The goal of this randomized controlled trial is to learn if an educational program can reduce stigma toward mental illness among primary health care providers. The main questions it aims to answer are: * Does the educational program decrease stigma toward mental illness among participants? * How does the program improve knowledge about mental illness? * What beliefs about mental illness do participants hold before and after the program? Researcher will compare the intervention group, who will receive the educational program, to a control group that will not receive the program to see if the educational program is effective in reducing stigma and improving knowledge. Participants will: Attend educational sessions designed to increase awareness and understanding of mental illness. Complete questionnaires about their attitudes, beliefs, and knowledge regarding mental illness before and after the program. Provide demographic information and professional background details.
This study aims to evaluate the effectiveness of an educational program designed to reduce stigma toward mental illness among primary health care providers in Kirkuk, Iraq. Given the critical role healthcare providers play in identifying and supporting individuals with mental health issues, addressing stigma is essential for improving mental health care delivery. Study Design: The study will utilize a randomized controlled trial (RCT) design, with participants assigned to either an intervention group that receives the educational program or a control group that does not. This design will allow for a comparison of outcomes between the two groups. Participants: Participants will include healthcare providers working in primary health care centers, specifically from the psychosocial, health promotion, and school health units. Primary healthcare providers within those centers will be chosen through simple random sampling to ensure a representative sample of participants. Intervention: The educational program will consist of interactive sessions that cover topics such as the nature of mental illness, its impact on individuals and families, effective communication strategies, and methods for providing empathetic care. The program will be delivered over eight sessions, including both lectures and group discussions to facilitate engagement and learning. Outcomes: The primary outcomes will include: Changes in stigma levels, assessed through the Opening Minds Scale for Health Care Providers (OMS-HC). Changes in knowledge about mental health, evaluated using the Mental Health Knowledge Questionnaire (MHKQ). Beliefs about mental illness, measured through the Beliefs toward Mental Illness scale (BMI). Reported and intended behaviors toward individuals with mental health problems, assessed using the Reported and Intended Behaviour Scale. Data will be collected at three time points: pre-intervention, post-intervention, and at a follow-up stage to assess the sustainability of the program's effects. Data Analysis: Statistical analyses will be conducted to compare pre- and post-intervention results between the intervention and control groups. Changes in stigma, knowledge, and beliefs will be analyzed to determine the program's overall effectiveness. Significance: By evaluating the impact of this educational program, the study aims to provide evidence-based recommendations for training healthcare providers in culturally sensitive mental health care practices. Ultimately, the findings could lead to improved mental health outcomes in the community by fostering a more supportive environment for individuals experiencing mental health issues.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
165
The intervention consists of an 8-session educational program designed to reduce stigma towards mental illness among primary healthcare providers. The program includes lectures and multimedia presentations on mental health, stigma, and its effects. It engages participants in role-playing exercises to simulate the experience of stigma and improve communication skills. Group discussions allow participants to reflect on personal beliefs and attitudes, and case studies provide real-world examples of stigma and intervention strategies. The program spans four days, with two sessions per day, each lasting 50-60 minutes.
Kirkuk Department of Health - Primary Health Care Sectors
Kirkuk, Kirkuk Governorate, Iraq
Change in Stigma Levels
The primary outcome measure is the change in stigma levels toward mental illness among healthcare providers, as assessed by the Opening Minds Scale for Health Care Providers (OMS-HC). Coding\\ On the 15-item scale: items 2, 6, 7, 8, 14 require reverse scoring. Outcomes: Total OMS-HC 15 mean score Total scale scores could range from 15 to 75 and a lower score indicates less stigma Subscales: 1. Attitudes of health care providers towards people with mental illness (5 items = 1, 9, 10, 11, 13, 15) The concepts captured in this subscale relate to general attitudes towards people with mental illness and the role of health care providers 2. Attitudes of health care providers towards disclosure and help-seeking (4 items = 3, 4, 5, 8) The concepts captured in this subscale relate to self-disclosure of mental illness and help seeking behavior 3. Attitudes of health care providers towards social distance (5 items = 2, 6, 7, 12, 14)
Time frame: Baseline pre the educational program, and at 3 months follow-up.
Mental Health Knowledge Questionnaire based on educational program.
This section of the questionnaire assesses the knowledge of primary health care providers about mental health topics covered in the educational program. It consists of 10 multiple-choice questions, each presented in a "best of five" format. Participants must choose the most appropriate answer from five options. The questions are designed to evaluate key concepts such as mental illness recognition, treatment modalities, stigma reduction strategies, and best practices in patient care. The goal is to measure the impact of the educational program on enhancing the participants' understanding and competence in mental health care.
Time frame: Before the educational program and at 3 months post-program completion.
Change in Knowledge About Mental Illness
The secondary outcome measure is the improvement in knowledge about mental illness, measured by the Mental Health Knowledge Questionnaire (MHKQ). A 16-item questionnaire, the scale consists of sixteen items rated on a dichotomous response scale (yes/no). One point is given for each 'yes' response on items 1, 3, 5, 7, 8, 11, 12, 15, 16 and 1 point is given for each 'no' response on items 2, 4, 6, 9, 10, 13 and 14. The item scores are added up to a total score (range: 0-16), with higher scores indicating higher MHK.
Time frame: Baseline pre the educational program, and at 3 month follow-up.
Change in Beliefs Toward Mental Illness
The Beliefs toward Mental Illness scale (BMI) consists of 3 subscales measuring dangerousness, Social and Interpersonal skills, and incurability. BMI is a 5-point Likert scale, consists of total 21 items, and ranging from 21 to 105. The higher score indicates more favorable beliefs towards mental illnesses
Time frame: Baseline pre the educational program, and at 3 months follow-up.
Change in Reported and Intended Behavior Toward People with Mental Illness
The primary outcome measure is the change in reported and intended behavior toward people with mental illness among healthcare providers, as assessed by the Reported and Intended Behaviour Scale (RIBS). RIBS is a 5-points Likert scale, ranging from 4 to 20 with higher score indicates more favorable intended behavior with mentally ill patients.
Time frame: Baseline pre the educational program, and at 3 follow-up.
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