Evaluating the changes in attitudes towards mental illness and physical disabilities after an anti-stigma course for occupational therapy students.

Students were not assigned to the courses. The anti-stigma group chose that course and the comparison group was taking a required sociology course in a different semester, so the groups may have differed in ways the study cannot account for (the authors name selection bias themselves). The two courses ran in different semesters, and the sociology course moved online during COVID-19, with its posttest postponed to September in 2020 or done online in 2021. The authors note this could itself have affected attitudes, so the comparison is not clean. Attitudes were measured only by what students said about themselves on questionnaires, which people can answer in socially desirable ways. Only 65 students at one university were analysed, and many enrolled students were left out (non-OT students, those who declined, those with incomplete data), so the results may not match the students who originally signed up. The comparison group also received a two-hour reading and lecture on stigma, so what was tested is the fuller anti-stigma course against brief stigma teaching, not against no teaching at all. Outcomes were measured only at the end of the course, so there is no follow-up and no way to tell whether any attitude change lasted. The control group had more students with a family member or friend with a disability (10 of 32 versus 3 of 33), a difference the paper reports as not significant. One-tailed statistical tests were used, which are more likely to call a difference significant than two-tailed tests.

The research was funded by the Ministry of Science and Technology in Taiwan (two grants: MOST 105-2511-S-006-007-MY3 and MOST 108-2511-H-006-010-MY3). The authors declared no potential conflicts of interest.

Do not read these improvements as proof that the anti-stigma course works. Students chose that course instead of being assigned to it, the comparison class ran in different semesters and was partly online because of COVID-19, and the results come from students' own ratings of their attitudes. The course also did not change stigmatizing attitudes towards mental illness.