Effects of online stigma-reduction programme for people experiencing mental health conditions: A systematic review and meta-analysis.
Yong-Shian Goh, Qing Yun Jenna Ow Yong, Wai-San Wilson Tam
PMID 34081384WHAT IT FOUND
Online anti-stigma programmes produced a small reduction in public stigma toward people with mental health conditions compared with control.
The gain was not clear versus face-to-face programmes and was fragile when one study was excluded.
Key findings
01In five pooled studies with 1203 participants, online anti-stigma programmes reduced public stigma compared with control groups (standardized mean difference -0.33, 95% CI -0.60 to -0.05, P = 0.02), but heterogeneity was high (I2 = 82%, P < 0.001).
02The main result was not robust: after excluding the study with the largest effect, the pooled difference was -0.22 (95% CI -0.44 to 0.01, P = 0.06), and the significant effect was seen mainly against wait-list or no-intervention controls rather than face-to-face controls.
03Three pooled follow-up studies with 428 participants found a small-to-medium reduction in stigma at follow-up (standardized mean difference -0.44, 95% CI -0.60 to -0.28, P < 0.001), but only three of five studies contributed follow-up data.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only five studies were pooled for the main outcome, and four studies were analysed narratively because summary data were missing. The pooled effect was fragile: it became -0.22 (95% CI -0.44 to 0.01, P = 0.06) after excluding one study, and heterogeneity was high (I2 = 82%, P < 0.001). Most significant comparisons were against wait-list or no-intervention controls, so the review does not clearly show online programmes work as well as face-to-face programmes. Follow-up data came from only three of five pooled studies, so long-term effects are uncertain. Risk of bias was high in allocation concealment, blinding of participants and personnel, and outcome assessment, with unclear selective reporting in many studies. Only English-language articles were included, and the included studies varied widely in population, intervention content, comparator and stigma measure. The review measured public stigma, not internalized or self-stigma, so it does not show how people with mental health conditions themselves are affected.
The easy way to misread this
Do not conclude that online anti-stigma programmes are proven equivalent to face-to-face programmes. The significant pooled effect was mainly against wait-list or no-intervention controls, and it was no longer significant after excluding one study.