Impact of Video Presentations on Medical Students' Attitudes Toward Mental Illness

Not Applicable

Completed

• Conditions: Psychosis; Depression; Stigmatization
• Interventions: Other: mhGAP didactic video; Other: Service user testimonial videos

• Registration Number: NCT03231761
• Lead Sponsor: George Washington University

Brief 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 (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 Timeline

• Study First Submitted: 2017-07-21
• Study First Submitted QC: 2017-07-24
• Study First Posted: 2017-07-27
• Study Start: 2017-08-21
• Primary Completion: 2018-08-31
• Study Completion: 2018-08-31
• Status Verified: 2019-01
• Last Update Submitted: 2019-01-02
• Last Update Posted: 2019-01-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 300

Inclusion Criteria

• Medical students in universities in Nepal

Exclusion Criteria

• Medical students are excluded if they have already completed their psychiatric clinical rotation

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
mhGAP didactic video	mhGAP didactic video	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
Service user testimonial videos	Service user testimonial videos	Videos with service user testimonials about depression and psychosis

Primary Outcome Measures

Name	Time	Method
Social Distance Scale	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

Secondary Outcome Measures

Name	Time	Method
Implicit Association Test (IAT)	Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)	Implicit Association Test for biases associating mental illness and physical illness by two attributes: violence and burdensomeness
Modified Community Informant Detection Tool (CIDT) vignettes for diagnostic and treatment knowledge assessment	Immediately after presentation of experimental, active comparator, or no intervention condition (duration of experimental and active comparator conditions is 15-20 minutes)	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

Trial Locations

Locations (2)

Tribhuvan University Institute of Medicine; 🇳🇵 Maharajgunj, Kathmandu, Nepal

Kathmandu University School of Medicine; 🇳🇵 Dhulikhel, Nepal