A Cluster-Randomized Controlled Intervention Study to Assess the Effect of a Contact Intervention in Reducing Leprosy-Related Stigma in Indonesia

Peters, Ruth; Dadun,; Zweekhorst, Marjolein; Bunders, Joske; Irwanto, Irwanto; Brakel, Wim H. van

doi:10.1371/journal.pntd.0004003

Cited by 68 publications

(71 citation statements)

References 56 publications

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“…In general, the effectiveness evaluation of interventions is considerably restricted. Only 9 studies applied standardized measures . Those incorporated stigma‐related attitudes and behaviours assessed from the perspective of the patients or the general public.…”

Section: Resultsmentioning

confidence: 99%

“…While both approaches indicated positive results, the participatory strategy seemed to be superior to the information‐based strategy. Further studies, establishing contact of patients and the general public, indicated positive results . To address self‐stigma, different studies assessed the effect of skills building and counselling for patients, mainly on group level.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Strategies to reduce stigma related to visible chronic skin diseases: a systematic review

Topp

Andrees

Weinberger

et al. 2019

Acad Dermatol Venereol

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Many patients with a visible chronic skin disease experience discrimination and stigmatization. This results in psychosocial impairments in addition to the burden of disease and emphasizes the urgency to implement effective stigma‐reduction strategies. To synthesize what is known globally about effective interventions to reduce stigma associated with visible chronic skin diseases, a systematic review was conducted. Four electronic databases were searched until May 2018. Studies evaluating interventions to reduce stigmatization in patients with visible chronic skin diseases and applying at least one stigma‐related outcome measure were included. Data were extracted on study design, country, study population, outcome measures and main findings. Results were subsequently synthesized in a narrative review. Critical Appraisal Skills Programme tools were used to assess study quality. Nineteen studies were included in the review. Study design was very heterogeneous and study quality rather poor. Thirteen studies addresses patients with leprosy in low‐ and middle‐income countries, and one study each targeted patients with onychomycosis, leg ulcer, facial disfigurement, atopic dermatitis, vitiligo and alopecia. Evaluated interventions were mainly multi‐faceted incorporating more than one type of intervention. While 10 studies focused on the reduction in self‐stigma and 4 on the reduction in public stigma, another 5 studies aimed at reducing both. The present review revealed a lack of high‐quality studies on effective approaches to reduce stigmatization of patients with visible chronic skin diseases. Development and evaluation of intervention formats to adequately address stigma is essential to promote patients’ health and well‐being.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Strategies to reduce stigma related to visible chronic skin diseases: a systematic review

Topp

Andrees

Weinberger

et al. 2019

Acad Dermatol Venereol

View full text Add to dashboard Cite

show abstract

“…Lusli et al [16,17] showed the benefit of psychosocial support like counselling on the leprosy-related stigma. Moreover, Peters et al [18,19] illustrated the success of a contact intervention in Indonesia to reduce leprosy-related stigma in the community. These interventions are likely to work for CL as well.…”

Section: Discussionmentioning

confidence: 99%

Psychological and Psychosocial Consequences of Zoonotic Cutaneous Leishmaniasis among Women in Tunisia: Preliminary Findings from an Exploratory Study

Chahed

Bellali

Jemaa³

2016

PLoS Negl Trop Dis

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BackgroundThe incidence of zoonotic cutaneous leishmaniasis (ZCL) makes it the most widespread parasitic disease in Tunisia and the Arab world. Yet, few studies have addressed its psychological and psychosocial effects. The purpose of this study was to examine the psychosocial impact of ZCL scars among Tunisian women.MethodsWe conducted an exploratory study, we administered Revised Illness Perception Questionnaire (IPQ-R), World Health Organization Quality Of Life-26 (WHOQOL-26) and Psoriasis Life Stress Inventory (PLSI) to a group of girls and women with ZCL scar in the region of Sidi Bouzid. This group was randomly selected from volunteers who came to primary health care facilities to seek for treatment for any pathology.ResultsDescriptive statistics showed that the collected scores from the three scales exhibit heterogeneous distributions: IPQ-R (M = 63.6, SD = 15.6), PSLI (M = 9.5, SD = 6.7), WHOQOL-Physical (M = 63, SD = 12.9), WHOQOL-Psychological (M = 52.6, SD = 11.1), WHOQOL-Social (M = 61.8, SD = 17.5), and WHOQOL-Environmental (M = 47.8, SD = 13.3). The correlation analyses performed on Inter and intra-subscales showed that the emotional representations associated with ZCL were correlated with the loss of self-esteem and feelings of inferiority (r = 0.77, p<0.05). In addition, high education level and the knowledge about ZCL are positively correlated with cognitive and emotional representation in the IPQ-R (r = 0.33, p<0.05). "Rejection experiences" and the "anticipation and avoidance of stress" were respectively negatively correlated with age (r = -0.33, p<0.05 and r = -0.31, p<0.05). Correlations between the scores on IPQ-R domains and PLSI factors were significant. The results showed that anticipation of rejection and avoidance of stress are strongly correlated with a negative perception of ZCL. Quality of life scores were not correlated with either age, education level, time of illness, or the number of facial or body scars. However, the correlations between quality of life scores and the multiple IPQ-R domains were all insignificant. Finally, there was a negative correlation between the scores on the perceived quality of social life and the knowledge about ZCL (r = -0.34, p<0.05).ConclusionsThis makes it vital to strengthen preventive health education. Conducting studies on ways to establish a holistic support system for managing ZCL, a system that covers the psychological challenges and the barriers it causes to women’s social and professional integration, is a vital first step.

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“…The SARI project aimed to assess the effectiveness of three stigma-reduction interventions in persons affected by leprosy in Cirebon District, West-Java, Indonesia: counselling, contact [35] and Social Economic Development (SED). The SARI project is a cluster-randomized controlled intervention study and uses the Interactive Learning and Action approach [36] as a guiding methodology.…”

Section: Methodsmentioning

confidence: 99%

The Impact of a Rights-Based Counselling Intervention to Reduce Stigma in People Affected by Leprosy in Indonesia

et al. 2016

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BackgroundThis paper assesses the impact of a counselling intervention on reducing leprosy-related stigma in Cirebon District, Indonesia. The unique features of this intervention are its rights-based approach, the underlying Cognitive Behavioural Therapy (CBT) model, the three types of counselling and the lay and peer counsellors who were involved.Methodology/principal findingsMixed methods (e.g. three scales, interviews, focus group discussions and reflection notes) were used to assess the impact of the intervention, which ran over a two-year period. There was a control area with no interventions. The study participants were people affected by leprosy and other key persons (e.g. family members). The sample size differs per method, for example, data regarding 67 counselling clients and 57 controls from a cohort, and notes from 207 counselling clients were examined. The notes showed that most clients faced stigma on a daily basis, whether internalized, anticipated and/or enacted. A significant reduction was found between the before and after total scores of the SARI Stigma Scale (p-value < 0.001), Participation Scale Short (p-value < 0.001) and WHO Quality of Life score (p-value < 0.001) among the counselling clients. While there is also an effect in the control group, it is much larger in the intervention group. Qualitative data indicates that knowledge and rights trigger change. Clients took steps to improve their life such as re-connecting with neighbours, helping in household activities and applying for jobs. Challenges include the wish to conceal their condition.Conclusion/significanceThe findings show that the counselling intervention was effective in reducing stigma, promoting the rights of people with leprosy and facilitating their social participation. More research is needed on how to create a more sustainable intervention, preferably structurally embedded in the health or social services.

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A Cluster-Randomized Controlled Intervention Study to Assess the Effect of a Contact Intervention in Reducing Leprosy-Related Stigma in Indonesia

Cited by 68 publications

References 56 publications

Strategies to reduce stigma related to visible chronic skin diseases: a systematic review

Strategies to reduce stigma related to visible chronic skin diseases: a systematic review

Psychological and Psychosocial Consequences of Zoonotic Cutaneous Leishmaniasis among Women in Tunisia: Preliminary Findings from an Exploratory Study

The Impact of a Rights-Based Counselling Intervention to Reduce Stigma in People Affected by Leprosy in Indonesia

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