Short, Animated Storytelling (SAS) for Addiction Stigma Reduction (SAS)

Short, Animated Storytelling Video to Reduce Addiction Stigma: Protocol for a Multi-country, Online, Randomized, Controlled Trial With 13,500 Participants

Stigma towards people with addiction is a well-documented problem that negatively impacts help-seeking, treatment and recovery. Social contact with people recovering from addiction can promote empathy and reduce stigma, but social contact is difficult to scale. Short, animated storytelling (SAS) is a novel health communication approach that scales easily because it can leapfrog barriers associated with language, culture, literacy and education levels. This study will investigate if a SAS video intervention can be used to reduce stigma, boost optimism and hope, and increasing empathy towards people with addiction. The study will also explore mechanisms of action of SAS interventions, by measuring the contribution of sound design to the effect of the intervention.

Study Overview

• Status: Completed
• Conditions: Social Stigma Towards People With Addiction
• Intervention / Treatment: Other: SAS video

• Study Type: Interventional
• Enrollment (Actual): 13397
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • Stanford, California, United States, 95305
      • Stanford University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Adults with basic English proficiency between the ages of 18-49

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SAS video full intervention group; Participants view the full SAS video intervention with sound on Day 1.	Other: SAS video; The intervention is a short, animated storytelling video, with soundtrack, aimed at reducing addiction stigma.; Other Names: short animated storytelling video
Experimental: SAS video partial intervention (without sound); Participants view the partial SAS video intervention without sound on Day 1.	Other: SAS video; The intervention is a short, animated storytelling video, with soundtrack, aimed at reducing addiction stigma.; Other Names: short animated storytelling video
No Intervention: Active Control Group; Participants read written information about addiction prevalence

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Addiction Stigma Scale Score as measured by the Attribution Questionnaire (AQ)	Participants complete an 18-item shortened version of the validated AQ. The AQ-18 will be scored along a 9-point Likert scale indicating the extent to which participants agree with the item ranging from "not at all" to "very much" with a maximum score of 27 for each 3-item construct. Higher scores indicate greater stigma.	Immediately post-intervention on Day 1 and after two weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Optimism Scale Score	Participants complete the Brief García's Interactive Optimism Scale (BIOS-G). The BIOS-G is an instrument designed to assess an individual's level of general optimism towards their life and other people. The scale includes 4 statements for which respondents indicate their level of agreement from 1 ("Of course not") to 4 ("Yes, of course"). Higher scores indicate a greater level of optimism.	Immediately post-intervention on Day 1 and after two weeks
Change in Attitude Thermometer Score	Participants will indicate their warmth towards subject using a self-report stigma thermometer. Using a scale scores from zero to 100, with higher scores indicating more empathy or more favorable attitudes.	Immediately post-intervention on Day 1 and after two weeks
Change in Levels of Hope using a visual analogue scale (VAS)	Participants self-report levels of hope using a VAS, a longstanding, validated tool for assessing related constructs of stress and subjective well-being. The scale goes from zero to 100 and higher scores indicate higher levels of hope.	Immediately post-intervention on Day 1 and after two weeks

Collaborators and Investigators

• Sponsor: Stanford University
• Collaborators: Alexander von Humboldt Association; Stanford Center for Digital Health
• Investigators: Principal Investigator: Maya Adam, MD, PhD, Stanford University

Publications and helpful links

General Publications

• Adam M, Klapow M, Greuel M, Seeff M, Rohr JK, Gordon A, Amsalem D, Barnighausen T. Short, Animated Storytelling Video to Reduce Addiction Stigma in 13,500 Participants Across Multiple Countries Through an Online Approach: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2025 May 5;14:e73382. doi: 10.2196/73382.

Study record dates

Study Major Dates

• Study Start (Actual): July 3, 2025
• Primary Completion (Actual): August 22, 2025
• Study Completion (Actual): August 22, 2025

Study Registration Dates

• First Submitted: November 22, 2024
• First Submitted That Met QC Criteria: November 22, 2024
• First Posted (Actual): November 26, 2024

Study Record Updates

• Last Update Posted (Estimated): September 3, 2025
• Last Update Submitted That Met QC Criteria: September 1, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Compulsive Behavior; Impulsive Behavior; Behavior, Addictive
• Other Study ID Numbers: 76457

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: All data will be made available via the Stanford Medicine Research Repository.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No