Use of Football in Programs to Reduce Stigma Toward Mental Illness: A Comparison of the Effectiveness of Contact Interaction and Video-Based Approaches

Primary outcomes

1. Knowledge

   Time frame: pre-intervention, immediately post-intervention, and at one- and six-month follow-ups.

   The Mental Health Knowledge Schedule (MAKS), consisting of 12 items, will be used to assess the public's knowledge related to mental health stigma. The questionnaire is divided into two parts: knowledge about mental illness and agreement with statements regarding mental health conditions. Responses are rated on a five-point Likert scale (5 = Strongly agree, 4 = Slightly agree, 3 = Neither agree nor disagree / Don't know, 2 = Slightly disagree, 1 = Strongly disagree). The total score ranges from 12 to 60, with higher scores indicating a greater level of knowledge about mental health. Items 7 to 12 are designed to assess recognition and familiarity with various mental health conditions, helping to contextualize responses to the earlier items.

2. Attitudes

   Time frame: pre-intervention, immediately post-intervention, and at one- and six-month follow-ups.

   The Questionnaire on Stigmatizing Attitudes Towards Mental Illness will be used in this study. After undergoing cultural adaptation and psychometric validation, the final Chinese version consists of 16 items across four dimensions: Negative Stereotypes (5 items), Social Distance (3 items), Negative Evaluation (5 items), and Self-Stigma (3 items). Responses are measured on a six-point Likert scale (6 = Strongly agree, 5 = Agree, 4 = Slightly agree, 3 = Slightly disagree, 2 = Disagree, 1 = Strongly disagree). The total score ranges from 16 to 96, with higher scores indicating greater levels of negative stigmatizing attitudes toward mental illness.

3. Intent

   Time frame: pre-intervention, immediately post-intervention, and at one- and six-month follow-ups.

   The Social Distance Scale will be adopted to assess participants' level of social distance toward individuals with mental illness, serving as an indicator of intent to act. The scale consists of 8 items, which evaluate willingness to engage with people with mental illness in various situations, such as living in the same community or building, sharing a residence, dining together, forming friendships, working together, employing, or helping them. Responses are rated on a six-point Likert scale (6 = Strongly agree, 5 = Agree, 4 = Slightly agree, 3 = Slightly disagree, 2 = Disagree, 1 = Strongly disagree). Higher scores indicate a greater willingness to interact with individuals with mental illness. This scale is considered to be particularly sensitive to measuring implicit bias.