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Impact of 'HIV-related stigma-reduction workshops' on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study.

ABSTRACT: INTRODUCTION:People living with HIV and AIDS (PLWHA) experience stigma and discrimination throughout their life. The consequences of stigma and discrimination are severe when enacted by healthcare providers (HCPs), and result in a delay in or poor adherence to treatment. Studies have demonstrated the presence of stigmatising behaviours among HCPs, yet only a few have presented the impact of interventions on the knowledge and attitude of practising (clinicians and nurses) and future (students) HCPs. OBJECTIVES:To evaluate knowledge, attitudes and infection risk perceptions related to HIV/AIDS among practising and future HCPs in central India. In addition, the impact of the 'HIV-related stigma-reduction workshop' using a pre-intervention and post-intervention study design was evaluated. SETTINGS AND PARTICIPANTS:The study was conducted in 2016 at two tertiary-care hospitals and three healthcare colleges in central India. Overall, 650 HCPs (75 clinicians and 211 nurses) and students (205 medical, 123 nursing and 36 Diploma in Medical and Laboratory Technology (DMLT)) voluntarily participated in the study. INTERVENTION:The educational intervention comprised of training in epidemiology, the transmission and treatment of the HIV infection, the rights of PLWHA, the duties of HCPs and the use of standard precautions. RESULTS:At pre-intervention, DMLT students had the lowest and clinicians the highest knowledge scores (24% and 45%, respectively). The stigmatised attitude was reflected in all groups, the lowest among clinicians (21%) and the highest among DMLT students (34%). Improvement in the post-intervention knowledge scores was the highest in medical students (36%) and the lowest among clinicians (16%). The participants' attitudes improved between 3% and 17% across all groups. CONCLUSIONS:Significant post-intervention improvements were seen in both knowledge and attitudes in all groups. Students had a higher tendency to improve than HCPs. Further long-term studies are needed to evaluate the sustainability of the improvements in knowledge and attitudes of the participants.

SUBMITTER: Machowska A

PROVIDER: S-EPMC7201299 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Impact of 'HIV-related stigma-reduction workshops' on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study.

Machowska Anna A Bamboria Babu Lal BL Bercan Courtney C Sharma Megha M

BMJ open 20200412 4

<h4>Introduction</h4>People living with HIV and AIDS (PLWHA) experience stigma and discrimination throughout their life. The consequences of stigma and discrimination are severe when enacted by healthcare providers (HCPs), and result in a delay in or poor adherence to treatment. Studies have demonstrated the presence of stigmatising behaviours among HCPs, yet only a few have presented the impact of interventions on the knowledge and attitude of practising (clinicians and nurses) and future (stud ...[more]

PMID: 32284388

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Project description:BACKGROUND:Tuberculosis (TB) remains the prime killer disease among infectious diseases. TB control depends on early case detection and treatment in a directly observed treatment short course (DOTS) programme. The success of DOTS depends on the ability of the health care system to identify and properly manage TB cases. The present study aims to assess healthcare provider (HCP) knowledge, attitude and perceived stigma regarding TB and perception about traditional healers. METHODS:A descriptive cross sectional study was conducted among 108 HCPs using a semi-structured, self-administered questionnaire from September 2014 to January 2015. The study district has a high TB burden area with one district hospital, 4 health centres, and 18 health posts. All health facilities and HCPs available during the study period in the district were included in the study. Statistical software for social science (SPSS) version 22 and STATA version 14 were used to enter and analyse data, respectively. RESULTS:The majority (64%) of the HCPs had poor overall knowledge regarding TB, and 67.6 and 57.6% had poor knowledge regarding TB diagnosis and nature of the disease, respectively. Moreover, most 66.7 and 55.6% of the HCPs had an unfavourable attitude towards TB and TB control systems, respectively. Slightly under half (49.1%) of the HCPs had a favourable attitude towards TB patients, and the majority (88.9%) had low perceived stigma. The majority (87.0%) of the HCPs indicated the importance of community involvement in TB control activity. Moreover, most (60.2%) of the HCPs showed willingness to collaborate with traditional healers (THs) on TB control activity. CONCLUSIONS:Healthcare workers' knowledge gap and unfavourable attitude towards TB control systems reported in this study may cause poor TB care delivery. HCPs' perception of the importance of community involvement in TB control and willingness to collaborate with THs on TB management could be an opportunity to strengthen the World Health Organization's (WHO's) component of End TB strategy through community engagement. Training and workshops could be used to address the knowledge gap and the unfavourable attitude regarding TB among HCPs.

Project description:Although physicians in Thailand can carry out abortions legally, unsafe abortion rates remain high and have serious consequences for women's health. Training programs for healthcare providers on the 'Care of unplanned and adolescent pregnancies for the prevention of unsafe abortions' have been implemented in Thailand with the aim of providing information and challenging negative attitudes about abortions. This study investigated the participants of the training courses in order to: (i) evaluate their knowledge and attitudes towards safe abortions; and (ii) investigate the factors that determine their knowledge and attitudes. A pre-post study design was applied. Descriptive statistics were calculated to provide an overview of the data. Bivariate analysis, a Wilcoxon signed rank test and a multivariable analysis using multiple linear regression were applied to determine the changes in attitudes and assess the likelihood of behaviour change towards adolescents and women experiencing unplanned pregnancy and abortions, according to demographic and professional characteristics. Having had the training, healthcare providers' change in attitudes towards adolescents and women experiencing unplanned pregnancies and abortions were found to be 0.67 points for the nine responses of attitudes and 0.79 points for the 14 responses on various abortion scenarios. Changes in attitude were significantly different among the varying health professional types, with non-doctors increasing by 0.53 points, non-obstetricians and non-gynaecologists increasing by 0.46 points and obstetricians and gynaecologists (OBGYN) increasing by 0.32 points. Positive attitudes towards unplanned pregnancies and unsafe abortions and attitudes towards abortion scenarios significantly increased. The career type of the health professional was a significant factor in improving attitudes. The training program was more effective among non-doctor healthcare providers. Therefore, non-doctors could be the target population for training in the future.

Project description:Background:Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, REducing Stigma among HealthcAre Providers to ImprovE mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services into primary healthcare. Methods:This protocol describes a mixed methods pilot and feasibility study in primary care centers in Chitwan, Nepal. The qualitative component will include key informant interviews and focus group discussions. The quantitative component consists of a pilot cluster randomized controlled trial (c-RCT), which will establish parameters for a future effectiveness study of RESHAPE compared to training as usual (TAU). Primary healthcare facilities (the cluster unit, k?=?34) will be randomized to TAU or RESHAPE. The direct beneficiaries of the intervention are the primary healthcare workers in the facilities (n?=?150); indirect beneficiaries are their patients (n?=?100). The TAU condition is existing mental health training and supervision for primary healthcare workers delivered through the Programme for Improving Mental healthcarE (PRIME) implementing the mental health Gap Action Programme (mhGAP). The primary objective is to evaluate acceptability and feasibility through qualitative interviews with primary healthcare workers, trainers, and mental health service users. The secondary objective is to collect quantitative information on health worker outcomes including mental health stigma (Social Distance Scale), clinical knowledge (mhGAP), clinical competency (ENhancing Assessment of Common Therapeutic factors, ENACT), and implicit attitudes (Implicit Association Test, IAT), and patient outcomes including stigma-related barriers to care, daily functioning, and symptoms. Discussion:The pilot and feasibility study will contribute to refining recommendations for implementation of mhGAP and other mental health services in primary healthcare settings in low-resource health systems. The pilot c-RCT findings will inform an effectiveness trial of RESHAPE to advance the evidence-base for optimal approaches to training and supervision for non-specialist providers. Trial registration:ClinicalTrials.gov identifier, NCT02793271.

Dataset Information

Impact of 'HIV-related stigma-reduction workshops' on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study.

Publications

Impact of 'HIV-related stigma-reduction workshops' on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study.

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