short, animated storytelling video to reduce addiction stigma: A pilot randomized controlled trial.

BACKGROUND AND AIMS: Public stigma towards people with addiction negatively impacts help-seeking, treatment and recovery. This pilot study tested the feasibility of conducting a large-scale, online trial to measure the effect of a short, animated storytelling (SAS) stigma reduction video, with and without soundtrack, on addiction stigma, optimism, warmth towards people with addiction, and hopefulness at two timepoints (immediately post-exposure and 14 days later). DESIGN: We used a parallel group, three-arm randomized controlled trial (RCT). SETTING: We conducted this fully online study on the Prolific Academic research platform (participant recruitment) and the Qualtrics survey platform (data collection). PARTICIPANTS: We recruited 631 English-speaking adult participants, aged 18-49, residing in the United States. INTERVENTIONS: Intervention group A received the SAS video intervention. Intervention group B group received the SAS video intervention without sound. The control group received written information about global addiction prevalence, estimated to be time-equivalent with the video interventions. MEASUREMENTS: We measured participant retention rate at the two-week follow-up to determine the feasibility of conducting the definitive trial. Our co-primary outcomes were addiction stigma, optimism, warmth towards people with addiction and hopefulness, measured using an abbreviated 18-item version of the Attribution Questionnaire (AQ-18), the Brief García's Interactive Optimism Scale (BIOS-G), a stigma thermometer and a visual analogue scale (VAS). We used repeated-measures ANOVA to assess group-by-time interactions and compared changes from baseline to post-intervention. Participants completed follow-up surveys 14 days post-intervention. FINDINGS: The retention rate from baseline to follow-up was 88.0 %. Exposure to both the video with sound and without sound resulted in significant positive changes compared to the control group, for pity [F (4,1046) = 3.26, η2 = 0.012, p = 0.011], willingness to help [F (4,1046) = 8.48, η2 = 0.031, p < 0.001], dangerousness [F (4,1046) = 2.95, η2 = 0.011, p = 0.019], avoidance [F (4,1046) = 4.25, η2 = 0.016, p = 0.002], as well as optimism [F (2,595) = 7.7, η2 = 0.014, p < 0.001], warmth toward people with addiction [F (2,594) = 6.5, η2 = 0.014, p = 0.002], and hopefulness [F (2,594) = 5.4, η2 = 0.013, p = 0.005]. No effects were observed for fear or blame stigma sub-scales. These effects were no longer visible at follow-up in this pilot sample. No significant differences were observed between the video with sound and the video without sound. CONCLUSIONS: This pilot study demonstrates the feasibility of proceeding with our registered, largescale, multi-country, online RCT. The significant effect observed in a relatively small pilot population, after a single exposure to this 2.5 min SAS intervention aimed at reducing addiction stigma, was unanticipated and is worthy of highlighting. A larger sample size will adequately power the full trial to detect both immediate effects and their potential durability over time, in various global settings.