Effectiveness of communication program on reduction of TB stigma and discrimination among high-school students in Bangkok: a quasi-experimental study

Abstract

Tuberculosis (TB) is a contagious disease through airborne transmission, and it is still a major cause of illness in Thailand. In addition, some patients with TB infection suffer from stigma and discrimination while living in their community. However, the stigma of TB patients is also reported to be high among high school students. The study aimed to explore the effectiveness of communication program on reduction of TB stigma and discrimination among high-school students in Bangkok. A quasi-experimental study was implemented in two high schools with 212 high-school students (Experimental group =108; Control group=104). Purposive and systematic sampling techniques were adopted in the selection of schools and students. The experimental group received the communication program for a three-month study period, whereas the control group received no intervention. Data collection was conducted by the questionnaires at baseline, 3 months, and 5 months. Data were analyzed using the Chi-square test, Fisher’s exact test, Paired t-test, Independent sample t-test, and Generalized Estimating Equations (GEE). The outcomes revealed that the communication program was found to be effective in reducing TB stigma (p-value <0.05,CI=4.962, -1.723) and increasing TB knowledge(p-value <0.05, CI=1.825, 2.537), TB attitudes (p-value <0.05, CI=4.493, 6.280), and self-efficacy on TB stigma and discrimination (p-value <0.05, CI=7.133, 9.483) as compared to the control group. However, there was no significant difference within and between both groups for TB discrimination (p-value >0.05, CI=-1.398, 0.810). The study suggests that the communication program should be adopted in school to make up for the TB knowledge and TB attitudes, and to reduce TB stigma among high-school students.