Implementation science and stigma reduction interventions in low- and middle-income countries: a systematic review.


BACKGROUND:Interventions to alleviate stigma are demonstrating effectiveness across a range of conditions, though few move beyond the pilot phase, especially in low- and middle-income countries (LMICs). Implementation science offers tools to study complex interventions, understand barriers to implementation, and generate evidence of affordability, scalability, and sustainability. Such evidence could be used to convince policy-makers and donors to invest in implementation. However, the utility of implementation research depends on its rigor and replicability. Our objectives were to systematically review implementation studies of health-related stigma reduction interventions in LMICs and critically assess the reporting of implementation outcomes and intervention descriptions. METHODS:PubMed, CINAHL, PsycINFO, and EMBASE were searched for evaluations of stigma reduction interventions in LMICs reporting at least one implementation outcome. Study- and intervention-level characteristics were abstracted. The quality of reporting of implementation outcomes was assessed using a five-item rubric, and the comprehensiveness of intervention description and specification was assessed using the 12-item Template for Intervention Description and Replication (TIDieR). RESULTS:A total of 35 eligible studies published between 2003 and 2017 were identified; of these, 20 (57%) used qualitative methods, 32 (91%) were type 1 hybrid effectiveness-implementation studies, and 29 (83%) were evaluations of once-off or pilot implementations. No studies adopted a formal theoretical framework for implementation research. Acceptability (20, 57%) and feasibility (14, 40%) were the most frequently reported implementation outcomes. The quality of reporting of implementation outcomes was low. The 35 studies evaluated 29 different interventions, of which 18 (62%) were implemented across sub-Saharan Africa, 20 (69%) focused on stigma related to HIV/AIDS, and 28 (97%) used information or education to reduce stigma. Intervention specification and description was uneven. CONCLUSION:Implementation science could support the dissemination of stigma reduction interventions in LMICs, though usage to date has been limited. Theoretical frameworks and validated measures have not been used, key implementation outcomes like cost and sustainability have rarely been assessed, and intervention processes have not been presented in detail. Adapted frameworks, new measures, and increased LMIC-based implementation research capacity could promote the rigor of future stigma implementation research, helping the field deliver on the promise of stigma reduction interventions worldwide.




BMC medicine


Kemp CG,Jarrett BA,Kwon CS,Song L,Jetté N,Sapag JC,Bass J,Murray L,Rao D,Baral S




Has Abstract


2019-02-15 00:00:00












  • Lifestyle factors in preventing mental health disorders: an interview with Felice Jacka.

    abstract::In this video Q&A, we talk to Associate Professor Felice Jacka about population health approaches to the primary prevention of mental disorders across the lifespan. These include addressing lifestyle factors, such as diet, smoking and physical activity. Latest strategies are being developed through epidemiological stu...

    journal_title:BMC medicine

    pub_type: 面试


    authors: Jacka FN

    更新日期:2015-10-14 00:00:00

  • Prostate-specific antigen-based screening: controversy and guidelines.

    abstract::Although prostate-specific antigen (PSA) screening has improved the detection of prostate cancer, allowing for stage migration to less advanced disease, the precise mortality benefit of early detection is unclear. This is in part due to a discrepancy between the two large randomized controlled trials comparing PSA scr...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Kim EH,Andriole GL

    更新日期:2015-03-24 00:00:00

  • Mental health and smoking cessation-a population survey in England.

    abstract:BACKGROUND:To reduce inequalities between individuals with and without mental health problems, a better understanding is required of triggers and success of quit attempts among the third of smokers with mental health problems. The aim was to assess whether there are differences by mental health status in (i) triggers f...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Brose LS,Brown J,McNeill A

    更新日期:2020-06-25 00:00:00

  • Trustworthy guidelines - excellent; customized care tools - even better.

    abstract:BACKGROUND:The ability to do online searches for health information has led to concerns that patients find the results confusing and that they often lead to expectations for treatments that have little supportive evidence. At the same time, the science of summarizing research evidence has advanced to the point where it...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Elwyn G,Quinlan C,Mulley A,Agoritsas T,Vandvik PO,Guyatt G

    更新日期:2015-09-01 00:00:00

  • Effects of an 18-week exercise programme started early during breast cancer treatment: a randomised controlled trial.

    abstract:BACKGROUND:Exercise started shortly after breast cancer diagnosis might prevent or diminish fatigue complaints. The Physical Activity during Cancer Treatment (PACT) study was designed to primarily examine the effects of an 18-week exercise intervention, offered in the daily clinical practice setting and starting within...

    journal_title:BMC medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Travier N,Velthuis MJ,Steins Bisschop CN,van den Buijs B,Monninkhof EM,Backx F,Los M,Erdkamp F,Bloemendal HJ,Rodenhuis C,de Roos MA,Verhaar M,ten Bokkel Huinink D,van der Wall E,Peeters PH,May AM

    更新日期:2015-06-08 00:00:00

  • Recent developments in Alzheimer's disease therapeutics.

    abstract::Alzheimer's disease is a devastating neurological disorder that affects more than 37 million people worldwide. The economic burden of Alzheimer's disease is massive; in the United States alone, the estimated direct and indirect annual cost of patient care is at least $100 billion. Current FDA-approved drugs for Alzhei...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审


    authors: Rafii MS,Aisen PS

    更新日期:2009-02-19 00:00:00

  • Alcohol intake, wine consumption and the development of depression: the PREDIMED study.

    abstract:BACKGROUND:Alcoholic beverages are widely consumed. Depression, the most prevalent mental disorder worldwide, has been related to alcohol intake. We aimed to prospectively assess the association between alcohol intake and incident depression using repeated measurements of alcohol intake. METHODS:We followed-up 5,505 h...

    journal_title:BMC medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Gea A,Beunza JJ,Estruch R,Sánchez-Villegas A,Salas-Salvadó J,Buil-Cosiales P,Gómez-Gracia E,Covas MI,Corella D,Fiol M,Arós F,Lapetra J,Lamuela-Raventós RM,Wärnberg J,Pintó X,Serra-Majem L,Martínez-González MA,PREDIMED G

    更新日期:2013-08-30 00:00:00

  • The human fetal adrenal produces cortisol but no detectable aldosterone throughout the second trimester.

    abstract:BACKGROUND:Human fetal adrenal glands are highly active and, with the placenta, regulate circulating progesterone, estrogen and corticosteroids in the fetus. At birth the adrenals are essential for neonate salt retention through secretion of aldosterone, while adequate glucocorticoids are required to prevent adrenal in...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Johnston ZC,Bellingham M,Filis P,Soffientini U,Hough D,Bhattacharya S,Simard M,Hammond GL,King P,O'Shaughnessy PJ,Fowler PA

    更新日期:2018-02-12 00:00:00

  • Reductions in sugar sales from soft drinks in the UK from 2015 to 2018.

    abstract:BACKGROUND:The consumption of free sugars in the UK is more than double the guideline intake for adults and close to triple for children, with soft drinks representing a significant proportion. The aim of this study was to assess how individual soft drink companies and consumers have responded to calls to reduce sugar ...

    journal_title:BMC medicine

    pub_type: 历史文章,杂志文章


    authors: Bandy LK,Scarborough P,Harrington RA,Rayner M,Jebb SA

    更新日期:2020-01-13 00:00:00

  • Real-time numerical forecast of global epidemic spreading: case study of 2009 A/H1N1pdm.

    abstract:BACKGROUND:Mathematical and computational models for infectious diseases are increasingly used to support public-health decisions; however, their reliability is currently under debate. Real-time forecasts of epidemic spread using data-driven models have been hindered by the technical challenges posed by parameter estim...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Tizzoni M,Bajardi P,Poletto C,Ramasco JJ,Balcan D,Gonçalves B,Perra N,Colizza V,Vespignani A

    更新日期:2012-12-13 00:00:00

  • New players in the preventive treatment of migraine.

    abstract::Migraine is a common, chronic disorder of the brain causing much disability, as well as personal, familial and societal impact. Several oral preventive agents are available in different countries for the prevention of migraine, but none have performed better than 50% improvement in 50% of patients in a clinical trial....

    journal_title:BMC medicine

    pub_type: 杂志文章,评审


    authors: Mitsikostas DD,Rapoport AM

    更新日期:2015-11-10 00:00:00

  • Antidepressant use and cognitive decline in community-dwelling elderly people - The Three-City Cohort.

    abstract:BACKGROUND:Cognitive impairment is very common in late-life depression, principally affecting executive skills and information processing speed. The aim of the study was to examine the effect of antidepressant treatment on cognitive performances over a 10-year period. METHODS:The community-based cohort included 7381 p...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Carrière I,Norton J,Farré A,Wyart M,Tzourio C,Noize P,Pérès K,Fourrier-Réglat A,Ritchie K,Ancelin ML

    更新日期:2017-04-19 00:00:00

  • A robust blood gene expression-based prognostic model for castration-resistant prostate cancer.

    abstract:BACKGROUND:Castration-resistant prostate cancer (CRPC) is associated with wide variations in survival. Recent studies of whole blood mRNA expression-based biomarkers strongly predicted survival but the genes used in these biomarker models were non-overlapping and their relationship was unknown. We developed a biomarker...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Wang L,Gong Y,Chippada-Venkata U,Heck MM,Retz M,Nawroth R,Galsky M,Tsao CK,Schadt E,de Bono J,Olmos D,Zhu J,Oh WK

    更新日期:2015-08-21 00:00:00

  • Targeted rotavirus vaccination of high-risk infants; a low cost and highly cost-effective alternative to universal vaccination.

    abstract:BACKGROUND:The cost-effectiveness of universal rotavirus (RV) vaccination is controversial in developed countries. As a result, RV vaccination programs do not currently exist in most European countries. Hospitalization is the main driver of RV disease costs, and prematurity, low birth weight (LBW) and underlying medica...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Bruijning-Verhagen P,Mangen MJ,Felderhof M,Hartwig NG,van Houten M,Winkel L,de Waal WJ,Bonten MJ

    更新日期:2013-04-26 00:00:00

  • Comparing the effects of HIV self-testing to standard HIV testing for key populations: a systematic review and meta-analysis.

    abstract:BACKGROUND:We update a previous systematic review to inform new World Health Organization HIV self-testing (HIVST) recommendations. We compared the effects of HIVST to standard HIV testing services to understand which service delivery models are effective for key populations. METHODS:We did a systematic review of rand...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Witzel TC,Eshun-Wilson I,Jamil MS,Tilouche N,Figueroa C,Johnson CC,Reid D,Baggaley R,Siegfried N,Burns FM,Rodger AJ,Weatherburn P

    更新日期:2020-12-03 00:00:00

  • Neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service: a population-based, randomised study.

    abstract:BACKGROUND:The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute...

    journal_title:BMC medicine

    pub_type: 杂志文章,随机对照试验


    authors: Parkkari J,Taanila H,Suni J,Mattila VM,Ohrankämmen O,Vuorinen P,Kannus P,Pihlajamäki H

    更新日期:2011-04-11 00:00:00

  • Risk prediction models for dementia: role of age and cardiometabolic risk factors.

    abstract:BACKGROUND:Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) risk score is the only currently available midlife risk score for dementia. We compared CAIDE to Framingham cardiovascular Risk Score (FRS) and FINDRISC diabetes score as predictors of dementia and assessed the role of age in their associa...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Fayosse A,Nguyen DP,Dugravot A,Dumurgier J,Tabak AG,Kivimäki M,Sabia S,Singh-Manoux A

    更新日期:2020-05-19 00:00:00

  • Loss of KCNJ10 protein expression abolishes endocochlear potential and causes deafness in Pendred syndrome mouse model.

    abstract:BACKGROUND:Pendred syndrome, a common autosomal-recessive disorder characterized by congenital deafness and goiter, is caused by mutations of SLC26A4, which codes for pendrin. We investigated the relationship between pendrin and deafness using mice that have (Slc26a4+/+) or lack a complete Slc26a4 gene (Slc26a4-/-). M...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Wangemann P,Itza EM,Albrecht B,Wu T,Jabba SV,Maganti RJ,Lee JH,Everett LA,Wall SM,Royaux IE,Green ED,Marcus DC

    更新日期:2004-08-20 00:00:00

  • Recent advances in triple negative breast cancer: the immunotherapy era.

    abstract:BACKGROUND:Several accomplishments have been achieved in triple-negative breast cancer (TNBC) research over the last year. The phase III IMpassion130 trial comparing chemotherapy plus atezolizumab versus chemotherapy plus placebo brought breast cancer into the immunotherapy era. Nevertheless, despite encouraging result...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审


    authors: Marra A,Viale G,Curigliano G

    更新日期:2019-05-09 00:00:00

  • Disparities in access to diagnosis and care in Blantyre, Malawi, identified through enhanced tuberculosis surveillance and spatial analysis.

    abstract:BACKGROUND:A sizeable fraction of tuberculosis (TB) cases go undiagnosed. By analysing data from enhanced demographic, microbiological and geospatial surveillance of TB registrations, we aimed to identify modifiable predictors of inequitable access to diagnosis and care. METHODS:Governmental community health workers (...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: MacPherson P,Khundi M,Nliwasa M,Choko AT,Phiri VK,Webb EL,Dodd PJ,Cohen T,Harris R,Corbett EL

    更新日期:2019-01-29 00:00:00

  • Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease.

    abstract:BACKGROUND:The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utili...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审


    authors: Malojcic B,Giannakopoulos P,Sorond FA,Azevedo E,Diomedi M,Oblak JP,Carraro N,Boban M,Olah L,Schreiber SJ,Pavlovic A,Garami Z,Bornstein NM,Rosengarten B

    更新日期:2017-02-09 00:00:00

  • Diagnostic accuracy of quantitative PCR (Xpert MTB/RIF) for tuberculous pericarditis compared to adenosine deaminase and unstimulated interferon-γ in a high burden setting: a prospective study.

    abstract:BACKGROUND:Tuberculous pericarditis (TBP) is associated with high morbidity and mortality, and is an important treatable cause of heart failure in developing countries. Tuberculous aetiology of pericarditis is difficult to diagnose promptly. The utility of the new quantitative PCR test (Xpert MTB/RIF) for the diagnosis...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Pandie S,Peter JG,Kerbelker ZS,Meldau R,Theron G,Govender U,Ntsekhe M,Dheda K,Mayosi BM

    更新日期:2014-06-18 00:00:00

  • Mapping malaria by combining parasite genomic and epidemiologic data.

    abstract:BACKGROUND:Recent global progress in scaling up malaria control interventions has revived the goal of complete elimination in many countries. Decreasing transmission intensity generally leads to increasingly patchy spatial patterns of malaria transmission in elimination settings, with control programs having to accurat...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Wesolowski A,Taylor AR,Chang HH,Verity R,Tessema S,Bailey JA,Alex Perkins T,Neafsey DE,Greenhouse B,Buckee CO

    更新日期:2018-10-18 00:00:00

  • State of inequality in malaria intervention coverage in sub-Saharan African countries.

    abstract:BACKGROUND:Scale-up of malaria interventions over the last decade have yielded a significant reduction in malaria transmission and disease burden in sub-Saharan Africa. We estimated economic gradients in the distribution of these efforts and of their impacts within and across endemic countries. METHODS:Using Demograph...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Galactionova K,Smith TA,de Savigny D,Penny MA

    更新日期:2017-10-18 00:00:00

  • Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative.

    abstract:BACKGROUND:Accurate and timely cause of death (COD) data are essential for informed public health policymaking. Medical certification of COD generally provides the majority of COD data in a population and is an essential component of civil registration and vital statistics (CRVS) systems. Accurate completion of the med...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Hart JD,Sorchik R,Bo KS,Chowdhury HR,Gamage S,Joshi R,Kwa V,Li H,Mahesh BPK,Mclaughlin D,Mikkelsen L,Miki J,Napulan R,Rampatige R,Reeve M,Sarmiento C,War NS,Richards N,Riley ID,Lopez AD

    更新日期:2020-03-09 00:00:00

  • Evidence for placebo effects on physical but not on biochemical outcome parameters: a review of clinical trials.

    abstract:BACKGROUND:Recent reviews on placebo effects in clinical trials suggest that objective changes following placebo treatments may not exist or, at least, have been considerably overestimated. However, the possibility that yet unidentified subsets of parameters are responsive to placebo treatments has not been taken into ...

    journal_title:BMC medicine

    pub_type: 杂志文章,meta分析,评审


    authors: Meissner K,Distel H,Mitzdorf U

    更新日期:2007-03-19 00:00:00

  • Hospital admissions in relation to body mass index in UK women: a prospective cohort study.

    abstract:BACKGROUND:Adiposity is associated with many adverse health outcomes but little direct evidence exists about its impact on the use of health care services. We aim to describe the relationship between body mass index (BMI) and rates of hospital admission in middle-aged UK women. METHODS:Among 1,251,619 Million Women St...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Reeves GK,Balkwill A,Cairns BJ,Green J,Beral V,Million Women Study Collaborators.

    更新日期:2014-03-15 00:00:00

  • Combining serological and contact data to derive target immunity levels for achieving and maintaining measles elimination.

    abstract:BACKGROUND:Vaccination has reduced the global incidence of measles to the lowest rates in history. However, local interruption of measles virus transmission requires sustained high levels of population immunity that can be challenging to achieve and maintain. The herd immunity threshold for measles is typically stipula...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Funk S,Knapp JK,Lebo E,Reef SE,Dabbagh AJ,Kretsinger K,Jit M,Edmunds WJ,Strebel PM

    更新日期:2019-09-25 00:00:00

  • Which patients with advanced respiratory disease die in hospital? A 14-year population-based study of trends and associated factors.

    abstract:BACKGROUND:Strategies in many countries have sought to improve palliative care and reduce hospital deaths for non-cancer patients, but their effects are not evaluated. We aimed to determine the trends and factors associated with dying in hospital in two common progressive respiratory diseases, and the impact of a natio...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Higginson IJ,Reilly CC,Bajwah S,Maddocks M,Costantini M,Gao W,GUIDE_Care project.

    更新日期:2017-02-01 00:00:00

  • Plasmodium falciparum dihydroartemisinin-piperaquine failures in Cambodia are associated with mutant K13 parasites presenting high survival rates in novel piperaquine in vitro assays: retrospective and prospective investigations.

    abstract:BACKGROUND:The declining efficacy of dihydroartemisinin-piperaquine against Plasmodium falciparum in Cambodia, along with increasing numbers of recrudescent cases, suggests resistance to both artemisinin and piperaquine. Available in vitro piperaquine susceptibility assays do not correlate with treatment outcome. A nov...

    journal_title:BMC medicine

    pub_type: 杂志文章


    authors: Duru V,Khim N,Leang R,Kim S,Domergue A,Kloeung N,Ke S,Chy S,Eam R,Khean C,Loch K,Ken M,Lek D,Beghain J,Ariey F,Guerin PJ,Huy R,Mercereau-Puijalon O,Witkowski B,Menard D

    更新日期:2015-12-22 00:00:00