Background and Hypothesis Racial discrimination and public stigma toward Black individuals living with schizophrenia create disparities in treatment-seeking and engagement. Brief, social-contact-based video interventions efficaciously reduce stigma. It remains unclear whether including racial identity experiences in video narrative yields greater stigma reduction. We hypothesized that we would replicate findings showing sustained stigma reduction in video-intervention groups vs control and that Black participants would show greater stigma reduction and emotional engagement than non-Black participants only for a racial-insights video presenting a Black protagonist. Study Design Recruiting using a crowdsourcing platform, we randomized 1351 participants ages 18–30 to (a) brief video-based intervention, (b) racial-insights-focused brief video, or (c) non-intervention control, with baseline, post-intervention, and 30-day follow-up assessments. In 2-minute videos, a young Black protagonist described symptoms, personal struggles, and recovery from schizophrenia, with or without mentioning race-related experiences. Study Results A 3 × 3 ANOVA showed a significant group-by-time interaction for total scores of each of five stigma-related domains: social distance, stereotyping, separateness, social restriction, and perceived recovery (all P < .001). Linear mixed modeling showed a greater reduction in stigma from baseline to post-intervention among Black than non-Black participants in the racial insights video group for the social distance and social restriction domains. Conclusions This randomized controlled trial replicated and expanded previous findings, showing the anti-stigma effects of a brief video tailored to race-related experiences. This underscores the importance of personalized, culturally relevant narratives, especially for marginalized groups who, more attuned to prejudice and discrimination, may particularly value identification and solidarity. Future studies should explore mediators/moderators to improve intervention efficacy.

中文翻译：

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“作为一名患有精神分裂症的黑人很难”：通过简短视频干预减少公众耻辱的随机对照试验

背景和假设种族歧视和公众对精神分裂症黑人患者的耻辱造成了寻求治疗和参与方面的差异。简短的、基于社交接触的视频干预措施可以有效减少耻辱感。目前尚不清楚将种族身份经历纳入视频叙事是否能更大程度地减少耻辱。我们假设，我们将复制显示视频干预组与对照组相比耻辱感持续减少的研究结果，并且仅在呈现黑人主角的种族见解视频时，黑人参与者会比非黑人参与者表现出更大的耻辱感减少和情感参与。研究设计使用众包平台进行招募，我们将 1351 名 18-30 岁的参与者随机分配到（a）基于简短视频的干预，（b）以种族见解为重点的简短视频，或（c）非干预控制，包括基线、后期-干预和30天的跟踪评估。在 2 分钟的视频中，一位年轻的黑人主角描述了精神分裂症的症状、个人挣扎和康复情况，有或没有提到与种族相关的经历。研究结果 3 × 3 方差分析显示，五个耻辱相关领域的总分均存在显着的按时间分组的交互作用：社交距离、刻板印象、分离、社交限制和感知恢复（所有 P < .001）。线性混合模型显示，在种族见解视频组中，在社交距离和社交限制领域，黑人参与者从基线到干预后的耻辱感比非黑人参与者有更大程度的减少。结论 这项随机对照试验复制并扩展了之前的研究结果，显示了针对种族相关经历定制的简短视频的反耻辱效果。这强调了个性化的、与文化相关的叙述的重要性，特别是对于边缘化群体来说，他们更容易受到偏见和歧视，可能特别重视认同和团结。未来的研究应该探索中介/调节因素以提高干预效果。