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Stigma Intervention Among Primary Health Workers in Toronto

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03043417
Recruitment Status : Unknown
Verified July 2017 by Akwatu Khenti, Centre for Addiction and Mental Health.
Recruitment status was:  Active, not recruiting
First Posted : February 6, 2017
Last Update Posted : July 6, 2017
Sponsor:
Collaborator:
Canadian Institutes of Health Research (CIHR)
Information provided by (Responsible Party):
Akwatu Khenti, Centre for Addiction and Mental Health

Brief Summary:
This project is measuring the effectiveness of an anti-stigma intervention among primary care providers. Both staff and clients will be asked to complete survey data in order to measure the effectiveness. This is a randomized control trial in that three health centres will receive the intervention and three will not. Results will determine if this intervention reduces stigma among staff toward people with a mental health problem and/or substance use problem.

Condition or disease Intervention/treatment Phase
Mental Health Disorder Substance Use Behavioral: CHC's given the intervention Not Applicable

Detailed Description:

The Office of Transformative Global Health at the Centre for Addiction and Mental Health (CAMH), with funding provided by the Canadian Institutes of Health Research (CIHR), has developed and will be implementing a three year anti-stigma study. This project is a randomized control study which compares the effectiveness of an anti-stigma intervention in three Toronto community health centres. Six centres were selected and randomized so that three receive the intervention and the other three do not. The goal is to determine if the intervention impacts service providers' attitudes and behaviours towards people with mental health problems and addictions. Additionally, the study measures client's perceptions of stigma in order to see if they believe stigma has been reduced or eliminated. The interventions incorporate the following components: innovative contact-based training, raising awareness, recovery-based arts, and a thorough analysis of each centre's policies and procedures.

Innovative contact-based training utilizes an adult education model and focuses on the results of a preliminary situational assessment conducted at each site. Emphasis is placed on concurrent disorders, cultural issues, and inter-professional collaboration. Four three-hour workshops were held at each intervention CHC throughout the project period and included a needs-based curriculum, contact-based education to reduce prejudice and social intolerance, and culturally competent care for vulnerable populations. Raising awareness includes various forms of media such as posters to increase awareness about stigma.

Recovery-based arts was geared towards a local team of leaders who selected one art form for their CHC and were taught by an art expert. Approximately ten service users with a mental health and/or substance abuse problem were invited to participate along with three staff members. After 10 bi-weekly art workshops, staff and clients will showcase their work at each CHC. Finally, an analysis of policies and procedures have been conducted by research staff. This determines what already exists and using an anti-stigma/pro-recovery approach to identify strengths and areas for improvement. Program and policies were studied to identify unintended positive and negative impacts using a modified version of the Health Equity Assessment Tool. Features of the Quality Rights Tool Kit were also used. Recommendations from this process will be developed and shared with each CHC.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 270 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Exploring Stigma, Discrimination, and Recovery-based Perspectives Toward Mental Illness and Substance Use Problems
Study Start Date : May 2014
Estimated Primary Completion Date : March 2018
Estimated Study Completion Date : March 2018

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: CHC's given the intervention
Three CHC sites where all staff receive all components of the intervention. Training, Media, Art workshops, and a Policy analysis as well as survey completion.
Behavioral: CHC's given the intervention
CHC's NOT given the intervention

No Intervention: CHC's with NO intervention
Three CHC sites where all staff and a selection of clients complete surveys but receive no intervention.



Primary Outcome Measures :
  1. Opening Minds Scale for Health Care Providers (OMS-HC) [ Time Frame: 2 years ]
    The OMS-HC is a 20-item Canadian scale that was developed specifically to measure stigma among healthcare providers toward individuals with mental illness.This scale has good internal consistency (Cronbach's alpha = 0.82), satisfactory test-retest reliability, intra-class correlation (0.66; 95% CI: 0.54-0.75)59 and sensitivity to change.

  2. Mental Illness: Clinicians Attitudes Scale (MICA) [ Time Frame: 2 years ]
    MICA is a 16-item scale that was also designed to measure attitudes among healthcare workers toward individuals with mental illness.The MICA scale has good internal consistency (Cronbach's alpha = 0.79), with a test-retest reliability (concordance) of 0.80 (95% CI: 0.68-0.91).

  3. Modified Borgadus Social Distance Scale [ Time Frame: 2 years ]
    The Modified Borgadus Social Distance Scale is based on the Borgadus Social Distance Scale.Our study will use a modified six-item version of this scale, focusing specifically on persons with one key mental illness (schizophrenia) and one key addiction (heroin dependence).



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Staff - all staff, no matter their position, is asked to participate.
  • Clients - individuals reporting current or past mental illness and/or substance use problems (MHSUD) AND have received services or participate in any programming at the CHC

Exclusion Criteria:

  • Staff - no exclusion criteria
  • Clients - Clients under the age of 18 years, clients who do not have a MHSUD, or clients that are not safely able to participate.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03043417


Locations
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Canada, Ontario
Centre for Addiction and Mental Health
Toronto, Ontario, Canada, M2N5E6
Sponsors and Collaborators
Centre for Addiction and Mental Health
Canadian Institutes of Health Research (CIHR)
Investigators
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Principal Investigator: Akwatu A Khenti, MA Centre for Addiction and Mental Health

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Akwatu Khenti, Director, Global Health, Centre for Addiction and Mental Health
ClinicalTrials.gov Identifier: NCT03043417    
Other Study ID Numbers: 0512014
First Posted: February 6, 2017    Key Record Dates
Last Update Posted: July 6, 2017
Last Verified: July 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by Akwatu Khenti, Centre for Addiction and Mental Health:
Stigma
Primary Health Care
Recovery
Additional relevant MeSH terms:
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Mental Disorders