Health Myths Research Articles

The Illusory Health Beliefs Scale: preliminary validation using exploratory factor and Rasch analysis.

Illusory health beliefs are ill-founded, erroneous notions about well-being. They are important as they can influence allied attitudes, actions, and behaviors to the detriment of personal and societal welfare. Noting this, and the prevalence of paranormal beliefs in contemporary Western society, researchers developed the Paranormal Health Beliefs Scale (PHBS). Modification of the PHBS for use with a United Kingdom-based sample resulted in the instrument broadening to incorporate illusory rather than merely paranormal health beliefs. The present study psychometrically assessed the emergent Illusory Health Beliefs Scale (IHBS). The principal objective was to validate the IHBS using a large, representative sample. Eight hundred and fifty participants (360 males, 482 females, eight non-binary) completed the IHBS alongside instruments assessing theoretically associated constructs (i.e., magical thinking, faith in scientifically unsubstantiated notions, and forms of self-referential, intuitive causation). Exploratory factor analysis revealed the existence of six meaningful IHBS dimensions: Religious/Spiritual, Superstition, Precognitive, Health Myths, Skepticism, and Health Pseudoscience. The IHBS demonstrated satisfactory reliability and convergent validity with theoretically aligned constructs. Rasch analysis at the subscale level revealed good item/person fit and item/person reliability, unidimensionality, and equivalency of items across subgroups (gender and religious affiliation). Analysis confirmed the IHBS was an effective measure of illusory health beliefs. However, researchers should undertake further work to refine the scale and evaluate its performance across different samples and time points.

Assessing the Accuracy of Generative Conversational Artificial Intelligence in Debunking Sleep Health Myths: Mixed Methods Comparative Study With Expert Analysis.

Adequate sleep is essential for maintaining individual and public health, positively affecting cognition and well-being, and reducing chronic disease risks. It plays a significant role in driving the economy, public safety, and managing health care costs. Digital tools, including websites, sleep trackers, and apps, are key in promoting sleep health education. Conversational artificial intelligence (AI) such as ChatGPT (OpenAI, Microsoft Corp) offers accessible, personalized advice on sleep health but raises concerns about potential misinformation. This underscores the importance of ensuring that AI-driven sleep health information is accurate, given its significant impact on individual and public health, and the spread of sleep-related myths. This study aims to examine ChatGPT's capability to debunk sleep-related disbeliefs. A mixed methods design was leveraged. ChatGPT categorized 20 sleep-related myths identified by 10 sleep experts and rated them in terms of falseness and public health significance, on a 5-point Likert scale. Sensitivity, positive predictive value, and interrater agreement were also calculated. A qualitative comparative analysis was also conducted. ChatGPT labeled a significant portion (n=17, 85%) of the statements as "false" (n=9, 45%) or "generally false" (n=8, 40%), with varying accuracy across different domains. For instance, it correctly identified most myths about "sleep timing," "sleep duration," and "behaviors during sleep," while it had varying degrees of success with other categories such as "pre-sleep behaviors" and "brain function and sleep." ChatGPT's assessment of the degree of falseness and public health significance, on the 5-point Likert scale, revealed an average score of 3.45 (SD 0.87) and 3.15 (SD 0.99), respectively, indicating a good level of accuracy in identifying the falseness of statements and a good understanding of their impact on public health. The AI-based tool showed a sensitivity of 85% and a positive predictive value of 100%. Overall, this indicates that when ChatGPT labels a statement as false, it is highly reliable, but it may miss identifying some false statements. When comparing with expert ratings, high intraclass correlation coefficients (ICCs) between ChatGPT's appraisals and expert opinions could be found, suggesting that the AI's ratings were generally aligned with expert views on falseness (ICC=.83, P<.001) and public health significance (ICC=.79, P=.001) of sleep-related myths. Qualitatively, both ChatGPT and sleep experts refuted sleep-related misconceptions. However, ChatGPT adopted a more accessible style and provided a more generalized view, focusing on broad concepts, while experts sometimes used technical jargon, providing evidence-based explanations. ChatGPT-4 can accurately address sleep-related queries and debunk sleep-related myths, with a performance comparable to sleep experts, even if, given its limitations, the AI cannot completely replace expert opinions, especially in nuanced and complex fields such as sleep health, but can be a valuable complement in the dissemination of updated information and promotion of healthy behaviors.

You must be myths-taken: Examining belief in falsehoods during the COVID-19 health crisis.

The prevalence of health myths is increasing with the rise of Internet use. Left unaddressed, online falsehoods can lead to harmful behaviours. In times of crisis, such as the recent COVID-19 pandemic, the circulation of many myths is exacerbated, often to varying degrees among different cultures. Singapore is a multicultural hub in Asia with Western and Asian influences. Although several studies have examined health myths from a Western or Eastern perspective, little research has investigated online health falsehoods in a population that is culturally exposed to both. Furthermore, most studies examined myths cross-sectionally instead of capturing trends in myth prevalence over time, particularly during crisis situations. Given these literature gaps, we investigated popular myths surrounding the recent COVID-19 pandemic within the multicultural setting of Singapore, by examining its general population. We further examined changes in myth beliefs over the two-year period during the pandemic, and population demographic differences in myth beliefs. Using randomised sampling, two online surveys of nationally representative samples of adults (aged 21-70 years) residing in Singapore were conducted, the first between October 2020 and February 2021 (N = 949), and the second between March and April 2022 (N = 1084). Results showed that 12.7% to 57.5% of the population were unable to identify various myths, such as COVID-19 was manmade, and that three of these myths persisted significantly over time (increases ranging from 3.9% to 9.8%). However, belief in myths varied across population demographics, with ethnic minorities (Indians and Malays), females, young adults and those with lower education levels being more susceptible to myths than their counterparts (p < 0.05). Our findings suggest that current debunking efforts are insufficient to effectively counter misinformation beliefs during health crises. Instead, a post-COVID-19 landscape will require targeted approaches aimed at vulnerable population sub-groups, that also focus on the erroneous beliefs with long staying power.

Assessing the Accuracy of Generative Conversational Artificial Intelligence in Debunking Sleep Health Myths: Comparative Study with Expert Analysis

Assessing the Accuracy of Generative Conversational Artificial Intelligence in Debunking Sleep Health Myths: Comparative Study with Expert Analysis

Do Psychology Students Believe Mental Health Myths more than Medical Students? A Response from the United Arab Emirates

Background Previous work has been done on assessing how much psychology students believe myths, as compared to the general population. This study focuses on the mental health myths discussed in the book 50 Great Myths of Popular Psychology. Objective This study seeks to investigate if Medicinae Baccalaureus, Baccalaureus Chirurgiae (MBBS, Bachelor of Medicine, Bachelor of Surgery) students are more likely than psychology students to accept mental health myths. Methods One hundred and two MBBS students and 209 psychology students at a university in the United Arab Emirates (UAE) were compared in their level of adherence to mental health myths. The measure was based on Lilienfeld et al.'s list of myths focused on mental health, and the comparison was done with a Mann-Whitney test. Results Psychology students came out with greater levels of acceptance of mental health myths. In both groups, the most believed myth pertained to Post Traumatic Stress Disorder. Conclusion In the UAE, students from both MBBS and psychology programs are prone to accepting mental health myths. The lower adherence to mental health myths amongst MBBS students may be due to stricter admissions policies. Teaching implications In the UAE, both MBBS and psychology programs must target efforts in expanding the critical thinking abilities of students, to dispel mental health myths.

A comparison of atrial fibrillation incidence among physician and the general population: Unravel the health myths for physicians

A comparison of atrial fibrillation incidence among physician and the general population: Unravel the health myths for physicians

Improving Nursing Students’ Knowledge about Health Myths in Indonesia

Health myths are one of the factors that can hinder the achievement of government programs in the health sector, resistance that arises from the community can be even greater if the myths that are believed to have taken root in social life and are considered to have magical elements in their implementation. To change the wrong health beliefs in society, the role of health workers in providing health education and health literacy to all levels in society is important. Based on the problems found, the team's goal was to improve nursing students’ knowledge about health myths in Indonesia. The implementation of these activities was carried out for 199 nursing students from 7 provinces (DKI Jakarta, West Java, Banten, Jambi, East Java, Central Java, and Southeast Sulawesi) online through Zoom. This activity is the final series of a series of activities carried out by the Institute of Training, Education, and Research, Nurse Share Idea (NSID) about health myths that exist in Indonesia, while the implementation of this series of activities has been carried out from November 2020 to August 2021. The results of the Wilcoxon test of activities carried out can be seen in table 3. which shows that the value of sig = 0.002 (&lt;0.005) means that the activities carried out have a positive impact on improving nursing students’ knowledge about health myths in Indonesia. Nurses have a role in facilitating public access to reliable health knowledge and information related to existing mythical issues. In supporting the role of nurses, activities to increase the knowledge of nurses and nursing students on topics related to health myths are also an important part to be considered and carried out on an ongoing basis because it has been proven to have a positive effect on its implementation.

Gesundheitsmythen – Falsche Überzeugungen, nur ein Laienproblem?

Background: Health myths are widespread and have a long shelf life. Both lay people and health professionals are exposed to misinformation. It therefore seems central to ask to what extent lay people and health professionals adopt health myths and what health-related prior knowledge and what informational basis underlies them. Methodology: In order to answer the question, an anonymous online survey (N = 577) was conducted among respondents with no, indirect and direct health-related background. In addition to socio-demographic criteria, 12 health myths, the assessment of safety and the preferred basis of health information were queried. Results: In contrast to lay people, members of health-related professional groups resort to reputable sources of information. However, the findings show that prior health knowledge and reputable sources do not protect against adopting health myths. Conclusion: The results suggest that both lay people and health professionals need to be more aware of the critical and reflective use of health information and of the emergence of health myths and psychological phenomena (e.g. illusory truth effect) of human perception bias.

Sexual Health Behaviors and Knowledge Among Ugandan Adolescent Girls: Implications for Advancing Comprehensive Sexual Health Education Technology.

Adolescent girls in Uganda have four-fold HIV infections than adolescent boys. Several barriers to accessing comprehensive sexual health education exist for adolescent girls in Uganda, including unequal, social, and economic statuses, limited access to education and health care services, discrimination, and violence. This study qualitatively examines sexual health behaviors and literacy among Ugandan adolescent girls and explores how technology may be leveraged to improve sexual and reproductive health outcomes in this population. Four focus group discussions (FGDs) were conducted among 32 adolescent girls aged 14-17 years enrolled in Suubi mHealth. Participants were randomly selected from four secondary schools participating in a randomized clinical trial known as Suubi4Her (N = 1260). FGDs were conducted in the local language, audio-recorded, transcribed verbatim, and translated. Translated transcripts were imported into Dedoose for data management and coding. Emerging themes included Influences for Sex/Relationships, HIV Knowledge, and Sources of Sexual Health Information. Participants reported common influences for sexual engagement included seeking resource security, limited parental communication, and peer influences. Participants also demonstrated knowledge gaps, requesting information such as how to prevent unplanned pregnancies and HIV, endorsing sexual health myths, and describing limitations to accessing sexual health information. Noticeable inconsistencies and limited access to information and resources regarding basic sexual health knowledge were reported, which inevitably increases adolescent girls' risks for adverse sexual and reproductive health outcomes. Developing culturally appropriate interventions may help advance the sexual and reproductive health needs of Ugandan adolescent girls.

Evaluation of Some Dental Myths Among the Adult Population in Riyadh, Saudi Arabia: A Cross-Sectional Study.

Background To provide effective oral health care to patients and healthy individuals, it is critical to recognize prevalent myths. Most myths cause patients to follow the wrong protocol in dentistry, which can make treatment difficult for the dentist. This study aimed to assess dental myths among the Saudi Arabian population in Riyadh. Methodology A descriptive cross-sectional questionnaire survey was conducted among Riyadh adults between August and October 2021. Saudi nationals aged 18-65 living in Riyadh without cognitive, hearing, or vision impairments and with limited or no trouble interpreting the questionnaire were surveyed. Only participants who consented to participate in the study were included. JMP Pro 15.2.0 was used to evaluate survey data. Frequency and percentage distributions were used for dependent and independent variables. The chi-square test evaluated the statistical significance of the variables, with a p-value of 0.05 being considered statistically significant. Results A total of 433 participants completed the survey. Half of the sample (50%) were aged 18-28; 50% were men; and 75% had a college degree. Higher-educated men and women did better on the survey. In particular, 80% of the participants believed "teething causes fever." "Placing a (pain killer) tablet on a tooth reduces pain" was believed by 34.40% of the participants, and 26% thought pregnant women should not get dental work. Lastly, 79% of the participants believed that "infants obtain calcium from their mother's teeth and bone." Most sources of these pieces of information were online (62.60%). Conclusions Nearly half of the participants believe in dental health myths, and as a result, people follow unhealthy practices. This results in long-term health consequences. The government and health professionals must prevent the spread of such misconceptions. In this regard, dental health education may be helpful. Most of this study's crucial findings are consistent with those of prior studies, indicating its accuracy.

Use of Hashtags related to Covid-19 infodemics by bot accounts

Abstract Background Along with the Covid-19 pandemic we need to fight an ‘infodemic'. Some of the most widespread social media platforms such as Facebook, Instagram and Twitter have implemented policies to combat the spread of misinformation about Covid. However, the online ecosystem is still full of health myths, hoaxes, and fake news that-either consciously or unconsciously-is propagated by social media users with different purposes, messages that can lead to attitudinal and behavioral changes which might result in inadequate health decision making Methods We use Twitter Stream API to collect tweets about Covid-19 during the early outbreak. Then we filtered those tweets with hashtags related to three infodemic topics: 5g, bill gates, UV and hydroxychloroquine. Then, we use Botometer to obtain the probability that each account is a bot or not. We use bot classification along with network analysis (Louvain community detection) to delve into the subtopics and the use of hashtags. Results The resulting data collection contains ∼14M tweets from ∼285K of different Twitter accounts. We selected only tweets written in English. Regarding 5G, the most important communities link China with the virus, are about “democratshateamerica” or conspiracy theories. Tweets about Bill Gates contain hashtags about Trump, America, or mention the batflu. Communities related with UV are about Trump disinfectant, or pointing out that tv channels spread fake news. Those tweets that mention hydroxychloroquine mostly contain hashtags that mention qanon or maga content. Conclusions In this paper, we analyze the use of hashtags by accounts classified as bots. Using Louvain community detection we identify co-occurring hashtags. Using social network analysis we identify which hashtags are the most important within the conversation. Key messages • We identify several communities around most important infodemic topics. Bots activity in most of the cases is about political content than spreading health misinformation. • This method allows to find subtopics based on the use of hashtags. Which allow public health policies to prevent the spread of infodemics.

No change without some continuity: Evergreen health myths resurfacing during the COVID-19 pandemic and associated journalistic corrections

Crises allow falsehoods to flourish in communication environments, prompting negative consequences. Corrections issued in response, such as journalistic fact-checks, have difficulty undoing the harm falsehoods cause. This has been attributed to the design and distribution of corrections, presented as diametral to how false / misleading claims are reported; however, this argument has never been tested in a single study. We addressed this research gap through a content analysis of journalistic coverage of health myths surrounding the COVID-19 pandemic in the context of journalistic corrections. We found that 86.1 % of the misinformation items addressed in this coverage echoed health myths described in the literature for other outbreaks, suggesting that misinformation is largely recycled and tweaked to apply to new outbreaks. We also found major differences regarding the actors that journalists presented as those in which falsehoods and corrections originated – with the former stemming mainly from the civil society domain and the latter from the science domain. Finally, we found differences in the key properties of misinformation and corrections in the journalistic coverage analyzed, agreeing with existing theorizing. This suggests that corrections have a competitive disadvantage compared with misinformation. To address this, corrections should employ more supporting visuals and decreased complexity.

Debunking health myths on the internet: the persuasive effect of (visual) online communication

AimDeveloping evidence-based recommendations on how to debunk health-related misinformation and more specific health myths in (online) communication is important for individual health and the society. The present study investigated the effects of debunking/correction texts created according to the latest research findings with regard to four different health myths on recipients’ belief, behaviour and feelings regarding the myths. Further, the study investigated the effects of different visualisations (machine-technical created image, diagram, image of an expert, message without an image) in the debunking texts.Subject and methodsA representative sample of German Internet users (N = 700) participated in an anonymous online survey experiment with a 4 (myths) × 4 (picture) mixed study design.ResultsThe results show that receiving an online news article that refutes a widespread health myth with or without the use of an image can significantly change the attitudes of the recipients toward this myth. The most influential variable was the attributed credibility: the more credible a debunking text is for a recipient, the more corrective effectiveness it has. However, the corrective messages did not differ in their persuasive effects depending on the image types used.ConclusionThe results offer an optimistic outlook on the correction of health-related misinformation and especially health myths and insight into why and how people change their beliefs (or not) and how beliefs in health myths can be reduced. The findings can be used by journalists, scientists, doctors and many other actors for efficient (online) communication.

Demystifying ‘diet culture’: Exploring the meaning of diet culture in online ‘anti-diet’ feminist, fat activist, and health professional communities

Social aspects of dieting are discussed in the extant feminist literature. However, despite frequent use of the term ‘diet culture’ in online communities critical of weight-loss dieting and popular books about the harms of restrictive eating, academic studies have not yet investigated its meaning holistically. We used thematic analysis to examine how those in the broad ‘anti-diet movement’ have challenged norms representing ‘diet culture,’ and how the term can be used to unite feminist researchers, activists, and health professionals. One-hundred and eighteen online qualitative survey participants (94.92% female; 37.29% health professionals; 51.70% anti-diet activists; Mage = 36.67) characterised ‘diet culture’ as ‘health myths about food and eating,’ and a ‘moral hierarchy of bodies’ driven by ‘systemic and structural factors.’ Feminist researchers, activists, and health professionals can use ‘diet culture’ to challenge myths and misconceptions about dieting and health, as well as the broader systems and structures that perpetuate these myths.

The Instagram/Facebook ban on graphic self‐harm imagery: A sentiment analysis and topic modeling approach

AbstractResearch indicates that adolescents who are vulnerable to self‐harm are likely to access social media specifically related to self‐harm, which often contains health myths and fails to provide linkages to appropriate resources. In this study, we examined the emotional discourse before and following a ban of graphic images of self‐harm on Facebook and Instagram. This observational case series study assesses a corpus of 8,013 tweets that specifically mention Facebook and/or Instagram between June 1, 2018, and May 31, 2019 (the ban occurred on February 7, 2019). Topical content was elucidated via statistical modeling to extract abstract topics in discourse. The graphic self‐harm ban produced emotional shifts in users of social media. A time series plot produced peaks of tweets on the banning of graphic images of self‐harm including political events, news coverage, and media exemplars of suicide (both celebrity and noncelebrity). We observed raw proportional differences with elevated emotions before the ban (i.e., disgust, joy, surprise, and trust) followed by elevated emotions occurring after the ban (i.e., anger, anticipation, and sadness). This study provides insight into how the policy‐change relating to self‐harm was received by those with a vested interest. These insights can be valuable to policymakers and advocates for those affected by self‐harm.

Oral Health Myths among General Population at Riyadh Region, Saudi Arabia

Background:Taboos or myths have got a connection from the history where there was no scientific understanding about the concepts of health they are part of culture and information shared or communicated by a number of people. Understanding myths and misbelieves are important to provide good oral care with health education to the people.Aim:The aim of this study is to assess the prevalence of oral health myths and to find its association between the demographic factors of general public in the Riyadh region of Saudi Arabia.Methodology:Questionnaire consisting of demographic details and myths about oral health problems was sent through Google forms. The link of questionnaire was sent through social media and requested to send the link to their friends and relatives.Results:About 50.71% of the study participants were against to myths and 23.48% of study participants were toward myths. The response in terms of agreement, disagreement or do not know was statistically not significant according to age, gender, or education.Conclusion:The prevalence of myths about dental treatment is almost 50%. This population needs to be educated to know the fact and to take action to rectify them about dental treatments.

Improving treatment outcomes for leprosy in Pernambuco, Brazil: a qualitative study exploring the experiences and perceptions of retreatment patients and their carers

BackgroundBrazil has a high leprosy burden and poor treatment outcomes (TOs), manifesting in high relapse rates. Pernambuco, an impoverished Brazilian state suffering notable geographical health inequalities, has ‘hyperendemic’ leprosy. Although current literature identifies barriers and facilitators influencing leprosy treatment compliance, inadequate investigation exists on other factors influencing TOs, including carers’ roles and psycho-dermatological impact. This qualitative study explores experiences and perceptions of leprosy patients and their carers in Pernambuco, Brazil; to identify location-specific factors influencing TOs, and consequently inform future management.Methods27, semi-structured, in-depth interviews were conducted with 14 patients and 13 carers. Participants were recruited using maximum variation and snowball sampling from three clinics in Petrolina, Pernambuco. Transcripts and field notes from both participant groups were separately analysed using conventional thematic and deviant case analysis. The University of Birmingham Internal Research Ethics Committee and Instituto Lauro de Souza Lima provided ethical approval.ResultsTwo homologous sets of four, primary, interdependent themes influencing leprosy TOs emerged: ‘personal factors’; ‘external factors’; ‘clinical factors’; and ‘the healthcare professional (HCP)-patient-carer relationship’. Poor participant knowledge and lack of symptomatic relief caused patients to distrust treatment. However, because participants thought HCP-led interventions were vital for optimal TOs, patients were effectively persuaded to adhere to pharmaceutical treatments. High standard patient and population education facilitated treatment engagement by encouraging evidence-based medicine belief, and dispelling health myths and stigma. Healthcare, on occasions, was perceived as disorganised, particularly in resource-scarce rural areas, and for those with mental health needs. Participants additionally experienced incorrect/delayed diagnoses and poor contact tracing. Leprosy’s negative socio-economic impact on employment – together with stigma, dependency and changing relationships – caused altered senses of identity, negatively impacting TOs. Better dialogue between patients, HCPs and carers facilitated individualised patient support.ConclusionThis study highlights the importance of: effective evidence-based leprosy education; communication between HCPs, patients and carers; state-funded support; and healthcare resource distribution. These findings, if prioritised on governmental scales, provide the valuable insight needed to inform location-specific management strategies, and consequently improve TOs. Future research should evaluate the effectiveness of these implementations. Failure to address these findings will hinder regional elimination efforts.

Understanding HIV and associated risk factors among religious groups in Zimbabwe

BackgroundThe influence of religion and belief systems is widely recognized as an important factor in understanding of health risk perception and myths in the general fight against the HIV pandemic. This study compares the understanding of HIV risk factors and utilization of some HIV services among religious groups in Zimbabwe.MethodsWe conducted secondary data statistical analysis to investigate the understanding of HIV and associated risk factors among religious groups in Zimbabwe using 2015–2016 Zimbabwe Demographic and Health Survey (ZDHS) data. We began by investigating associations between understanding of HIV and associated risk factors among religious groups. A multivariate stepwise backward elimination method was carried out to explore factors determining understanding of HIV risk after controlling for confounding factors using the most recent ZDHS data (2015–2016).ResultsThe results from the three surveys showed that, in general apostolic sector had low understanding of HIV and associated risk factors compared to other religious groups. Analysis of the 2015–2016 ZDHS data showed that women belonging to the apostolic sector were less likely to know where to get an HIV test odds ratio (OR) and 95% confidence interval, 0.665 (0.503–0.880) and to know that male circumcision reduces HIV transmission OR 0.863 (0.781–0.955). Women from this group had no knowledge that circumcised men can be infected if they do not use condoms OR 0.633 (0.579–0.693), nor that it is possible for a healthy-looking person to have HIV, OR 0.814 (0.719–0.921). They would not buy vegetables from a vendor with HIV OR 0.817 (0.729–0.915) and were less likely to support that HIV positive children should be allowed to attend school with HIV negative children OR 0.804 (0.680–0.950). Similar results were obtained for men in the apostolic sector. These men also did not agree that women were justified to use condoms if the husband has an Sexually Transmitted Infection (STI) OR 0.851 (0.748–0.967).ConclusionsOur results suggest that apostolic sector lack adequate knowledge of HIV and associated risk factors than other religious groups. Targeting HIV prevention programmes by religious groups could be an efficient approach for controlling HIV in Zimbabwe.

Z Factor: Drama as a tool to tackle mental health stigma: study design and protocol for community and public engagement in rural Zimbabwe

Background: Mental health is slowly gaining global significance as a key health issue, yet the stigma attached to psychosis is still a major problem. There has been little in-depth exploration of sustainable, cost-effective, and replicable community engagement strategies that address mental health myths and stigma, which are major barriers to early health-seeking behaviours. In low-income countries such as Zimbabwe, cultural and spiritual beliefs are at the centre of most mental health explanatory models, perpetuating an environment where mental health conversations are a cultural taboo. Mental health interventions should be accompanied by creative, evidence-based community engagement, ensuring that interventions are suitable for local settings and giving communities a voice in directing their health initiatives. Methods: Z Factor aimed to engage young adults and their support networks across a variety of socioeconomic groups in a rural district of Zimbabwe through their participation in an inter-ward five-staged drama competition. The focus was on psychosis, with subcategories of initial presentation/detection, seeking help/pathway to care, and the road to recovery/treatment. Each drama group’s composition included a young adult and a typical support network seeking treatment from the service provider of choice. Dramas were to act as discussion starters, paving the way toward broader and deeper psychosis treatment discussions among rural communities and gaining insight into service user expectations from health research. Conclusions: Outcomes of the pilot community engagement project will be instrumental in improving understanding community perceptions about psychosis treatment and recovery in rural Zimbabwe and increasing community awareness about psychosis, as well as paving the way for initiating service provider collaboration to promote early detection and encouraging early health-seeking behaviours. The above outcomes will also inform the design of models for more responsive community and public engagement initiatives in similar low resource settings in Zimbabwe and beyond.

Z Factor: Drama as a tool to tackle mental health stigma: study design and protocol for community and public engagement in rural Zimbabwe.

Background: Mental health is slowly gaining global significance as a key health issue, yet the stigma attached to psychosis is still a major problem. There has been little in-depth exploration of sustainable, cost-effective, and replicable community engagement strategies that address mental health myths and stigma, which are major barriers to early health-seeking behaviours. In low-income countries such as Zimbabwe, cultural and spiritual beliefs are at the centre of most mental health explanatory models, perpetuating an environment where mental health conversations are a cultural taboo. Mental health interventions should be accompanied by creative, evidence-based community engagement, ensuring that interventions are suitable for local settings and giving communities a voice in directing their health initiatives. Methods: Z Factor aimed to engage young adults and their support networks across a variety of socioeconomic groups in a rural district of Zimbabwe through their participation in an inter-ward five-staged drama competition. The focus was on psychosis, with subcategories of initial presentation/detection, seeking help/pathway to care, and the road to recovery/treatment. Each drama group's composition included a young adult and a typical support network seeking treatment from the service provider of choice. Dramas were to act as discussion starters, paving the way toward broader and deeper psychosis treatment discussions among rural communities and gaining insight into service user expectations from health research. Conclusions: Outcomes of the pilot community engagement project will be instrumental in improving understanding community perceptions about psychosis treatment and recovery in rural Zimbabwe and increasing community awareness about psychosis, as well as paving the way for initiating service provider collaboration to promote early detection and encouraging early health-seeking behaviours. The above outcomes will also inform the design of models for more responsive community and public engagement initiatives in similar low resource settings in Zimbabwe and beyond.