Gender and racial/ethnic matching in brief video-based anti-stigma interventions for adolescents: a randomized controlled trial.

Brief video-based social contact interventions have shown promise in reducing depression stigma among adolescents. However, it is unclear whether tailoring content to match the viewer’s gender or ethnicity enhances their effectiveness. This study examined whether demographic concordance between adolescent viewers and video protagonists reduces stigma and increases treatment-seeking intentions. In this randomized controlled trial, 1,127 U.S. adolescents aged 14–18 were assigned to view one of seven intervention videos featuring adolescent actors varying by race/ethnicity (Black/White/Hispanic), gender (female/male/non-binary), and clinical condition (depressed/control), or an informational control. Depression stigma and treatment-seeking intentions were assessed at baseline, immediately post-intervention, and at 14- and 30-day follow-ups. Emotional engagement with the videos was also measured and examined as a potential moderator. Matched viewers showed significantly greater stigma reduction than unmatched viewers, particularly among Hispanic adolescents viewing the Hispanic protagonist video (2.5 ± 3.0 Hispanic vs. 1.5 ± 3.1 other; t = 3.2, p = .002). Male viewers of male protagonists also showed greater reductions (2.2 ± 3.2 watching males vs. 1.1 ± 3.3 watching females; t = 2.51, p = .012). Higher emotional engagement was consistently associated with greater reductions in stigma (e.g., 2.5 ± 3.4 vs. 1.5 ± 3.2; t = 2.34, p = .02). No effects were found for treatment-seeking intentions. Findings suggest that brief video-based interventions can reduce depression stigma among adolescents, with greater impact when the storyteller shares key demographic characteristics with the viewer, particularly among historically underserved or stigmatized groups. Emotional engagement further enhances these effects. Future research should examine how to effectively integrate identity-congruent content into social media environments to maximize reach and relevance, while mitigating potential risks such as exposure to misinformation.