Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.

Stigma is a critical barrier for TB care delivery; yet data on stigma reduction interventions is limited. This review maps the available literature on TB stigma reduction interventions, using the Health Stigma and Discrimination framework and an implementation analysis to identify research gaps and...

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Main Authors: Isabel Foster, Michelle Galloway, Wieda Human, Michaile Anthony, Hanlie Myburgh, Nosivuyile Vanqa, Dillon T Wademan, Goodman Makanda, Phumeza Tisile, Ingrid Schoeman, Graeme Hoddinott, Ruvandhi R Nathavitharana
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0000989
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author Isabel Foster
Michelle Galloway
Wieda Human
Michaile Anthony
Hanlie Myburgh
Nosivuyile Vanqa
Dillon T Wademan
Goodman Makanda
Phumeza Tisile
Ingrid Schoeman
Graeme Hoddinott
Ruvandhi R Nathavitharana
author_facet Isabel Foster
Michelle Galloway
Wieda Human
Michaile Anthony
Hanlie Myburgh
Nosivuyile Vanqa
Dillon T Wademan
Goodman Makanda
Phumeza Tisile
Ingrid Schoeman
Graeme Hoddinott
Ruvandhi R Nathavitharana
author_sort Isabel Foster
collection DOAJ
description Stigma is a critical barrier for TB care delivery; yet data on stigma reduction interventions is limited. This review maps the available literature on TB stigma reduction interventions, using the Health Stigma and Discrimination framework and an implementation analysis to identify research gaps and inform intervention design. Using search terms for TB and stigma, we systematically searched PubMed, EMBASE and Web of Science. Two independent reviewers screened all abstracts, full-texts, extracted data, conducted a quality assessment, and assessed implementation. Results were categorized by socio-ecological level, then sub-categorized by the stigma driver or manifestation targeted. After screening 1865 articles, we extracted data from nine. Three studies were implemented at the individual and interpersonal level using a combination of TB clubs and interpersonal support to target internal and anticipated stigma among persons with TB. Two studies were implemented at the interpersonal level using counselling or a video based informational tool delivered to households to reduce stigma drivers and manifestations. Three studies were implemented at the organizational level, targeting drivers of stigma among healthcare workers (HW) and enacted stigma among HWs. One study was implemented at the community level using an educational campaign for community members. Stakeholder consultation emphasized the importance of policy level interventions and education on the universality of risk to destigmatize TB. Review findings suggest that internal and anticipated TB stigma may be addressed effectively with interventions targeted towards individuals using counselling or support groups. In contrast, enacted TB stigma may be better addressed with information-based interventions implemented at the organizational or community level. Policy level interventions were absent but identified as critical by stakeholders. Implementation barriers included the lack of high-quality training and integration with mental health services. Three key gaps must be addressed in future research: consistent stigma definitions, standardized stigma measurement, and measurement of implementation outcomes.
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spelling doaj.art-000850d5fe534696bc08b1559c68536b2023-09-03T14:12:42ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-01210e000098910.1371/journal.pgph.0000989Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.Isabel FosterMichelle GallowayWieda HumanMichaile AnthonyHanlie MyburghNosivuyile VanqaDillon T WademanGoodman MakandaPhumeza TisileIngrid SchoemanGraeme HoddinottRuvandhi R NathavitharanaStigma is a critical barrier for TB care delivery; yet data on stigma reduction interventions is limited. This review maps the available literature on TB stigma reduction interventions, using the Health Stigma and Discrimination framework and an implementation analysis to identify research gaps and inform intervention design. Using search terms for TB and stigma, we systematically searched PubMed, EMBASE and Web of Science. Two independent reviewers screened all abstracts, full-texts, extracted data, conducted a quality assessment, and assessed implementation. Results were categorized by socio-ecological level, then sub-categorized by the stigma driver or manifestation targeted. After screening 1865 articles, we extracted data from nine. Three studies were implemented at the individual and interpersonal level using a combination of TB clubs and interpersonal support to target internal and anticipated stigma among persons with TB. Two studies were implemented at the interpersonal level using counselling or a video based informational tool delivered to households to reduce stigma drivers and manifestations. Three studies were implemented at the organizational level, targeting drivers of stigma among healthcare workers (HW) and enacted stigma among HWs. One study was implemented at the community level using an educational campaign for community members. Stakeholder consultation emphasized the importance of policy level interventions and education on the universality of risk to destigmatize TB. Review findings suggest that internal and anticipated TB stigma may be addressed effectively with interventions targeted towards individuals using counselling or support groups. In contrast, enacted TB stigma may be better addressed with information-based interventions implemented at the organizational or community level. Policy level interventions were absent but identified as critical by stakeholders. Implementation barriers included the lack of high-quality training and integration with mental health services. Three key gaps must be addressed in future research: consistent stigma definitions, standardized stigma measurement, and measurement of implementation outcomes.https://doi.org/10.1371/journal.pgph.0000989
spellingShingle Isabel Foster
Michelle Galloway
Wieda Human
Michaile Anthony
Hanlie Myburgh
Nosivuyile Vanqa
Dillon T Wademan
Goodman Makanda
Phumeza Tisile
Ingrid Schoeman
Graeme Hoddinott
Ruvandhi R Nathavitharana
Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.
PLOS Global Public Health
title Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.
title_full Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.
title_fullStr Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.
title_full_unstemmed Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.
title_short Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.
title_sort analysing interventions designed to reduce tuberculosis related stigma a scoping review
url https://doi.org/10.1371/journal.pgph.0000989
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