Reducing Stigma Toward Mental Illness and Substance Use Issues in Primary Health Care in Chile

Pontificia Universidad Catolica de Chile

Status: Enrolling

Conditions: Substance Abuse; Stigmatization; Mental Health

Treatments: Other: Recovery-Based Arts; Other: Raising Awareness; Other: Developing teams of Local Leaders; Other: Innovative Contact-Based Education; Other: Analysis of Internal Policies, Procedures and Protocols

Study type: Interventional

Funder types: Other

Identifiers

NCT05578066

FONDECYT 1201504

Details and patient eligibility

About

This research project aims to determine the effectiveness of a comprehensive anti-stigma intervention in reducing stigmatizing attitudes and behaviours among Primary Health Care (PHC) providers toward individuals with mental illness and/or substance use issues (MISUI) in the Chilean context, using Centros de de Salud Familiar (CESFAMs) as the point of intervention.

Full description

The intervention model will be culturally adapted with CESFAM PHC provider and user input to be relevant and valid to Chile. The 18-month intervention includes five (5) components that are simultaneously implemented in CESFAMs: (1) Develop a Team of Local Champions in each intervention CESFAM, comprising PHC providers and users; (2) Analysis of Internal CESFAM Policies, Procedures, and Protocols to determine areas of improvement in service delivery for individuals with MISUI; (3) Raising Awareness of stigma toward MISUI using various forms of media within the CESFAM; (4) Innovative Contact-Based Education workshops on anti-stigma and recovery principles, co-lead by academic/clinical trainers and a person with lived experience of MISUI; and (5) Recovery-Based Arts, a multi-week arts workshop for PHC providers and users to produce artwork related to MISUI and recovery, culminating in an exhibition to showcase artwork for the CESFAM providers, users, and community.

Due to Coronavirus disease of 2019 (COVID-19) sanitary context some of the interventions may be developed remotly dependind on each primary healthcare center needs and capability. This interventions will be implemented in years two and three of the study and the final year of the study is dedicated to integrated data analysis, a 6-month follow-up data collection, and dissemination of results.

If the intervention proves to be effective, control CESFAMs will be provided with an anti-stigma initial training and protocols for intervention implementation.

Enrollment: 16 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• CESFAM must serve a registered population of at least 15,000 people
• CESFAM have at least 50 staff employed

Exclusion criteria

• CESFAM being part of another antistigma program.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

16 participants in 2 patient groups

Intervention group

Experimental group

Description:

The experimental group will be composed by aproximately 8 CESFAM with 36 Primary Health Care providers that are currently employed with a total of 288 providers per arm. And some PHC users that have received care there for Mental Health Abuse Issues in the three months prior to study participation. The interventions include a comprehensive, 18-month, recovery-oriented anti-stigma intervention is composed by five components. 1. Developing a Team of Local Champions 2. Analysis of Internal Policies, Procedures and Protocols 3. Raising Awareness 4. Innovative Contact-Based Education 5. Recovery based Arts. Teams of leaders developed as part of the first component will assist the research team with the implementation of the anti-stigma intervention at their respective CESFAM.

Treatment:

Other: Analysis of Internal Policies, Procedures and Protocols

Other: Recovery-Based Arts

Other: Developing teams of Local Leaders

Other: Innovative Contact-Based Education

Other: Raising Awareness

Control group

No Intervention group

Description:

The control group will be composed by aproximately 8 CESFAM with 36 Primary Health Care providers that are currently employed with a total of 288 providers per arm. And some PHC users that have received care there for Mental Health Abuse Issues in the three months prior to study participation. Data will be collected from this group in order to generate an integrated analysis with the information recolected from the intervention group.