Intervenciones con medios masivos de comunicación para la reducción del estigma relacionado con la salud mental
Appendices
Appendix 1. Cochrane Central Register of Controlled Trials search strategy
CENTRAL, The Cochrane Library, Issue 7, 2011
stigma OR discrimination OR prejudi* OR social perception OR social distance OR human rights
AND
mental* OR psych* OR depress* OR schizo* OR bipolar OR anxiety OR substance OR alcohol OR dementia OR intellectual disabil* OR learning disabil* OR retardation OR anorex* or bulimi* OR obsessi* OR phobi* OR panic
AND
media OR communication OR television OR radio OR film OR cinema OR movie OR newspap* OR internet OR video OR DVD OR publication OR advert* OR social market* OR campaign* OR messag* OR narrative OR social contact OR audio* OR virtual OR health promotion OR online
315 records found
Appendix 2. MEDLINE and EMBASE search strategy
MEDLINE (OvidSP),1966 to 15 August 2011
EMBASE (OvidSP) 1947 to 15 August 2011
1. stereotyping/
2. (stereotyp* or stigma* or label* or negative image* or ignoran* or misconception* or misperception* or literacy or ((public* or community or social or popular) adj perception*)).tw.
3. social perception/
4. public opinion/
5. prejudice/
6. exp attitude/
7. ((public* or community or social or popular) adj attitude*).tw.
8. (((negative or positive or chang*) adj3 attitude*) or prejudice* or hostil* or intoleran*).tw.
9. social distance/
10. rejection psychology/
11. human rights/
12. (rights or discriminat* or marginali* or rejecting behavior or injustice* or (social adj (distance or justice or rejection or acceptance or exclusion or inclusion))).tw.
13. or/1‐12
14. mental health/
15. mental health services/
16. exp mental disorders/
17. mentally ill persons/
18. ((mental* or psychiatr* or psychological* or developmental* or learning or substance*) adj (ill* or disorder* or disease* or distress* or disab* or problem* or health* or well‐being or wellbeing or patient* or treatment or retardation)).tw.
19. ((chronic* or severe* or serious* or persistent) adj (mental* or psychiatr* or psychological*)).tw.
20. (emotional adj3 (disorder* or problem*)).tw.
21. (psychos#s or psychotic* or schizo* or depression or depressive or bipolar or mania or manic or obsessi* or panic or phobic or phobia or anorexi* or bulimi* or borderline or narcissis* or personality adj1 disorder or self injur* or self harm or dementia or substance abuse).tw.
22. or/14‐21
23. exp mass media/
24. (mass communication or media or broadcast* or radio or television or cinema or film* or movie* or trailer* or journalis*).tw.
25. serial publications/
26. (newspaper* or magazin* or newsletter* or press).tw.
27. journalism/
28. publishing/
29. communications media/
30. telecommunications/
31. electronic mail/
32. (electronic mail* or email* or e‐mail* or webmail* or mailing list* or discussion list* or listserv*).tw.
33. cellular phone/
34. (((mobile or cell* or wireless) adj (phone* or telephone*)) or text messag* or texting or texted or sms or mms).tw.
35. tape recording/
36. optical storage devices/
37. multimedia/
38. (audio* or video* or cassette* or tape* or dvd* or compact dis* or cd or cds or multimedia or multi media).tw.
39. internet/
40. (internet or web or website* or online or blog* or weblog* or podcast* or portal* or e‐communication* or electronic communication* or computer program* or computer mediated).tw.
41. video games/
42. video recording/
43.(apps or facebook or twitter or tweet or bebo or youtube or myspace or chatroom or chatroom or viral message or viral advert or wiki* or virtual*).tw.
44. software/
45. hypermedia/
46. user computer interface/
47. computer assisted instruction/
48. books/
49. pamphlets/
50. (pamphlet* or booklet* or leaflet* or flyer* or brochure* or print* media or print* material* or publication*).tw.
51. publications/
52. government publications as topic/
53. information dissemination/
54. (information adj2 (distribut* or disseminat*)).tw.
55. advertising as topic/
56. public relations/
57. persuasive communication/
58. famous persons/
59. ((famous adj (person* or people)) or celebrit*).tw.
60. social marketing/
61. (campaign* or message* or advert* or marketing or public relation* or publicity or public information or (communication adj (program* or strateg*)) or positive framing or (rais* adj2 awareness)).tw.
62. virtual or indirect or record* or film* or audio*) adj10 (social contact or testimony* or stor* or account* or experience* or narrative* or play or theat*)
63. Health promotion /
64. ((community or broadbased or broad based or public) adj3 education program*).tw.
65. (poster* or billboard* or ribbon* or button* or badge* or visual art* or street art* or (promotion* adj (item* or material*)) or festival* or entertainment).tw.
66. or/ 24‐66
67. 13 and 23 and 67
68. randomized controlled trial.pt.
69. controlled clinical trial.pt.
70. random*.tw.
71. placebo*.tw.
72. trial.tw.
73. groups.ab.
74. evaluation studies.pt.
75. evaluat*.tw.
76. follow up studies/
77. prospective studies/
78. (experiment* or intervention*).tw.
79. (pre test or pretest or post test or posttest).tw.
80. (preintervention or postintervention).tw.
81. time series.tw.
82. time point*.tw.
83. or/69‐83
84. exp animals/ not humans.sh.
85. 84 not 85
86. 68 and 86
3303 records found in MEDLINE
9530 records found in EMBASE
Appendix 3. PsycINFO search strategy
OvidSP, 1806 to 15 August 2011
1. stereotyping/
2. (stereotyp* or stigma* or label* or negative image* or ignoran* or misconception* or misperception* or literacy or ((public* or community or social or popular) adj perception*)).tw.
3. Stigma/
4. social perception/
5. public opinion/
6. prejudice/
7. exp attitude/
8. ((public* or community or social or popular) adj attitude*).tw.
9. (((negative or positive or chang*) adj3 attitude*) or prejudice* or hostil* or intoleran*).tw.
10. social distance/
11. rejection psychology/
12. human rights/
13. (discriminat* or marginali* or rejecting behavior or injustice* or (social adj (distance or justice or rejection or acceptance or exclusion or inclusion))).tw.
14. or/1‐13
15. mental health/
16. mental health services/
17. exp mental disorders/
18. mentally ill persons/
19. ((mental* or psychiatr* or psychological*) adj (ill* or disorder* or disease* or distress* or disab* or problem* or health* or well‐being or wellbeing or patient* or treatment or retardation)).tw.
20. ((chronic* or severe* or serious* or persistent) adj (mental* or psychiatr* or psychological*)).tw.
21. (emotional adj3 (disorder* or problem*)).tw.
22. (((psychos#s or psychotic* or schizo* or depression or depressive or bipolar or mania or manic or obsessi* or panic or phobic or phobia or anorexi* or bulimi* or borderline or narcissis* or personality) adj1 disorder) or self injur* or self harm or dementia or substance abuse).tw.
23. or/15‐22
24. exp mass media/
25. (mass communication or media or broadcast* or radio or television or cinema or film* or movie* or trailer* or journalis*).tw.
26. serial publications/
27. (newspaper* or magazin* or newsletter* or press).tw.
28. journalism/
29. publishing/
30. communications media/
31. telecommunications/
32. electronic mail/
33. (electronic mail* or email* or e‐mail* or webmail* or mailing list* or discussion list* or listserv*).tw.
34. cellular phone/
35. (((mobile or cell* or wireless) adj (phone* or telephone*)) or text messag* or texting or texted or sms or mms).tw.
36. tape recording/
37. optical storage devices/
38. multimedia/
39. (audio* or video* or cassette* or tape* or dvd* or compact dis* or cd or cds or multimedia or multi media).tw.
40. internet/
41. (internet or web or website* or online or blog* or weblog* or podcast* or portal* or e‐communication* or electronic communication* or computer program* or computer mediated).tw.
42. Video games/
43. video recording/
44. (apps or facebook or twitter or tweet or bebo or youtube or myspace or chatroom or chatroom or viral message or viral advert or wiki* or virtual*).tw.
45. software/
46. hypermedia/
47. user computer interface/
48. computer assisted instruction/
49. books/
50. pamphlets/
51. (pamphlet* or booklet* or leaflet* or flyer* or brochure* or print* media or print* material* or publication*).tw.
52. publications/
53. government publications as topic/
54. information dissemination/
55. (information adj2 (distribut* or disseminat*)).tw.
56. advertising as topic/
57. public relations/
58. persuasive communication/
59. famous persons/
60. ((famous adj (person* or people)) or celebrit*).tw.
61. social marketing/
62. (campaign* or message* or advert* or marketing or public relation* or publicity or public information or (communication adj (program* or strateg*)) or positive framing or (rais* adj2 awareness)).tw.
63. ((virtual or indirect or record* or film* or audio*) adj10 (social contact or testimon* or stor* or account* or experience* or narrative* or play or theat*)).tw.
64. Health promotion/
65. ((community or broadbased or broad based or public) adj3 education program*).tw.
66. (poster* or billboard* or ribbon* or button* or badge* or visual art* or street art* or (promotion* adj (item* or material*)) or festival* or entertainment).tw.
67. or/24‐66
68. 14 and 23 and 67
69. randomized controlled trial.pt.
70. controlled clinical trial.pt.
71. random*.tw.
72. placebo*.tw.
73. trial.tw.
74. groups.ab.
75. evaluation studies.pt.
76. evaluat*.tw.
77. follow up studies/
78. prospective studies/
79. (experiment* or intervention*).tw.
80. (pre test or pretest or post test or posttest).tw.
81. (preintervention or postintervention).tw.
82. time series.tw.
83. time point*.tw.
84. or/69‐83
85. exp animals/ not humans.sh.
86. 84 not 85
87. 68 and 86
1808 records found
Appendix 4. CINAHL search strategy
EBSCOhost, 1981 to 16 August 2011
S55. s38 AND s54
S54. s50 NOT s53
S53. s51 NOT S52
S52. (MH "Human")
S51. (MH "Animals")
S50. s39 or s40 or s41 or s42 or s43 or s44 or s45 or s46 or s47 or s48 or s49
S49. (MH "Multiple Time Series")
S48. "preintervention or postintervention"
S47. "experiment* or intervention*"
S46. (MH "Comparative Studies")
S45. (MH "Crossover Design")
S44. (MH "Prospective Studies") OR "follow up stud*"
S43. "evaluation stud*"
S42. "trial or groups"
S41. "random* or placebo*"
S40. (MH "Clinical Trials") OR "controlled clinical trial"
S39. (MH "Randomized Controlled Trials")
S38. s13 and s21 and s35
S37. "randomized controlled trial or controlled clinical trial or random* or palcebo* or trial or groups or evaluation studies or evaluat* or follow up studies or prospective studies or cross over studies or comparative study"
S36. s13 and s21 and s35
S35. s22 or s23 or s24 or s25 or s26 or s27 or s28 or s29 or s30 or s31 or s32 or s33 or s34
S34. TX poster* or billboard* or ribbon* or button* or badge* or visual art* or street art* or promotion* or festival* or entertainment
S33. TX community or broadbased or broad based or public N3 education program*
S32. (MH "Health Promotion") OR "health promotion" OR (MH "Mental Health Promotion (Saba CCC)")
S31. TX campaign* or message* or advert* or marketing or public relation* or publicity or public information or communication or program* or strateg* or public figure* or persuasive communication or social marketing
S30. (MH "Selective Dissemination of Information") OR (MH "Consumer Health Information")
S29. (MH "Government Publications") OR (MH "Public Opinion")
S28. TX pamphlet* or booklet* or leaflet* or flyer* or brochure* or print* media or print* material* or publication*
S27. TX Blog* or apps or facebook or twitter or tweet or bebo or youtube or myspace or chatroom or chatroom or viral message or viral advert or wiki* or virtual* or software or hypermedia or user‐computer interface or computer assisted instruction
S26. TX internet or web or website* or online or on line or blog* or weblog* or podcast* or portal? or e‐communication* or electronic communication* or computer program* or computer mediated
S25. TX audio* or video* or cassette* or tape* or dvd* or compact dis* or cd or cds or multimedia or multi media or computer storage devices or optical disks or audiorecording or videorecording
S24. TX mobile or cell* or wireless N2 phone* or telephone*
S23. TX electronic mail* or email* or e‐mail* or webmail* or mailing list* or discussion list* or listserv* or mobile or cell* or wireless phone* or wireless telephon* or text messag* or texting or texted or SMS or MMS
S22. TX mass communication or media or broadcast* or radio or television or cinema or film* or movie* or trailer* or journalis* or serial publications or newspaper* or magazin* or newsletter* or press
S21. S14 or S15 or S16 or S17 or S18 or S19 or S20
S20. TX psychos?s or psychotic* or schizo* or depression or depressive or bipolar or mania or manic or obsessi* or panic or phobic or phobia or anorexi* or bulimi* or borderline or narcissis* or (personality N1 disorder) or self injur* or self harm or dementia
S19. (MH "Affective Disorders") OR (MH "Affective Disorders, Psychotic") OR "emotional disorder"
S18. "psychiatric illness"
S17. (MH "Mental Retardation") OR "mental retardation" OR (MH "Mentally Disabled Persons")
S16. (MH "Attitude to Mental Illness") OR (MH "Mentally Disabled Persons") OR (MH "Psychosocial Aspects of Illness") OR "mentally ill persons"
S15. (MH "Mental Disorders") OR "mental disorders" OR (MH "Behavioral and Mental Disorders (Non‐Cinahl)")
S14. (MH "Mental Health") OR "mental health" OR (MH "Mental Health Services")
S13. S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12
S12. "(rights or discriminat* or marginali* or rejecting behavior or injustice* or social) N5 (distance or justice or rejection or acceptance or exclusion or inclusion)"
S11. (MH "Human Rights") OR "human rights"
S10. "rejection psychology"
S9. "social distance"
S8. "(negative or positive or chang*) N5 (attitude* or prejudice*or hostil* or intoleran*)"
S7. "(public* or community or social or popular) N5 (attitude*)"
S6. (MH "Attitude") OR "attitude"
S5. (MH "Prejudice") OR "Prejudice"
S4. (MH "Public Opinion") OR "public opinion"
S3. "social perception"
S2. (stereotyp* or stigma* or label* or negative image* or ignoran* or misconception* or misperception* or literacy or public* or community or social or popular) N5 (perception*)
S1. (MH "Stereotyping")
401 records found
Appendix 5. ERIC search strategy
CSA, 1966 to 16 August 2011
1. stereotyping/
2. stereotyp* or stigma* or label* or negative image* or ignoran* or misconception* or misperception* or literacy or public* perception or community perception or social perception or popular perception
3. social perception or public opinion or prejudice or attitude or hostil* or intoleran* or social distance or rejection psychology or human rights
4. discriminat* or marginali* or rejecting behavio?r or injustice* or social distance or social justice or social rejection or social acceptance or social exclusion or social inclusion
5. or/1‐4
6. mental health or mental health services or mental disorders or mentally ill persons or mental* or psychiatr* or psychological* or well‐being or wellbeing or patient* or treatment or retardation
7. psychos* or psychotic* or schizo* or depression or depressive or bipolar or mania or manic or obsessi* or panic or phobic or phobia or anorexi* or bulimi* or borderline or narcissis* or personality or self injur* or self harm or dementia or substance abuse
8. or/6‐7
9. mass media or communication or mass communication or media or broadcast* or radio or television or cinema or film* or movie* or trailer* or journalis* or serial publications or newspaper* or magazin* or newsletter* or press or journalism or publishing or communications media or telecommunications or electronic mail or electronic mail* or email* or e‐mail* or webmail* or mailing list* or discussion list* or listserv*
10. cellular phone or mobile or cell* or wireless or phone* or telephone*or text messag* or texting or texted or sms or mms or tape recording or optical storage devices or multimedia or audio* or video* or cassette* or tape* or dvd* or compact dis* or cd or cds or multimedia or multi media
11. internet or web or website* or online or blog* or weblog* or podcast* or portal* or computer program* or computer mediated or video recording or apps or facebook or twitter or tweet or bebo or youtube or myspace or chatroom or chatroom or viral message or viral advert or wiki* or virtual* or software or hypermedia or user computer interface or computer assisted instruction
12. pamphlet* or booklet* or leaflet* or flyer* or brochure* or print* or material* or publication* or information dissemination or advertising or public relations or famous persons or celebrit* or social marketing or campaign* or message* or advert* or marketing or public relation* or publicity or public information or positive framing or community or broadbased or broad based or public education or program or poster* or billboard* or ribbon* or button* or badge* or visual art* or street art* or promotion* or festival* or entertainment
13. or/9‐12
14. 5 and 8 and 13
15. randomized controlled trial or controlled clinical trial or random or placebo* or trial or groups or evaluation studies or evaluat* or follow up studie or prospective studies or cross over studies or comparative study or time series or time point*
16. animals NOT humans
17. 15 NOT 16
18. 14 and 17
1782 records found
Appendix 6. Social Science Citation Index search strategy
ISI, 1956 to 16 August 2011
1. stereotyping
2. (stereotyp* or stigma* or label* or negative image* or ignoran* or misconception* or misperception* or literacy or ((public* or community or social or popular) near/1 perception*))
3. “social perception”
4. “public opinion”
5. prejudice
6. attitude
7. ((public* or community or social or popular) near/1 attitude*)
8. (((negative or positive or chang*) near/3 attitude*) or prejudice* or hostil* or intoleran*)
9. “social distance”
10. “rejection psychology”
11. “human rights”
12. discriminat* or marginali* or “rejecting behaviour” or injustice* or (social near/1 (distance or justice or rejection or acceptance or exclusion or inclusion)))
13. or/1‐12
14. “mental health”
15. “mental health services”
16. “mental disorders”
17. “mentally ill persons”
18. ((mental* or psychiatr* or psychological*) near/1 (ill* or disorder* or disease* or distress* or disab* or problem* or health* or well‐being or wellbeing or patient* or treatment or retardation))
19. ((chronic* or severe* or serious* or persistent) near/1 (mental* or psychiatr* or psychological*))
20. (emotional near/3 (disorder* or problem*))
21. (((psychos?s or psychotic* or schizo* or depression or depressive or bipolar or mania or manic or obsessi* or panic or phobic or phobia or anorexi* or bulimi* or borderline or narcissis* or personality) near/1 disorder) or self injur* or “self harm” or dementia or “substance abuse”)
22. or/14‐21
23. “mass media”
24. (“mass communication” or media or broadcast* or radio or television or cinema or film* or movie* or trailer* or journalis*)
25. “serial publications”
26. (newspaper* or magazin* or newsletter* or press)
27. journalism
28. publishing
29. “communications media”
30. telecommunications
31. “electronic mail”
32. (electronic mail* or email* or e‐mail* or webmail* or mailing list* or “discussion list*” or listserv*)
33. “cellular phone”
34. (((mobile or cell* or wireless) near/1 (phone* or telephone*)) or “text messag*” or texting or texted or sms or mms)
35. “tape recording”
36. “optical storage devices”
37. multimedia
38. (audio* or video* or cassette* or tape* or dvd* or compact dis* or cd or cds or multimedia or “multi media”)
39. internet
40. (internet or web or website* or online or blog* or weblog* or podcast* or portal* or e‐communication* or “electronic communication*” or “computer program*” or “computer mediated”)
41. “video recording”
42. (apps or facebook or twitter or tweet or bebo or youtube or myspace or chatroom or chatroom or “viral message” or “viral advert” or wiki* or virtual*)
43. software
44. hypermedia
45. “user computer interface”
46. “computer assisted instruction”
47. books
48. pamphlets
49. (pamphlet* or booklet* or leaflet* or flyer* or brochure* or print* media or print* material* or publication*)
50. publications
51. “government publications as topic”
52. “information dissemination”
53. (information near/2 (distribut* or disseminat*))
54. “advertising as topic”
55. “public relations”
56. “persuasive communication”
57. “famous persons”
58. ((famous near/1 (person* or people)) or celebrit*)
59. “social marketing”
60. (campaign* or message* or advert* or marketing or “public relation*” or publicity or public information or (communication adj (program* or strateg*)) or “positive framing” or (rais* near/2 awareness))
61. ((community or broadbased or “broad based” or public) near/3 “education program*”)
62. (poster* or billboard* or ribbon* or button* or badge* or “visual art*” or “street art*” or (promotion* near/1 (item* or material*)) or festival* or entertainment)
63. or/23‐62
64. 13 and 22 and 63
65. “randomized controlled trial”
66. “controlled clinical trial”
67. “random*”
68. “placebo*”
69. “trial”
70. “groups”
71. “evaluation studies”
72. “evaluat*”
73. “follow up studies”
74. “prospective studies”
75. “cross over studies”
76. “comparative study”
77. (experiment* or intervention*)
78. (“pre test” or pretest or “post test” or posttest)
79. (preintervention or postintervention)
80. “time series”
81. “time point*”
82. or/65‐81
83. animals/ not humans
84. 82 not 83
85. 64 and 84
3663 records found
Appendix 7. OpenSIGLE search strategy
http://www.opengrey.eu/) 1980 to 2005, searched 18 August 2011, 2005 date of final entry to database
(stigma OR discrimination OR stereotype* OR social perception OR public opinion OR attitude)
AND
(mental health OR mental health disorders OR mentally ill persons OR mental* or psychiatr* OR psycholog* OR eating disorder OR psycho* OR bipolar OR substance abuse OR anxiety) AND (mass media OR media OR communication OR radio OR television OR cinema OR film OR newspap* OR advertising)
46 records found
Appendix 8. Worldcat search strategy
OCLC, 1978 to 18th Augsut 2011
stigma OR discrimination OR prejudi* OR social perception OR social distance OR human rights
AND
(mental* OR psych* OR depress* OR schizo* OR bipolar OR anxiety OR substance OR alcohol OR dementia OR intellectual disabil* OR learning disabil* OR retardation OR anorex* or bulimi* OR obsessi* OR phobi* OR panic) AND
(media OR communication OR television OR radio OR film OR cinema OR movie OR newspap* OR internet OR video OR DVD OR publication OR advert* OR social market* OR campaign* OR messag* OR narrative OR social contact OR audio* OR virtual OR health promotion OR online)
AND
random* OR trial OR time series OR time point
80 records found
Appendix 9. metaRegister of Controlled Trials search strategy
http://www.controlled‐trials.com/mrct/mrct_about.asp, 1973 to 18 August 2011
stigma
AND
mental health
AND
mass media
0 records found
Study flow diagram.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Forest plot of comparison: 1 Mass media vs. control (main comparison), outcome: 1.1 Discrimination (Immediate).
Forest plot of comparison: 1 Mass media vs. control (main comparison): outcome 1.2 Discrimination.
Forest plot of comparison: 1 Mass media vs. control (main comparison), outcome: 1.3 Prejudice.
Forest plot of comparison: 1 Mass media vs. control (main comparison), outcome: 1.4 Prejudice.
Forest plot of comparison: 5 Mass media vs. control by presence of narratives, outcome: 5.1 Prejudice (at earliest follow‐up time point).
Forest plot of comparison: 6 Mass media vs. control by celebrity narratives, outcome: 6.1 Prejudice (at earliest follow‐up time point).
Forest plot of comparison: 7 Mass media vs. control by fictional narratives, outcome: 7.1 Prejudice (at earliest follow‐up time point).
Forest plot of comparison: 8 Mass media vs. control by type of message, outcome: 8.1 Prejudice (at earliest follow‐up time point).
Forest plot of comparison: 9 Mass media vs. control by type of media, outcome: 9.1 Prejudice (at earliest follow‐up time point)).
Comparison 1 Mass media vs. control: main comparison, Outcome 1 Discrimination (Immediate).
Comparison 1 Mass media vs. control: main comparison, Outcome 2 Discrimination.
Comparison 1 Mass media vs. control: main comparison, Outcome 3 Prejudice.
Comparison 1 Mass media vs. control: main comparison, Outcome 4 Prejudice.
Comparison 2 Mass media vs. control by income of country, Outcome 1 Prejudice (at earliest follow‐up time point).
Comparison 3 Mass media vs. control by number of mass media components, Outcome 1 Prejudice (at earliest follow‐up time point).
Comparison 4 Mass media vs. control by whether combined with non‐mass media, Outcome 1 Prejudice (at earliest follow‐up time point).
Comparison 5 Mass media vs. control by presence of narratives, Outcome 1 Prejudice (at earliest follow‐up time point).
Comparison 6 Mass media vs. control by celebrity narratives, Outcome 1 Prejudice (at earliest follow‐up time point).
Comparison 7 Mass media vs. control by fictional narratives, Outcome 1 Prejudice.
Comparison 8 Mass media vs. control by type of message, Outcome 1 Prejudice (at earliest follow‐up time point).
Comparison 9 Mass media vs. control by type of media, Outcome 1 Prejudice (at earliest follow‐up time point)).
| Mass media compared with inactive control for reducing mental health‐related stigma | ||||
| Patient or population: General public or any of its constituent groups (excluding groups comprising solely of people with mental ill health) Settings: Any Intervention: Mass media Comparison: Inactive control | ||||
| Outcomes | Relative effect | No of Participants | Quality of the evidence | Comments |
| Discrimination (i) not registering to attend focus group with people with schizophrenia (immediate)1 (ii) not visiting sheltered workshop for people with mental illness (9 months)2 (iii) distance placed between chairs when anticipating meeting with person with Tourette's syndrome3 | ORs (802 participants, 2 studies) (i) 1.30 (0.53 to 3.19) (i) 1.19 (0.85 to 1.65) SMDs (394 participants, 3 studies) (iii) median SMD ‐0.25 Range of SMDs ‐0.85 (‐1.39 to ‐0.31) to ‐0.17 (‐0.53 to 0.20) | 1196 (5) | ⊕⊕⊝⊝ | Quality of evidence downgraded for study limitations (risk of bias) and indirectness of measures (see Quality of the evidence for full details) |
| Prejudice Multiple scales4 Follow‐up (i) Immediate5 (ii) 1 week to 2 months6 (iii) 6 to 9 months7 | Median SMD (i) ‐0.38 (ii) ‐0.38 (iii) ‐0.49 Range of SMDs ‐2.94 (‐3.52 to ‐2.37) to 2.40 (0.62 to 4.18) Median SMDs are equivalent to reductions of 0.22, 0.22 and 0.29 points on the 1 to 4 point SDS scale [7], which is equivalent to reducing the level of prejudice from that associated with symptoms of schizophrenia to the level associated with symptoms of major depression8 | 3176 (19) | ⊕⊕⊝⊝ | Quality of evidence downgraded for study limitations (risk of bias) and indirectness of populations (see Quality of the evidence for full details) |
| Cost (i) Audiovisual public service announcement (ii) a) CD‐ROM b) printed manual (iii) magazine article | Relative costs (i) 100 US dollars (equivalent to £64 GBP) vs. nil (ii) a) 35,000 Australian dollars (£22,404 GBP) for 250 e‐learning CDs @ 140 dollars per CD (ii) b) 7,140 Australian dollars(£4,570 GBP) for 238 manuals @ 30 dollars per manual vs. nil (iii) 'printing costs' vs 'printing costs' | 416 (3) | ⊕⊝⊝⊝ | Quality of evidence downgraded for inconsistency of results, imprecision, and 'other' (data only being available on request, lack of cost‐effectiveness data) (see Quality of the evidence for full details) |
| Unforeseen adverse effects | Statements in two studies: (i) ‘Given that this was an educational intervention with a non‐clinical sample, there was no formal enquiry about adverse events. Informally, no adverse events were reported'; (ii) ‘No adverse effects, such as an increase in stigma as a result of the intervention, were identified’ | 2 (455) | ⊕⊕⊝⊝ | Quality of evidence downgraded for study limitations (risk of bias) and imprecision (see Quality of the evidence for full details) |
| CI: Confidence interval; OR: Odds ratio; SMD: Standardised mean difference | ||||
| GRADE Working Group grades of evidence | ||||
| [1] Penn 2003 [2] Yoshida 2002 [3] Woods 2002; Woods 2003; Woods 2005 [4] 28 different measures were used (see Characteristics of included studies) [5] Brown 2010; Bunn 2009; Coleman 2005; Corrigan (submitted); Finkelstein 2008; Iobst 2008; Matthews 2009; Morgan Owusu 2002; Penn 2003; Smith 2007; Woods 2002; Woods 2003; Woods 2005; Yoshida 2002 [6] Russell 1988; Demyan 2009; Brown 2010; Jorm 2010a [7] Yoshida 2002; Finkelstein 2008; Jorm 2010a [OR:1 indicated decreased stigma, > 1 indicates increased stigma; SMD < 0 indicates decreased stigma, > 0 indicates increased stigma] [8] Link 1999 This reference for the scale also reports a population standard deviation of 0.59 for social distance in relation to schizophrenia using the SDS from the observational study, General Social Survey 1996, USA. It gives SDS scores for different mental health conditions which are used for further interpretation. | ||||
| Comparison | No. of comparisons with positive direct of effect1 | Median effect size across all comparisons2 | Median effect size across all comparisons without unit of analysis errors3 | No. of comparisons showing statistically significant effects4 | Interpretation of median effect size across all comparisons5 |
| Mass media vs. control | |||||
| Immediate follow‐up | 3/4 | SMD = ‐0.25 OR = 1.30 | SMD = ‐0.25 | 1/4 (+) | Small/negligible |
| 6 to 9 months follow‐up | 0/1 | OR = 1.19 | OR = 1.19 | 0/1 | Negligible |
| Mass media vs. control by if 2+ mass media components | |||||
| 2+ mass media components | 0/1 | OR = 1.19 | OR = 1.19 | 0/1 | Negligible |
| One mass media component | 3/4 | SMD = ‐0.25 OR = 1.30 | SMD = ‐0.25 | 1/4 (+) | Small/negligible |
| Mass media vs. control by presence of narratives | |||||
| First‐person narratives | 3/4 | SMD = ‐0.25 OR = 1.30 | SMD = ‐0.25 | 1/4 (+) | Small/negligible |
| Third‐person narratives | 0/1 | OR = 1.19 | OR = 1.19 | 0/1 | Negligible |
| Mass media vs. control by type of primary message | |||||
| Recovery‐oriented | 0/1 | OR = 1.19 | OR = 1.19 | 0/1 | Negligible |
| Not to blame | 3/3 | SMD = ‐0.25 | SMD = ‐0.25 | 1/3 | Small |
| Multiple | 0/1 | OR = 1.30 | ‐ | 0/1 | Negligible |
| Mass media vs. control by fictional narratives | |||||
| Fictional narratives | 0/1 | OR = 1.19 | OR = 1.19 | 0/1 | Negligible |
| Non‐fictional narratives | 3/4 | SMD = ‐0.25 OR = 1.30 | SMD = ‐0.25 | 1/4 (+) | Small/negligible |
| Mass media vs. control by type of media | |||||
| Audiovisual | 3/4 | SMD = ‐0.25 OR = 1.30 | SMD = ‐0.25 | 1/4 (+) | Small/negligible |
| | 0/1 | OR = 1.19 | OR = 1.19 | 0/1 | Negligible |
| [1] Stigma‐reducing [2] When there was an even number of effect sizes the median reported is the mean of the two middle values. [3] This excludes cluster trials not adjusted for study design by the authors and without a study‐derived intra‐class correlation co‐efficient (Penn 2003) [4] (+) means in stigma‐reducing direction, (‐) means in stigma increasing direction [5] SMDs large ≥ 0.8; medium ≥ 0.5, small ≥ 0.2, negligible < 0.2; and for ORs large ≥ 4.3; medium ≥ 2.5, small ≥ 1.5, negligible < 1.5, based on Cohen’s (Cohen 1988) rule of thumb, and using a pragmatic decision about how to treat intermediate values | |||||
| Comparison | No. of comparisons with positive direct of effect1 | Median effect size across all comparisons2 | Median effect size across all comparisons without unit of analysis errors3 | No. of comparisons showing statistically significant effects4 | Interpretation of median effect size across all comparisons ( Cohen 1988)5 |
| Mass media vs. control | |||||
| Immediate follow‐up | 12/15 | ‐0.38 | ‐0.38 | 6/15 (+), 1/15 (‐) | Small |
| 1 to 8 weeks follow‐up | 3/5 | ‐0.38 | ‐0.38 | 2/5 (+) | Small |
| 6 to 9 months follow‐up | 3/3 | ‐0.49 | ‐0.49 | 1/3 (+) | Small‐to‐medium |
| Mass media vs. control by income of country | |||||
| Upper middle income | 1/1 | ‐1.69 | ‐1.69 | 1/1 | Large |
| High income | 14/18 | ‐0.42 | ‐0.42 | 7/18 (+) 1/18 (‐) | Small |
| Mass media vs. control by if 2+ mass media components | |||||
| 2+ mass media components | 4/6 | ‐0.49 | ‐0.49 | 3/6 (+) | Small‐to‐medium |
| One mass media component | 12/13 | ‐0.34 | ‐0.34 | 5/13 (+) 1/13 (‐) | Small |
| Mass media vs. control by if combined with non‐mass media | |||||
| With non‐mass media | 2/2 | ‐0.42 | ‐0.42 | 0/2 | Small |
| Mass media alone | 13/17 | ‐0.43 | ‐0.43 | 8/17 (+) 1/17 (‐) | Small |
| Mass media vs. control by presence of narratives | |||||
| First‐person narratives | 8/10 | ‐0.51 | ‐0.51 | 6/10 (+) 1/10 (‐) | Medium |
| Third‐person narratives | 4/5 | ‐0.03 | ‐0.03 | 2/5 (+) | Negligible |
| No narratives | 5/7 | ‐0.27 | ‐0.27 | 3/7 (+) 1/7 (‐) | Small |
| Mass media vs. control by celebrity narratives | |||||
| Celebrity narratives | 1/1 | ‐0.23 | ‐0.23 | 0/1 | Small |
| Non‐celebrity narratives | 11/15 | ‐0.48 | ‐0.44 | 7/15 (+) 1/15 (‐) | Small |
| Mass media vs. control by fictional narratives | |||||
| Fictional narratives | 2/3 | ‐0.42 | ‐0.42 | 1/3 (+) | Small |
| Non‐fictional narratives | 10/12 | ‐0.47 | ‐0.47 | 6/12 (+) 1/12 (‐) | Small |
| Mass media vs. control by type of message | |||||
| Biomedical | 1/2 | 0.99 | ‐0.42 | 1/2 (+) 1/2 (‐) | Large |
| Social inclusion/human rights | 1/1 | ‐2.94 | ‐2.94 | 1/1 (+) | Large |
| Recovery‐oriented | 5/5 | ‐0.30 | ‐0.30 | 1/5 (+) | Small |
| Negative impact of mental illness | 1/2 | ‐0.13 | ‐0.13 | 0/2 | Negligible |
| Seek professional care | 2/3 | ‐0.43 | ‐0.43 | 2/3 (+) | Small |
| Not to blame | 3/3 | ‐0.51 | ‐0.51 | 3/3 (+) | Medium |
| Hallucinatory experience | 1/2 | 0.22 | 0.22 | 1/2 (‐) | Small |
| Multiple messages | 3/4 | ‐0.70 | ‐0.71 | 1/4 (+) | Medium |
| Mass media vs. control by type of media | |||||
| Internet | 3/4 | ‐0.30 | ‐0.30 | 2/4 (+) | Small |
| Audiovisual | 7/10 | ‐0.47 | ‐0.47 | 5/10 (+) 1/10 (‐) | Small |
| Audio | 1/2 | 0.22 | 0.22 | 1/2 (‐) | Small |
| | 6/6 | ‐0.46 | ‐0.46 | 4/5 (+) | Small |
| [1] Stigma‐reducing [2] Excluding study with median and IQR data only (Kerby 2008). When there was an even number of effect sizes the median reported is the mean of the two middle values. [3] This excludes cluster trials not adjusted for study design by the authors and without a study‐derived intra‐class correlation co‐efficient (Penn 2003; Coleman 2005) [4] (+) means in stigma‐reducing direction, (‐) means in stigma increasing direction. Excluding study with median and IQR data only (Kerby 2008) [5] SMDs large ≥ 0.8; medium ≥ 0.5, small ≥ 0.2, negligible < 0.2, based on Cohen’s (Cohen 1988) rule of thumb, and using a pragmatic decision about how to treat intermediate values | |||||
| Study ID
| Measure | Intervention arm | Intervention group summary statistic | N(I) | Control group summary statistic | N(C) | Effect estimate/test statistic and P value/95% CI | |
|
| Psychiatric Knowledge Survey | A (Internet education) | Immediate follow‐up: 90.5% items correct Six‐months follow‐up: 65.6% items correct | 69 | 43.9% items correct | 48 | Pre‐post Χ2 P value < 0.0001 | |
| B (Printed documents) | Immediate follow‐up: 56.3% items correct Six‐months follow‐up: 49.6% items correct | 76 | 43.9% items correct | 48 | Pre‐post Χ2 P value < 0.0001 | |||
| Four knowledge items, beliefs about depression treatments selected | A (CD‐ROM) | 65.8% | 73 | 52.4%
| 82 | OR for pre‐post intervention interactions = 2.11 | ||
| B (manual) | 67.9% | 83 | 52.4% | 82 | OR for pre‐post intervention interactions = 3.64 | |||
| Seven knowledge items, item 1 (what is mental illness) selected | A (standard video) | 96.6% (29/30) | 30 | 76.7% (23/30) | 30 | OR = 8.83 (95% CI 1.01 to 76.96) | ||
| B (culturally specific video) | 96.6% (29/30) | 30 | 76.7% (23/30) | 30 | OR = 8.83 (95% CI 1.01 to 76.96) | |||
| Knowledge of Mental Illness scale | Booklet | 3.22 (1.48) | 301 | 3.03 (1.41) | 391 | Adjusted mean difference = 0.20, 95% CI ‐0.06 to 0.46, P = 0.133) | ||
| [1] Outcome measure used in two previous studies (Jorm 1997; Griffiths 2004); control group same for both intervention arms; statistic from paper, OR or SMD not calculable. [2] Four items, if recognised depression/schizophrenia from vignettes of person portrayed as meeting DSM‐IV‐TR criteria for the conditions DSM (Jorm 1997); two items developed for study: beliefs about treatments for schizophrenia/depression (% of all type treatments deemed by authors to be helpful endorsed by respondent; outcome for review as specified per protocol (Brennan 2009); data from earliest follow‐up time point (1 month). N assumed from consort diagram as not stated. [3] Items developed for study, dichotomous (correct or not); item 1 selected as knowledge outcome for review as specified per protocol [Grimshaw 2003] [4] Six‐item scale developed for study; continuous scale; linear regression model fitted including a random effect for clustering by sampling design (19 areas, average observations per cluster 36); from authors dataset; results presented are unadjusted means (SD) by arm along with the adjusted mean difference between arms, corresponding 95% confidence interval and P value. | ||||||||
| Intervention A (Internet education) %, n = 69 | Intervention B (printed articles) %, n = 76 | |
| Liked educational experience in general (yes/probably yes) | 97.1 | 89.3 |
| Topic is important (yes/probably yes) | 100 | 97.4 |
| Content is useful (y) (yes/probably yes) | 98.6 | 90.7 |
| Content is interesting (y) (yes/probably yes) | 100 | 86.8 |
| Content is unpleasant (no/probably no) | 81.2 | 73.3 |
| Content is difficult to understand (no/probably no) | 89.9 | 61.8 |
| Liked way information is presented (y) (yes/probably yes) | 87.0 | 60.5 |
| Intervention A (CD‐ROM) %, n = 63 to 64 | Intervention B (manual) %, n = 62 to 66 | |
| Read most/all of material | 95.3 | 100.0 |
| Material was easy/very easy to understand | 96.9 | 97.0 |
| Learnt a great deal/a fair bit from material | 90.6 | 90.1 |
| Material was useful/very useful | 93.8 | 98.4 |
| Will use intervention in future | 73.0 | 90.3 |
| Would probably/definitely recommend intervention to others | 96.9 | 98.4 |
| Yoshida 2002 (N = 106)1,2 | Mean (SD) |
|
| Favourability rating (1 to 5) | 3.67 (0.85) | |
| Looking forward to next issue of booklet rating (1 to 5) | 3.67 (1.04) | |
| Recommendation to others rating (1 to 5) | 3.29 (0.78) | |
| [1] Among participants who were aware of the intervention [2] High rating indicates a positive audience reaction | ||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Discrimination (Immediate) Show forest plot | 3 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 2 Discrimination Show forest plot | 2 | Odds Ratio (Random, 95% CI) | Totals not selected | |
| 2.1 Immediate | 1 | Odds Ratio (Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 2.2 6 ‐ 9 months | 1 | Odds Ratio (Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 3 Prejudice Show forest plot | 15 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 3.1 Immediate | 12 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 3.2 1 week ‐ 2 months | 4 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 3.3 6 ‐ 9 months | 2 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 4 Prejudice Show forest plot | 3 | Std. Mean Difference (Random, 95% CI) | Totals not selected | |
| 4.1 Immediate | 2 | Std. Mean Difference (Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 4.2 6 ‐ 9 months | 1 | Std. Mean Difference (Random, 95% CI) | 0.0 [0.0, 0.0] | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Prejudice (at earliest follow‐up time point) Show forest plot | 15 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 1.1 Upper‐middle income | 1 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 High income | 14 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Prejudice (at earliest follow‐up time point) Show forest plot | 15 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 1.1 Multiple mass media components | 4 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 One mass media component | 11 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Prejudice (at earliest follow‐up time point) Show forest plot | 15 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 1.1 Mass media combined with non‐mass media | 1 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 Mass media alone | 14 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Prejudice (at earliest follow‐up time point) Show forest plot | 15 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 1.1 First‐person narratives | 7 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 Third‐person narratives | 4 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.3 No narratives / none stated | 7 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Prejudice (at earliest follow‐up time point) Show forest plot | 11 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 1.1 Celebrity | 1 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 Non‐celebrity | 11 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Prejudice Show forest plot | 11 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 1.1 Fictional narrative | 2 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 Non‐fictional narrative | 9 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Prejudice (at earliest follow‐up time point) Show forest plot | 15 | Std. Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 1.1 Biomedical | 1 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 Social inclusion / human rights | 1 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.3 Recovery‐oriented | 4 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.4 Negative impact of mental illness | 2 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.5 Seek professional care | 3 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.6 Not to blame | 3 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.7 This is hallucinatory experience | 2 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.8 Multiple primary messages | 2 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Prejudice (at earliest follow‐up time point)) Show forest plot | 15 | Std. Mean Difference (IV, Random, 95% CI) | Totals not selected | |
| 1.1 Internet (also includes CD‐ROM) | 4 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.2 Recorded ‐ audiovisual | 7 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.3 Recorded ‐ audio | 2 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
| 1.4 Print | 5 | Std. Mean Difference (IV, Random, 95% CI) | 0.0 [0.0, 0.0] | |
