Implementing and Evaluating Contact Strategies to Reduce Stigma towards People Living with Dementia

Abstract

Despite the global rise in dementia and its associated stigma, research on dementia stigma and its reduction remains limited. This PhD research programme has three objectives: (1) to propose a theoretical framework of dementia stigma to guide evaluation of interventions, (2) to identify key predictors of dementia stigma, and (3) to design and evaluate stigma-reduction interventions based on indirect contact. Integrating the Attribution Model, Modified Labelling Theory, and cultural psychology, the thesis advances a multi-level dynamic model encompassing cognitive, emotional, behavioural, and cultural pathways. To identify populations with higher dementia stigma, Study 1 (N = 268) and Study 2 (N = 354) examined perceiver and target predictors using text- and video-based vignettes. Across both studies, Asian participants and individuals with lower contact quality with older people consistently reported higher dementia stigma across all outcomes. Guided by these findings, subsequent interventions focused on indirect contact strategies. Study 3 (N = 330) used parasocial contact videos featuring culturally matched people living with dementia among Asian and Anglo-European participants. Results showed a mixed pattern, with increased helping intentions alongside greater avoidance, and higher dementia stigma reported among Asian participants. To specifically target this group, Study 4 (N = 312) employed vicarious contact videos structured around Allport's (1954) facilitating conditions with Asian participants. Vicarious contact significantly reduced fear, anger, and avoidance, and increased helping intentions. These effects were mediated by reduced intergroup anxiety. Although attitudes did not improve directly, they improved indirectly via reduced intergroup anxiety. Overall, the findings highlight the practical importance of culturally sensitive contact-based interventions, particularly vicarious contact, to reduce dementia stigma.