Evaluating the efficacy of a film based e-intervention designed to reduce intellectual disability stigma in Nigeria and Kenya

Plain English Summary

Background and study aims
The consequences of stigma for the well-being of people with intellectual disabilities (ID) have raised public and global health concerns. This study aims to assess the impact of a film based e-intervention designed to challenge stigmatising attitudes among Nigerian and Kenyan internet-users.

Who can participate?
Any adult (18 years or older) person who is English speaking, a Nigerian or Kenyan citizen, and who has access to the internet.

What does the study involve?
The study is a pilot RCT with a repeated measures design conducted as a web survey. Data are collected at three time points (baseline, immediately post intervention (T1), and 1-month follow-up (T2)). It is conducted as an online survey, using Qualtrics. Invitations to participate in the research will be sent by email and adverts about the study will be placed on social media sites. An electronic link will direct participants to the data collection website where they will find more information about the study and the actual survey. Participants will be randomised to watch either a short experimental or control film, while masked to their assignment. Both films will be 6 minutes long – the experimental film features education about intellectual disability and indirect contact, including people with intellectual disabilities talking about their experiences of prejudice. The control film is on an unrelated topic, but matched in length and people featured to the experimental film.

What are the possible benefits and risks of participating?
The participants will benefit from increased awareness about intellectual disability and may find the intervention films and questionnaires useful in challenging negative attitudes. Thus, the study is likely not only to benefit participants but people with intellectual disabilities in the participating countries.
Second, it is unlikely that participation in the study will elicit distress in participants. However, it is conceivable that participants who have a family members with an intellectual disability may find some of the material presented distressing as it may resonate with their own experiences of prejudice and discrimination. Participants will be able to end their participation at any time. Information on services for people with intellectual disabilitis and their families in Nigeria and Kenya will be provided as part of a debrief. The respective services are run by collaborators who support this study and provide advocacy and support for people with intellectual disabilities and their families. Participants will also be invited to get in touch with the researchers if they have questions about the material or if they have been affected by the material in anyway.

Where is the study run from?
The study will take place online.

When is the study starting and how long is it expected to run for?
Recruitment of the study started in October 2016 and ran until the end of March 2017.

Who is funding the study?
The study was funded by University College London (Pro-Vice-Provost (Africa and the Middle East) Leadership fund and Research Fudning from the Research Dept of Clincial Educational & Health Psychology).

Who is the main contact?
Dr Katrina Scior PhD ClinPsyD
k.scior@ucl.ac.uk

Study website

https://uclpsych.eu.qualtrics.com/jfe/form/SV_5gK2LfSwTFGU0oB

Type

Public

Contact name

Dr Katrina Scior

ORCID ID

Contact details

Research Dept of Clinical
Educational and Health Psychology
University College London
1-19 Torrington Place
London
WC1E 7HB
United Kingdom
0207-6791845
k.scior@ucl.ac.uk

EudraCT/CTIS number

IRAS number

ClinicalTrials.gov number

Protocol/serial number

8807/001

Scientific title

Efficacy of a film-based e-intervention in reducing intellectual disability stigma among Nigerian and Kenyan Internet users: A randomised control trial.

Acronym

Study hypothesis

1. We expect that the intervention will result in more favourable attitudes to people with intellectual disabilities in the intervention group compared with the control group, both at the end of the intervention (T1) and at 1-month follow-up (T2).
2. We expect such changes to be observed on all three attitude components to be measured (cognition, affect and behaviour).

Ethics approval(s)

UCL Research Ethics Committee Academic Services, 26/05/2016, 8807/001

Study design

Randomised controlled trial

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Study setting(s)

Internet/virtual

Study type

Other

Patient information sheet

Condition

Stigmatising attitudes towards people with intellectual disabilities in Nigeria and Kenya

Intervention

Qualtrics, a web survey platform, will be used to randomly assign participants on a 1:1 ratio (using a block randomisation code embedded within the Qualtrics survey) to the experimental or control condition. This is a two site study. The experimental group will watch a 6-minute film guided by educational and indirect contact approaches. The education segment provides information about intellectual disability, its causes and consequences with an aim to counter stigmatising beliefs known to be common in Africa. This educational segment of the film is delivered by local experts to ensure its credibility. The indirect contact section features people with moderate intellectual disabilities from Nigeria/Kenya, talking about their experiences, hopes and aspirations, and demonstrating their capabilities. It will also highlight the magnitude of stigma they face in their respective countries. Separate films have been produced for the Nigerian and Kenyan studies to ensure credibility of both the experts and people with disabilities.
The control film is unrelated to intellectual disability and has been controlled for the following variables: length of film, and social and demographic characteristics of people featured in the film. The lengths of both the experimental and control films is 6 minutes to minimise the impact of poor internet connectivity and to avoid loss of interest among participants. Following the films, participants are asked to complete post-intervention measures, and if they consent will be contacted by email asking them to complete a follow-up survey a month later.

Intervention type

Behavioural

Primary outcome measure

Attitudes towards Intellectual Disabilities (ATTID) scale, which draws on a multidimensional understanding of attitudes, will be used as primary outcome measure. The ATTID assesses the cognitive, affective, and behavioural components of attitudes across five-factors: two factors (Discomfort and Sensitivity/Tenderness) in the affective dimension; two factors (Knowledge of Causes and Knowledge of Capacity and Rights) in the cognitive dimension; and one factor (Interaction) in the behavioural dimension. This study uses the ATTID short form which consists of 36 items, using a 5-point Likert scale (1 = agree completely to 5 = disagree completely; plus an option of 9 to indicate “I don’t know”/”not applicable”).
The causal beliefs listed in the ATTID will be supplemented with three items from the supernatural causes subscale of the Intellectual Disabilities Literacy Scale (IDLS) to tap into superstitious causal attributions common in African countries and implicated in intellectual disability stigma. Measures will be administered at three time points: baseline, post-intervention (T1), and 1-month follow-up (T2).

Secondary outcome measures

Socio-demographic data (age, gender, ethnicity, place of residence, religious affiliation, educational attainment, and prior contact with someone with ID) will also be recorded at T1.

Overall study start date

14/04/2015

Overall study end date

31/07/2017

Reason abandoned (if study stopped)

Participant inclusion criteria

1. Aged 18 years or over
2. English speaking
3. Nigerian or Kenyan citizen
4. Internet user

Participant type(s)

All

Age group

Adult

Lower age limit

18 Years

Sex

Both

Target number of participants

796 in total

Participant exclusion criteria

Does not meet inclusion criteria

Recruitment start date

26/10/2016

Recruitment end date

31/03/2017

Countries of recruitment

Kenya, Nigeria

Study participating centre

Internet (No physical recruitment site)
N/A
Nigeria

Organisation

University College London

Sponsor details

Research Dept of Clinical
Educational and Health Psychology
University College London
Gower Street
London
WC1E 6BT
England
United Kingdom
+44 2076791897
k.scior@ucl.ac.uk

Sponsor type

University/education

Website

https://www.ucl.ac.uk/pals/research/clinical-educational-and-health-psychology/research-groups/ucl-unit-stigma-research-uclus

ROR

https://ror.org/02jx3x895

Funder type

Not defined

Funder name

University College London

Alternative name(s)

University College London in United Kingdom, Collegium Universitatis Londinensis, UCL

Funding Body Type

government organisation

Funding Body Subtype

Universities (academic only)

Location

United Kingdom

Publication and dissemination plan

Planned publication in a high-impact peer reviewed journal

Intention to publish date

30/06/2018

Individual participant data (IPD) sharing plan

The datasets analysed during the current study will be available, after deidentification of individual participant data, upon request from the corresponding author (Dr Katrina Scior, k.scior@ucl.ac.uk). To gain access, data requestors will need to provide a methodologically sound proposal, and if approved, sign a data access agreement. Data will be made available from between 3 months to 5 years following publication.

IPD sharing plan summary

Not provided at time of registration

Study outputs