Abstract
BackgroundThe stigma of schizophrenia constitutes a major barrier to early detection and treatment of this illness. Anti-stigma education has been welcomed to reduce stigma among the general public. This study examined the factors associated with the effectiveness of a web-based educational program designed to reduce the stigma associated with schizophrenia.MethodsUsing Link’s Devaluation-Discrimination Scale to measure stigma, the effect of the program was measured by the difference in pre- and post-program tests. In the present study, we focused on program participants whose stigma towards schizophrenia had considerably improved (a reduction of three points or more between pre- and post-program tests) or considerably worsened (an increase of three points or more). The study participants were 1,058 parents of middle or high school students across Japan, including 508 whose stigma had significantly decreased after the program and 550 whose stigma had significantly increased. We used multiple logistic regression analysis to predict a considerable reduction in stigma (by three or more points) using independent variables measured before exposure to the program. In these models, we assessed the effects of demographic characteristics of the participants and four measures of knowledge and views on schizophrenia (basic knowledge, Link’s Devaluation-Discrimination Scale, ability to distinguish schizophrenia from other conditions, and social distance).ResultsParticipants’ employment status, occupation, basic knowledge of schizophrenia, pre-program Link’s Devaluation-Discrimination Scale score, and social distance were significant factors associated with a considerable decrease in the stigma attached to schizophrenia following the educational program. Specifically, full-time and part-time employees were more likely to experience reduced stigma than parents who were self-employed, unemployed, or had other employment status. Considerable decreases in stigma were more likely among parents working in transportation and communication or as homemakers than among other occupational groups. In addition, parents with higher pre-program levels of stigma, lower basic knowledge, or lower social distance were more likely to have reduced levels of stigma.ConclusionsBased on the regression analysis results presented here, several possible methods of reducing stigma were suggested, including increasing personal contact with people with schizophrenia and the improvement of law and insurance systems in primary and secondary industries.
Highlights
The stigma of schizophrenia constitutes a major barrier to early detection and treatment of this illness
The percentages working in the production labor service sector were 24.9 and 20.9%, the percentages working in transportation and communication were 4.2 and 7.1%, and the percentages working as professionals were 16.9 and 20.5% for those in the stigma-increased and stigma-decreased groups, respectively
The primary objective of this study was to explore the factors related to the characterization of considerably decreasing or increasing stigma using appropriate statistical analyses, and the results suggest that our educational program resulted in considerable decreases in stigma for participants with specific characteristics
Summary
The stigma of schizophrenia constitutes a major barrier to early detection and treatment of this illness. This study examined the factors associated with the effectiveness of a web-based educational program designed to reduce the stigma associated with schizophrenia. There have been many studies on demographic and social characteristics associated with stigma towards schizophrenia, including educational attainment, occupation, and previous contact with people with schizophrenia [4,6,7]. A notable exception is a recent study by Yoshii [8] that showed that the factors reducing the risk of stigma associated with schizophrenia in Japanese parents were family income, previous contact with people with schizophrenia, and participation in welfare activities for people with mental illness
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