StigmatizationNCT03231761
Impact of Video Presentations on Medical Students' Attitudes Toward Mental Illness
A study testing Service user testimonial videos and mhGAP didactic video in people with Stigmatization and Depression, run by George Washington University at 2 sites in Nepal.
Trial summary
This is a randomized controlled trial examining the impact of videos on medical students' implicit and explicit attitudes and knowledge related to mental illness in Nepal. Medical students are randomized to one of three conditions: (a) no video, (b) a didactic video based on the mental health Gap Action Programme… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Stigmatization, Depression, Psychosis
- What is being tested?
- Service user testimonial videos and mhGAP didactic video
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 300 participants
- Where
- 2 sitesNepal
- Study dates
- 21 Aug 2017to 31 Aug 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Medical students in universities in Nepal
Who cannot join
- Medical students are excluded if they have already completed their psychiatric clinical rotation
Trial locations and contacts
2 sites in 1 country.
Nepal2 sites
Kathmandu University School of Medicine
Dhulikhel
Tribhuvan University Institute of Medicine
Maharajgunj, Kathmandu
About this study
Official title: A Randomized Controlled Trial of the Impact of Video Presentations on Medical Students' Explicit and Implicit Attitudes Toward Mental Illness in Nepal
This is a randomized controlled trial examining the impact of videos on medical students' implicit and explicit attitudes and knowledge related to mental illness in Nepal. Medical students are randomized to one of three conditions: (a) no video, (b) a didactic video based on the mental health Gap Action Programme (mhGAP) modules for depression and psychosis; and (c) videos with personal testimonials from mental health service users with depression and psychosis.
Read the detailed description
Stigma towards mental health patients exists within health systems worldwide, affecting high- and low-income countries alike. Stigmatizing beliefs held by health professionals toward mental illness can have detrimental health impacts on the patients. These stigmatizing beliefs against mental health patients within the health system have been noted across South Asia, including Nepal. Two sources of stigmatizing beliefs towards mental illness are explicit (conscious) and implicit (unconscious) attitudes held by health professionals. There is a dearth of research that investigates both explicit and implicit attitudes of health professionals towards mental health in South Asia though. One method to reduce stigma is through contact with people who suffer from mental illness. However, there is a gap in the literature on low- and middle-income countries integrating contact with mental health service users in health provider trainings. Forthcoming research in Nepal is exploring the causal impact of service user involved mental health trainings of health professionals on explicit and implicit attitudes as well as clinical care, but this research has yet to investigate the effects of service user training on health professional students (in progress). Research efforts on mental health trainings should be expanded to student populations to reduce negative attitudes before providers enter the workforce.
The purpose of this study is to evaluate whether information-based training with or without service user testimony is more effective at reducing implicit and explicit biases toward mental health patients and increasing clinical care in Nepali health professional students. The findings from this study will fill the gap in research that evaluates intervention efficacy of reducing stigma towards mental health patients in Nepali student health education. By implementing mental health trainings, the long-term goals of this intervention are to reduce stigma held by health professionals against mental health patients and improve clinical care in Nepal by reducing negative implicit and explicit attitudes.
- Conditions
- Stigmatization, Depression, Psychosis
- Being tested
- Service user testimonial videos, mhGAP didactic video
- Medical subject headings
- Stereotyping, Depression, Psychotic Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Service user testimonial videosOther
Service users describe their personal experiences receiving care for depression or psychosis and the impact of the treatment on their quality of life
mhGAP didactic videoOther
Video with a narrated slide presentation describing diagnosis and treatment of depression and psychosis
| Study group | Role | What they receive |
|---|---|---|
| Service user testimonial videos | Experimental | Videos with service user testimonials about depression and psychosis Receives: Other: Service user testimonial videos |
| mhGAP didactic video | Active comparator | The intervention in the active comparator arm includes two didactic videos with instruction about depression and psychosis based on the World Health Organization mental health Gap Action Programme (mhGAP) modules for those conditions Receives: Other: mhGAP didactic video |
| No video | No intervention | Participants do not observe any videos prior to the assessment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Social Distance Scale
Likert rating scale with items referring to level of social distance from persons with mental illness
Measured: Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)
Secondary outcomes (2)
Implicit Association Test (IAT)
Implicit Association Test for biases associating mental illness and physical illness by two attributes: violence and burdensomeness
Measured: Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)
Modified Community Informant Detection Tool (CIDT) vignettes for diagnostic and treatment knowledge assessment
Vignettes followed by knowledge assessment (multiple choice and free response questions) to evaluate ability to correctly diagnose and recommend treatment for person with depression and psychosis, based on vignettes from CIDT used in Nepal
Measured: Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jul 2017
- Study start21 Aug 2017
- Primary completion31 Aug 2018
- Study completion31 Aug 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for StigmatizationStudies of the same condition, open and under way.
- More trials run by George Washington UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 300 participants (actual)
Sponsor and investigators
- Lead sponsor
- George Washington University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Brandon A Kohrt, MD, PhD, George Washington University
- Investigators
- Brandon Kohrt, MD, PhD, Principal investigator, George Washington University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03231761
- Sponsor's protocol ID
- 146/2017
- Status last verified
- Jan 2019
- First submitted
- 21 Jul 2017
- Last updated
- 3 Jan 2019
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: Upon request, the researchers will share medical student response data if approved by the principal investigator, and medical school research officials.
Publications
Tergesen CL, Gurung D, Dhungana S, Risal A, Basel P, Tamrakar D, Amatya A, Park LP, Kohrt BA. Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial. Int J Environ Res Public Health. 2021 Feb 22;18(4):2143. doi: 10.3390/ijerph18042143.
PubMed 33671743
Study at a glance
From the registry record, last updated by the sponsor on 3 Jan 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Controlled Trial of the Impact of Video Presentations on Medical Students' Explicit and Implicit Attitudes Toward Mental Illness in Nepal
- ClinicalTrials.gov ID
- NCT03231761
- Acronym / sponsor ID
- 146/2017
- Conditions
- Stigmatization, Depression, Psychosis
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 300 participants (actual)
- Lead sponsor
- George Washington UniversityUniversity, hospital or other
- Study start
- 21 Aug 2017 (actual)
- Primary completion
- 31 Aug 2018 (actual)
- Study completion
- 31 Aug 2018 (actual)
- First posted
- 27 Jul 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a randomized controlled trial examining the impact of videos on medical students' implicit and explicit attitudes and knowledge related to mental illness in Nepal. Medical students are randomized to one of three conditions: (a) no video, (b) a didactic video based on the mental health Gap Action Programme (mhGAP) modules for depression and psychosis; and (c) videos with personal testimonials from mental health service users with depression and psychosis.
Detailed description
Stigma towards mental health patients exists within health systems worldwide, affecting high- and low-income countries alike. Stigmatizing beliefs held by health professionals toward mental illness can have detrimental health impacts on the patients. These stigmatizing beliefs against mental health patients within the health system have been noted across South Asia, including Nepal. Two sources of stigmatizing beliefs towards mental illness are explicit (conscious) and implicit (unconscious) attitudes held by health professionals. There is a dearth of research that investigates both explicit and implicit attitudes of health professionals towards mental health in South Asia though. One method to reduce stigma is through contact with people who suffer from mental illness. However, there is a gap in the literature on low- and middle-income countries integrating contact with mental health service users in health provider trainings. Forthcoming research in Nepal is exploring the causal impact of service user involved mental health trainings of health professionals on explicit and implicit attitudes as well as clinical care, but this research has yet to investigate the effects of service user training on health professional students (in progress). Research efforts on mental health trainings should be expanded to student populations to reduce negative attitudes before providers enter the workforce.
The purpose of this study is to evaluate whether information-based training with or without service user testimony is more effective at reducing implicit and explicit biases toward mental health patients and increasing clinical care in Nepali health professional students. The findings from this study will fill the gap in research that evaluates intervention efficacy of reducing stigma towards mental health patients in Nepali student health education. By implementing mental health trainings, the long-term goals of this intervention are to reduce stigma held by health professionals against mental health patients and improve clinical care in Nepal by reducing negative implicit and explicit attitudes.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Service user testimonial videos | Experimental | Other: Service user testimonial videosVideos with service user testimonials about depression and psychosis |
| mhGAP didactic video | Active comparator | Other: mhGAP didactic videoThe intervention in the active comparator arm includes two didactic videos with instruction about depression and psychosis based on the World Health Organization mental health Gap Action Programme (mhGAP) modules for those conditions |
| No video | No intervention | –Participants do not observe any videos prior to the assessment |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Medical students in universities in Nepal
Key exclusion criteria (1 listed)
- Medical students are excluded if they have already completed their psychiatric clinical rotation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Service user testimonial videosService users describe their personal experiences receiving care for depression or psychosis and the impact of the treatment on their quality of life | Other | Service user testimonial videos |
| mhGAP didactic videoVideo with a narrated slide presentation describing diagnosis and treatment of depression and psychosis | Other | mhGAP didactic video |
Primary outcome
Social Distance Scale
Time frame: Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)
Likert rating scale with items referring to level of social distance from persons with mental illness
2 secondary outcomes
Implicit Association Test (IAT)
Time frame: Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)
Modified Community Informant Detection Tool (CIDT) vignettes for diagnostic and treatment knowledge assessment
Time frame: Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jan 2019.
- Derived from this study: PubMed 33671743Tergesen CL, Gurung D, Dhungana S, Risal A, Basel P, Tamrakar D, Amatya A, Park LP, Kohrt BA. Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial. Int J Environ Res Public Health. 2021 Feb 22;18(4):2143. doi: 10.3390/ijerph18042143.
- Individual participant dataSharing planned: Undecided. Upon request, the researchers will share medical student response data if approved by the principal investigator, and medical school research officials.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Brandon Kohrt, MD, PhD principal investigator
George Washington University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Service user testimonial videos and mhGAP didactic video in people with Stigmatization and Depression, run by George Washington University at 2 sites in Nepal.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Jan 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Nepal. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Social Distance Scale (time frame: Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03231761, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Jan 2019.