Social contact as a strategy to reduce stigma in low- and middle-income countries: A systematic review and expert perspectives.

Journal: PLOS global public health

Volume: 4

Issue: 3

Year of Publication: 

Affiliated Institutions:  IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands. Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health and Centre for Implementation Science, King's College London, United Kingdom. Department of Development & Education of Youth in Diverse Societies, Utrecht University, Utrecht, The Netherlands. Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. Faculty of Science, Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. Department of Research and Development, War Child, Amsterdam, The Netherlands.

Abstract summary 

Social contact (SC) has been identified as a promising strategy for stigma reduction. Different types of SC exist. Various scholars defined positive factors to strengthen SC. This study aims to investigate the application and effectiveness of SC as a strategy to reduce stigmatisation across stigmas, settings and populations in low- and middle-income countries (LMICs). We specifically examine the use of positive factors. A systematic review was conducted in twelve electronic databases using key terms related to stigma AND social contact AND intervention AND LMICs. Data were synthesised narratively. Study quality was assessed with the Joanna Briggs Institute critical appraisal checklists. Additionally, semi-structured interviews were used with first/corresponding authors of included publications to investigate their practical experiences with SC. Forty-four studies (55 publications) were identified. Various stigmas (n = 16) were targeted, including mental health (43%). Indirect (n = 18) and direct contact (n = 16) were used most frequently, followed by collaboration, imagined and vicarious contact, or a combination. The most applied additional strategy was education. Almost half of the studies, explicitly or implicitly, described positive factors for SC, such as PWLE training or disconfirming stereotypes. The majority suggested that SC is effective in reducing stigma, although inconsistent reporting overshadows conclusions. Perspectives of people with lived experience (PWLE) were infrequently included. Expert perspectives stressed the importance of contextualisation, PWLE participation, and evaluation of SC. This study provides an overview of SC as a stigma reduction strategy within LMICs. Conclusions about which type of SC is more effective or whether SC is more effective for a specific stigma category cannot be drawn. We recommend future research to strengthen reporting on effectiveness as well as PWLE perspective and SC processes, and to further critically examine the potential of SC. An overview of positive factors applied to strengthen SC is provided, which can stimulate reflection and guide future SC.

Authors & Co-authors:  Damsté Gronholm Groot Gurung Makhmud Peters Hartog

Study Outcome 

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Statistics
Citations :  Goffman E. Stigma: Notes on the management of spoiled identity: Simon and Schuster; 1963.
Authors :  7
Identifiers
Doi : e0003053
SSN : 2767-3375
Study Population
Male,Female
Mesh Terms
Other Terms
Study Design
Study Approach
Country of Study
Publication Country
United States