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Intervention to Reduce Serious Mental Illness and Suicide Stigma Among Medical Students

Not Applicable
Conditions
Stigmatization
Clinical Competence
Interventions
Behavioral: SMI/SIA Stigma Reduction Intervention
Other: Disaster Preparedness Course
Registration Number
NCT05325320
Lead Sponsor
Ponce Medical School Foundation, Inc.
Brief Summary

The team aims to develop and test the efficacy of a serious mental illness (SMI) and suicide ideation and attempt (SIA) stigma reduction intervention for medical students. The team expects that after intervention exposure, relative to control group, participants in the experimental condition will manifest more favorable change in knowledge, attitudes, and behaviors.

Detailed Description

People with serious mental illness (PSMI; i.e. Schizophrenia and bipolar disorder) die, on average, 25 years earlier than the general population. Suicide is a key factor for this disparity as it is the leading cause of unnatural deaths among this population. Research identifies Latinos as a particularly vulnerable group, accounting for one of the highest rates (over 30%) of serious mental illness (SMI) among ethnic minorities in the United States (US). Latinos also hold one of the highest prevalence of suicide ideation and attempts (SIA) with rates of 10.1% and 4.4% respectively. This scenario worsens for one Latino subgroup, Puerto Ricans, who have the highest prevalence of SMI (36%) and SIA among Latinos in the US (7.9% and 3.5% respectively). Taken together, these facts present a concerning scenario for Latinos, especially Puerto Ricans with SMI/SIA. Health professionals play a key role in identifying SMI/SIA among patients; unfortunately, SMI/SIA stigma hinders this process.

The proposed study aims to: 1) develop the content of an intervention to reduce SMI/SIA stigma among medical students, 2) determine the acceptability and feasibility of implementing the intervention among medical students by examining recruitment/screening procedures, participation/refusal/retention rates, and participant satisfaction, and; 3) pilot test the preliminary efficacy of the intervention in reducing SMI/SIA stigma among medical students by increasing knowledge of SMI and SIA, reducing negative attitudes towards SMI/SIA and increasing behavioral skills for providing healthcare to PSMI.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
126
Inclusion Criteria
  • Medical student currently in third year of medical school training
Exclusion Criteria
  • Do not speak English

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Stigma Reduction InterventionSMI/SIA Stigma Reduction InterventionParticipants randomized to the experimental condition will receive the SMI/SIA Stigma Reduction Intervention.
Disaster Preparedness CourseDisaster Preparedness CourseParticipants randomized to the control condition will receive a Disaster Preparedness Course, addressing the basics of natural disaster preparedness.
Primary Outcome Measures
NameTimeMethod
Increase from baseline in scores on the Behavioral Health Skills Inventory (BHSI)Baseline, immediately after intervention, 2 week follow-up

This 29-item inventory assesses standardized patient simulation interactions including three behavioral components addressing general healthcare related behaviors, SMI related behaviors and SIA related behaviors. Scores range from 0 to 58, with higher numbers reflecting higher skills in healthcare service delivery for PSMI/SIA.

Secondary Outcome Measures
NameTimeMethod
Increase from baseline in scores on the Literacy of Suicide Scale (LOSS)Baseline, immediately after intervention, 2 week follow-up

This SIA knowledge measure is answered in a correct/incorrect/don't know format. The 27 items are rated on a 3-point scale (true, false, or I don't know), with correct responses allocated a score of 1 and incorrect or I don't know responses assigned a score of 0. Higher LOSS scores indicate higher suicide literacy.

Decrease from baseline in scores on The Emotional Reactions ScaleBaseline, immediately after intervention, 2 week follow-up

This scale was adapted from the original Emotional Reactions to the Mentally Ill Scale to include a suicide ideation case. This 9-item scale includes two vignettes of a person with SIA to assess emotional reaction to the scenario. Each item is rated in a 5-point Likert scale.

Increase from baseline in scores on the Serious Mental Illness Literacy ScaleBaseline, immediately after intervention, 2 week follow-up

This adapted and pilot tested version of the Mental Health Literacy Scale, measures participants' knowledge regarding SMI. The Scale addresses the ability to recognize SMI including: Bipolar Disorder and Schizophrenia. The Scale is composed of two sections measuring SMI knowledge. The first is composed of 15 items (4-point Likert Scale) ranging from (1) very unlikely to (4) very likely. The second section is composed of 20 items using a 5-point Likert Scale ranging from (1) strongly disagree to (5) strongly agree.

Decrease from Stigma of Suicide Scale (Short Version)Baseline, immediately after intervention, 2 week follow-up

This three-factor scale measures stigma towards people who die by suicide. This short version consists of 16-items. Each item consists of a one-word descriptor of a person who dies by suicide, rated on a 5-point Likert scale from (1) strongly disagree to (5) strongly agree.

Increase from baseline in scores on the Cross-Cultural Care Scale (CCCS)Baseline, immediately after intervention, 2 week follow-up

This adaptation of the Cross- Cultural Care Scale which assesses preparedness to treat diverse patient populations. This 19-item scale is rated in a 5-point Likert format.

Decrease from baseline in scores on The Mental Health Stigma Scale for Health ProfessionalsBaseline, immediately after intervention, 2 week follow-up

Used to evaluate mental illness stigma among health professionals, including medical students. This 12-item measure uses a 5-point Likert from (1) strongly agree to (5) strongly disagree. It has three dimensions (social distance, negative character attributions, and self-sufficiency problems).

Trial Locations

Locations (2)

Florida International University

🇺🇸

Miami, Florida, United States

Ponce Health Sciences University

🇵🇷

Ponce, Puerto Rico

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