TYPE Study Protocol
PUBLISHED 20 December 2022
DOI 10.3389/fpsyt.2022.1083042
OPEN ACCESS
EDITED BY
Mohammadreza Shalbafan,
Iran University of Medical Sciences,
Iran
REVIEWED BY
Lingyun Zeng,
Shenzhen Kangning Hospital, China
Muhammed Fatih Önsüz,
Eski¸ sehir Osmangazi University, Turkey
Pamela Vaccari Jimenez,
University of Concepción, Chile
*CORRESPONDENCE
Jaime C. Sapag
jsapag@uc.cl
SPECIALTY SECTION
This article was submitted to
Public Mental Health,
a section of the journal
Frontiers in Psychiatry
RECEIVED 28 October 2022
ACCEPTED 21 November 2022
PUBLISHED 20 December 2022
CITATION
Sapag JC, Traub C, Velasco PR,
Arratia T, Alvarado R, Aracena M,
Poblete FC, Villarroel L, Bravo P,
Álvarez-Huenchulaf C, Jofré
Escalona A, Vargas-Malebrán N,
Bobbili S, Bustamante I, Khenti A and
Corrigan PW (2022) Reducing stigma
toward mental illness and substance
use issues in primary health care
in Chile: Protocol of a cluster
controlled trial study.
Front. Psychiatry 13:1083042.
doi: 10.3389/fpsyt.2022.1083042
COPYRIGHT
© 2022 Sapag, Traub, Velasco, Arratia,
Alvarado, Aracena, Poblete, Villarroel,
Bravo, Álvarez-Huenchulaf, Jofré
Escalona, Vargas-Malebrán, Bobbili,
Bustamante, Khenti and Corrigan. This
is an open-access article distributed
under the terms of the Creative
Commons Attribution License (CC BY).
The use, distribution or reproduction in
other forums is permitted, provided
the original author(s) and the copyright
owner(s) are credited and that the
original publication in this journal is
cited, in accordance with accepted
academic practice. No use, distribution
or reproduction is permitted which
does not comply with these terms.
Reducing stigma toward mental
illness and substance use issues
in primary health care in Chile:
Protocol of a cluster controlled
trial study
Jaime C. Sapag
1,2,3,4
*, Carolina Traub
1
, Paola R. Velasco
1
,
Tamara Arratia
1
, Rubén Alvarado
5,6
, Marcela Aracena
7
,
Fernando C. Poblete
1
, Luis Villarroel
1
, Paulina Bravo
8
,
Cinthia Álvarez-Huenchulaf
1
, Ana Jofré Escalona
1
,
Nelson Vargas-Malebrán
1
, Sireesha Bobbili
3,4
,
Inés Bustamante
9
, Akwatu Khenti
3,4
and Patrick W. Corrigan
10
1
Departamento de Salud Pública, División de Salud Pública y Medicina Familiar, Escuela de
Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,
2
Departamento de Medicina Familiar, División de Salud Pública y Medicina Familiar, Escuela de
Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,
3
Dalla
Lana School of Public Health, University of Toronto, Toronto, ON, Canada,
4
Centre for Addiction
and Mental Health, Toronto, ON, Canada,
5
Departamento de Salud Pública, Escuela de Medicina,
Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile,
6
Programa de Salud Mental,
Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile,
7
Escuela de
Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile,
8
Escuela de Enfermería, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago,
Chile,
9
Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima,
Peru,
10
Illinois Institute of Technology, Chicago, IL, United States
Background: Chile is implementing a Community Mental Health Model with
a strong role of primary health care (PHC). PHC has great potential to early
detection and provision of accessible and coordinated services to people who
present mental illness and/or substance use issues (MISUI). However, stigma
toward people with MISUI among PHC professionals is a significant barrier to
accessing good quality of care. A wealth of literature supports the importance
of reducing stigma for this population. The main goal of this research project
is to determine the effectiveness of a comprehensive anti-stigma intervention
in reducing stigmatizing attitudes and behaviors among PHC providers toward
individuals with MISUI in the Chilean context, using Centros de Salud Familiar
(CESFAMs) as the point of intervention.
Methods: The intervention is based on an initiative that was previously
developed in Canada and then also pilot-tested in Lima, Peru, with the
Center for Addiction and Mental Health (Ontario, Canada). The model will be
culturally adapted with CESFAM PHC provider and user inputs to be relevant
and valid to Chile. The 18-month intervention includes five (5) components
that are simultaneously implemented in CESFAMs: (1) Develop a Team of
Local Champions in each intervention CESFAM, comprising PHC providers
and users; (2) Analysis of Internal CESFAM Policies, Procedures, and Protocols
to determine areas of improvement in service delivery for individuals with
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