The effectiveness of a self-stigma reduction intervention upon stigma measures for patients with tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) in Vietnam: a randomised controlled trial

A four-day workshop titled "from the inside out". The workshop was designed specifically for people with TB and MDR-TB. It has eight modules where the participants learn about self-stigma and self-shame, how to address these issues and change the way they think through interactive exercises, case studies, educational games, reflective writing and group work. • Module 1: What is self-stigma? An introduction to the concept of self-stigma. (~ 4 hours) • Module 2: Dealing with self-stigma and shame: Explores self-stigma and shame, enabling participants to learn how to identify and cope with their thoughts and feelings. (~12 hours) • Module 3: DR-TB: Explores the impact of DR-TB on self-stigma. (~2 hours) • Module 4: Transmission control and self-stigma: Self-stigma in the context of transmission control. (~ 4 hours) • Module 5: Health rights, TB, and self-stigma. (~4 hours) • Module 6: Treatment: Linkage between treatment for TB and self-stigma. (~2 hours) • Module 7: Planning for the future: TB Free! What now? (~2 hours) • Module 8: Evaluation of self-stigma and its impact. (~2 hours) The workshops will be run one 8 hour day per week over 3 or 4 weeks. The duration of each activity will be documented in the first adaptation workshop, and then we will know whether we will need the fourth day or if it is possible to complete all of the modules over three days. Coverage will be recorded by the researchers using an attendance sheet for the participants at the start of the day and after lunch. At the end of the workshop, the participants will have a score ranging from 1-8 for attendance, where 1 would indicate a half day. If they do not attend, the researcher will contact them to ask them to join another session. Participation will be recorded twice a day. Together, the two researchers will discuss the extent of each participant's participation in the workshop. They will give them a score from 0-1, where 0 would indicate did not participate at all, did not contribute to the discussion or join activities, 0.5 half participates, sometimes joined in, sometimes did not and 1 would indicate full participation, they were involved in all activities and completed all tasks required. Both attendance and participation scores will be added up separately over the four days to give a total score ranging from 0 to 8 each. Where 6 or greater would indicate excellent participation and attendance, less than 6 ( less than 75%) is not acceptable attendance. For participation, 4-6 is good, 2-4 is poor, and less than 2 would indicate no participation.