supporting the efficacy of a brief, one-day stigma reduction intervention based on the inter-group contact theory. Findings from the current study could also provide practical suggestions for future intervention design in the stigma field.