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Evans WD, Ulasevich A, Hatheway M, Deperthes B. Systematic Review of Peer-Reviewed Literature on Global Condom Promotion Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2262. [PMID: 32230929 PMCID: PMC7177514 DOI: 10.3390/ijerph17072262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 12/25/2022]
Abstract
Background: Globally, 1.7 million people were newly infected with HIV in 2018. Condoms are inexpensive, cost-effective, reduce HIV/STI incidence, morbidity, mortality, and unintended pregnancies, and result in health care cost savings. Given the rapid increase in at-risk adolescent and young adult (AYA) populations in countries with high HIV/STI prevalence as well as the reductions in donor support, promoting consistent condom use remains crucial. We synthesized all peer-reviewed literature on condom promotion programs with a focus on promotion in low and lower middle income (LMIC) countries and with AYA users. Methods: We systematically reviewed the published literature. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods, we identified 99 articles published between 2000-2019. Results: Condom promotion programs were generally effective in changing attitudes, social norms, and beliefs in favor of condom use, and 85% demonstrated positive effects on multiple condom use measures. Programs targeting AYA were at least equally as effective as those targeting others and often showed greater use of best practices, such as mass media (66%) and audience segmentation (31%). We also saw differences between programs in the intervention strategies they used and found greater effects of marketing strategies on AYA compared to the overall sample. Conclusion: Condoms remain essential to prevention, and donor support must be maintained to combat the HIV/STI epidemic.
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Affiliation(s)
- William D. Evans
- Milken Institute School of Public Health and The George Washington University, Washington, DC 20052, USA;
| | | | - Megan Hatheway
- Milken Institute School of Public Health and The George Washington University, Washington, DC 20052, USA;
| | - Bidia Deperthes
- United Nations Family Planning Agency, New York, NY 10017, USA;
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2
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Abstract
One of the four national HIV prevention goals is to incorporate combinations of effective, evidence-based approaches to prevent HIV infection. In fields of public health, techniques that alter environment and affect choice options are effective. Structural approaches may be effective in preventing HIV infection. Existing frameworks for structural interventions were lacking in breadth and/or depth. We conducted a systematic review and searched CDC's HIV/AIDS Prevention Research Synthesis Project's database for relevant interventions during 1988-2013. We used an iterative process to develop the taxonomy. We identified 213 structural interventions: Access (65%), Policy/Procedure (32%), Mass Media (29%), Physical Structure (27%), Capacity Building (24%), Community Mobilization (9%), and Social Determinants of Health (8%). Forty percent targeted high-risk populations (e.g., people who inject drugs [12%]). This paper describes a comprehensive, well-defined taxonomy of structural interventions with 7 categories and 20 subcategories. The taxonomy accommodated all interventions identified.
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Hood KB, Shook NJ, Belgrave FZ. "Jimmy Cap Before You Tap": Developing Condom Use Messages for African American Women. JOURNAL OF SEX RESEARCH 2017; 54:651-664. [PMID: 27136298 DOI: 10.1080/00224499.2016.1168351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study examined which characteristics of persuasive communications are most effective in changing African American women's condom use attitudes. Focus groups were convened with 40 African American women (Mage = 25.54, SD = 4.67) to assess their opinions on current effective strategies used to promote condom use among their peers. Participants discussed effective characteristics of messaging campaigns (i.e., source, message type, channel) and how these could be used in future prevention messages. Findings revealed that making messages that are fun, catchy, and informative, delivered frequently through social media, TV, or radio by a peer or celebrity would be perceived as most effective in changing young African American women's attitudes. Other themes that emerged were that condom use is more strongly associated with pregnancy prevention than HIV prevention and that sexual partners were perceived to have negative condom use attitudes. Recommendations centered on increasing exposure of HIV prevention messages by placing messages on the Internet and including a funny phrase or jingle in the message so that it is easy to remember and could potentially serve as a conversation starter for discussing safe sex with partners.
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Affiliation(s)
| | | | - Faye Z Belgrave
- c Center for Cultural Experiences in Prevention , Virginia Commonwealth University
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Beaudoin CE, Chen H, Agha S. Estimating Causal Effects With Propensity Score Models: An Evaluation of the Touch Condom Media Campaign in Pakistan. JOURNAL OF HEALTH COMMUNICATION 2016; 21:415-423. [PMID: 26855176 DOI: 10.1080/10810730.2015.1095818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Rapid population growth in Pakistan poses major risks, including those pertinent to public health. In the context of family planning in Pakistan, the current study evaluates the Touch condom media campaign and its effects on condom-related awareness, attitudes, behavioral intention, and behavior. This evaluation relies on 3 waves of panel survey data from men married to women ages 15-49 living in urban and rural areas in Pakistan (N = 1,012): Wave 1 was March 15 to April 7, 2009; Wave 2 was August 10 to August 24, 2009; and Wave 3 was May 1 to June 13, 2010. Analysis of variance provided evidence of improvements in 10 of 11 condom-related outcomes from Wave 1 to Wave 2 and Wave 3. In addition, there was no evidence of outcome decay 1 year after the conclusion of campaign advertising dissemination. To help compensate for violating the assumption of random assignment, propensity score modeling offered evidence of the beneficial effects of confirmed Touch ad recall on each of the 11 outcomes in at least 1 of 3 time-lagged scenarios. By using these different time-lagged scenarios (i.e., from Wave 1 to Wave 2, from Wave 1 to Wave 3, and from Wave 2 to Wave 3), propensity score modeling permitted insights into how the campaign had time-variant effects on the different types of condom-related outcomes, including carryover effects of the media campaign.
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Affiliation(s)
| | - Hongliang Chen
- a Department of Communication , Texas A&M University , College Station , Texas , USA
| | - Sohail Agha
- b Integrated Delivery , The Bill and Melinda Gates Foundation , Seattle , Washington , USA
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5
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Delk J, Springer AE, Kelder SH, Grayless M. Promoting teacher adoption of physical activity breaks in the classroom: findings of the Central Texas CATCH Middle School Project. THE JOURNAL OF SCHOOL HEALTH 2014; 84:722-730. [PMID: 25274172 DOI: 10.1111/josh.12203] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 03/03/2014] [Accepted: 05/11/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Research suggests that physical activity breaks (ABs) during class increase students' physical activity levels and provide an academic benefit. This study evaluates a 3-year intervention aimed at encouraging teacher AB use. METHODS Thirty central Texas middle schools were assigned to 1 of 3 conditions: training-only (Basic), training plus facilitator support (Basic Plus), and training/facilitator support and a social marketing campaign (Basic Plus SM). Teachers completed surveys at end of years 2 (N = 1039) and 3 (N = 831) to assess exposure to program, self-efficacy, and frequency of AB use. RESULTS At end of year 3, teachers in facilitator-supported conditions reported increased exposure, self-efficacy, and use compared to Basic condition. Only 43.2% of teachers in the Basic condition reported receiving training in ABs compared to 84.2% and 90.6% in the Basic Plus and Basic Plus SM conditions, respectively. Additionally, a greater percentage of teachers in the facilitator-support conditions reported conducting ABs weekly (Basic = 23.3%, Basic Plus = 34.4%, Basic Plus SM = 38.7%, at year 3; p < .001). CONCLUSIONS Despite perceived barriers, including fear that ABs will detract from instructional time, the intervention was successful in having a core group of teachers implement them weekly. More research is needed to increase the percentage of teachers implementing ABs regularly.
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Affiliation(s)
- Joanne Delk
- University of Texas School of Public Health, Austin Regional Campus, Michael & Susan Dell Center for Healthy Living, 1616 Guadalupe St. Suite 6.300, Austin, TX 78701.
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Robinson MN, Tansil KA, Elder RW, Soler RE, Labre MP, Mercer SL, Eroglu D, Baur C, Lyon-Daniel K, Fridinger F, Sokler LA, Green LW, Miller T, Dearing JW, Evans WD, Snyder LB, Kasisomayajula Viswanath K, Beistle DM, Chervin DD, Bernhardt JM, Rimer BK. Mass media health communication campaigns combined with health-related product distribution: a community guide systematic review. Am J Prev Med 2014; 47:360-71. [PMID: 25145620 DOI: 10.1016/j.amepre.2014.05.034] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 05/05/2014] [Accepted: 05/28/2014] [Indexed: 11/26/2022]
Abstract
CONTEXT Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury. EVIDENCE ACQUISITION Using methods previously developed for the Community Guide, a systematic review (search period, January 1980-December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products. EVIDENCE SYNTHESIS Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns. CONCLUSIONS Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics.
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Affiliation(s)
- Maren N Robinson
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Kristin A Tansil
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Randy W Elder
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta.
| | - Robin E Soler
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Magdala P Labre
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Shawna L Mercer
- Community Guide Branch, Division of Epidemiology, Analysis and Library Services, Center for Surveillance, Epidemiology and Laboratory Services , CDC, Atlanta
| | - Dogan Eroglu
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | - Cynthia Baur
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | - Katherine Lyon-Daniel
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | - Fred Fridinger
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | - Lynn A Sokler
- Office of Associate Director of Communications, Office of the Director, CDC, Atlanta
| | | | - Therese Miller
- Agency for Healthcare Research and Quality, Rockville, MD
| | | | | | | | | | - Diane M Beistle
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta
| | | | | | - Barbara K Rimer
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina
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Jacob V, Chattopadhyay SK, Elder RW, Robinson MN, Tansil KA, Soler RE, Labre MP, Mercer SL. Economics of mass media health campaigns with health-related product distribution: a community guide systematic review. Am J Prev Med 2014; 47:348-59. [PMID: 25145619 PMCID: PMC4682205 DOI: 10.1016/j.amepre.2014.05.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 05/05/2014] [Accepted: 05/28/2014] [Indexed: 10/24/2022]
Abstract
CONTEXT The objective of this systematic review was to determine the costs, benefits, and overall economic value of communication campaigns that included mass media and distribution of specified health-related products at reduced price or free of charge. EVIDENCE ACQUISITION Economic evaluation studies from a literature search from January 1980 to December 2009 were screened and abstracted following systematic economic review methods developed by The Community Guide. Data were analyzed in 2011. EVIDENCE SYNTHESIS The economic evidence was grouped and assessed by type of product distributed and health risk addressed. A total of 15 evaluation studies were included in the economic review, involving campaigns promoting the use of child car seats or booster seats, pedometers, condoms, recreational safety helmets, and nicotine replacement therapy. CONCLUSIONS Economic merits of the intervention could not be determined for health communication campaigns associated with use of recreational helmets, child car seats, and pedometers, primarily because available economic information and analyses were incomplete. There is some evidence that campaigns with free condom distribution to promote safer sex practices were cost-effective among high-risk populations and the cost per quit achieved in campaigns promoting tobacco cessation with nicotine replacement therapy products may translate to a cost per quality-adjusted life-year less than $50,000. Many interventions were publicly funded trials or programs, and the failure to properly evaluate their economic cost and benefit is a serious gap in the science and practice of public health.
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Affiliation(s)
- Verughese Jacob
- Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, CDC, Atlanta, Georgia.
| | - Sajal K Chattopadhyay
- Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, CDC, Atlanta, Georgia
| | - Randy W Elder
- Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, CDC, Atlanta, Georgia
| | - Maren N Robinson
- Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, CDC, Atlanta, Georgia
| | - Kristin A Tansil
- Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, CDC, Atlanta, Georgia
| | - Robin E Soler
- Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, CDC, Atlanta, Georgia
| | - Magdala P Labre
- Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, CDC, Atlanta, Georgia
| | - Shawna L Mercer
- Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, CDC, Atlanta, Georgia
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8
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Araujo J, Ghiya ND, Calugar A, Popovic T. Analysis of three factors possibly influencing the outcome of a science review process. Account Res 2014; 21:241-64. [PMID: 24422703 DOI: 10.1080/08989621.2013.848798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- John Araujo
- a Office of the Associate Director for Science, Office of the Director, Centers for Disease Control and Prevention , Atlanta , Georgia , USA
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9
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Giordano TP, Rodriguez S, Zhang H, Kallen MA, Jibaja-Weiss M, Buscher AL, Arya M, Suarez-Almazor ME, Ross M. Effect of a clinic-wide social marketing campaign to improve adherence to antiretroviral therapy for HIV infection. AIDS Behav 2013; 17:104-12. [PMID: 22983536 DOI: 10.1007/s10461-012-0295-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This demonstration study tested the impact of a 5-month clinic-wide social marketing campaign at improving adherence to antiretroviral therapy (ART). The intervention included a video, posters, pens, mugs, and lapel buttons with the campaign slogan "Live the Solution: Take Your Pills Every Day." Participants self-reported adherence over a 4-week interval, the primary outcome, with a visual analogue scale. Pre- and post-intervention surveys were completed by 141 participants. Adherence did not change over time (absolute mean change -2.02 %, paired t test P = 0.39). Among the 39.7 % of participants who correctly identified the campaign slogan on the post-intervention survey, adherence increased by 3.3 %, while it decreased in the other participants by 5.5 % (paired t test P = 0.07). The well-received campaign did not increase short-term adherence to ART, but adherence tended to increase in participants who were more engaged with the intervention. Future interventions should engage patients more completely and have a more potent effect on adherence.
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Chandran TM, Berkvens D, Chikobvu P, Nöstlinger C, Colebunders R, Williams BG, Speybroeck N. Predictors of condom use and refusal among the population of Free State province in South Africa. BMC Public Health 2012; 12:381. [PMID: 22639964 PMCID: PMC3432618 DOI: 10.1186/1471-2458-12-381] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 05/28/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND This study investigated the extent and predictors of condom use and condom refusal in the Free State province in South Africa. METHODS Through a household survey conducted in the Free Sate province of South Africa, 5,837 adults were interviewed. Univariate and multivariate survey logistic regressions and classification trees (CT) were used for analysing two response variables 'ever used condom' and 'ever refused condom'. RESULTS Eighty-three per cent of the respondents had ever used condoms, of which 38% always used them; 61% used them during the last sexual intercourse and 9% had ever refused to use them. The univariate logistic regression models and CT analysis indicated that a strong predictor of condom use was its perceived need. In the CT analysis, this variable was followed in importance by 'knowledge of correct use of condom', condom availability, young age, being single and higher education. 'Perceived need' for condoms did not remain significant in the multivariate analysis after controlling for other variables. The strongest predictor of condom refusal, as shown by the CT, was shame associated with condoms followed by the presence of sexual risk behaviour, knowing one's HIV status, older age and lacking knowledge of condoms (i.e., ability to prevent sexually transmitted diseases and pregnancy, availability, correct and consistent use and existence of female condoms). In the multivariate logistic regression, age was not significant for condom refusal while affordability and perceived need were additional significant variables. CONCLUSIONS The use of complementary modelling techniques such as CT in addition to logistic regressions adds to a better understanding of condom use and refusal. Further improvement in correct and consistent use of condoms will require targeted interventions. In addition to existing social marketing campaigns, tailored approaches should focus on establishing the perceived need for condom-use and improving skills for correct use. They should also incorporate interventions to reduce the shame associated with condoms and individual counselling of those likely to refuse condoms.
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Affiliation(s)
| | | | | | | | - Robert Colebunders
- Institute of Tropical Medicine, Antwerp, Belgium
- Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Brian Gerard Williams
- South African Centre for Epidemiological Modeling and Analysis, University of Stellenbosch, Stellenbosch, South Africa
| | - Niko Speybroeck
- Institut de Recherche Santé et Societé (IRSS), Université catholique de Louvain, Brussels, Belgium
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Chin HB, Sipe TA, Elder R, Mercer SL, Chattopadhyay SK, Jacob V, Wethington HR, Kirby D, Elliston DB, Griffith M, Chuke SO, Briss SC, Ericksen I, Galbraith JS, Herbst JH, Johnson RL, Kraft JM, Noar SM, Romero LM, Santelli J. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services. Am J Prev Med 2012; 42:272-94. [PMID: 22341164 DOI: 10.1016/j.amepre.2011.11.006] [Citation(s) in RCA: 202] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 10/27/2011] [Accepted: 11/22/2011] [Indexed: 11/27/2022]
Abstract
CONTEXT Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. EVIDENCE ACQUISITION Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identified 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. EVIDENCE SYNTHESIS Meta-analyses were conducted for each strategy on the seven key outcomes identified by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent findings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. CONCLUSIONS Based on these findings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the effectiveness of group-based abstinence education.
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Affiliation(s)
- Helen B Chin
- Community Guide Branch, Epidemiology and Analysis Program Office, National Center for Immunization and Respiratory Diseases, CDC, Atlanta GA 30333, USA
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12
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Agha S, Beaudoin CE. Assessing a thematic condom advertising campaign on condom use in urban Pakistan. JOURNAL OF HEALTH COMMUNICATION 2012; 17:601-623. [PMID: 22272557 DOI: 10.1080/10810730.2011.635768] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study aims to assess communication processes involving a thematic condom advertising campaign in Pakistan in 2009. To evaluate the social marketing campaign for Touch condoms, the authors conducted a nationally representative survey of 1,606 men married to women aged 15-49 years. About 15% of urban married men were aware of Touch advertising. After controlling for a range of other variables including daily television viewership, confirmed awareness of Touch advertising was associated with a higher level of belief in the effectiveness of condoms, reduced embarrassment in negotiating condom use, reduced embarrassment in purchasing condoms, increased discussion of family planning, and increased use of condoms and other contraceptive methods. The findings have implications for the further development and dissemination of contraceptive advertising in Pakistan, as well as the broader construction of scientific knowledge on how advertising can influence contraceptive and other critical health behaviors in other contexts.
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Affiliation(s)
- Sohail Agha
- Population Services International/Tulane University, Karachi, Pakistan
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13
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Sznitman S, Vanable PA, Carey MP, Hennessy M, Brown LK, Valois RF, Stanton BF, Salazar LF, DiClemente R, Farber N, Romer D. Using culturally sensitive media messages to reduce HIV-associated sexual behavior in high-risk African American adolescents: results from a randomized trial. J Adolesc Health 2011; 49:244-51. [PMID: 21856515 PMCID: PMC3159865 DOI: 10.1016/j.jadohealth.2010.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 12/06/2010] [Accepted: 12/07/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE To test the long-term effects of a mass media intervention that used culturally and developmentally appropriate messages to enhance human immunodeficiency virus (HIV)-preventive beliefs and behavior of high-risk African American adolescents. METHODS Television and radio messages were delivered for more than 3 years in two cities (Syracuse, NY; and Macon, GA) that were randomly selected within each of the two regionally matched city pairs, with the other cities (Providence, RI; and Columbia, SC) serving as controls. African American adolescents, aged 14-17 years (N = 1,710), recruited in the four cities over a 16-month period, completed audio computer-assisted self-interviews at recruitment and again at 3, 6, 12, and 18-months postrecruitment to assess the long-term effects of the media program. To identify the unique effects of the media intervention, youth who completed at least one follow-up and who did not test positive for any of the three sexually transmitted infections at recruitment or at 6-and 12-month follow-up were retained for analysis (N = 1,346). RESULTS The media intervention reached virtually all the adolescents in the trial and produced a range of effects including improved normative condom-use negotiation expectancies and increased sex refusal self-efficacy. Most importantly, older adolescents (aged 16-17 years) exposed to the media program showed a less risky age trajectory of unprotected sex than those in the nonmedia cities. CONCLUSION Culturally tailored mass media messages that are delivered consistently over time have the potential to reach a large audience of high-risk adolescents, to support changes in HIV-preventive beliefs, and to reduce HIV-associated risk behaviors among older youth.
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Affiliation(s)
- Sharon Sznitman
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia PA
| | | | | | - Michael Hennessy
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia PA
| | - Larry K. Brown
- Department of Psychiatry and Human Behavior, Brown University, Providence RI
| | - Robert F. Valois
- Arnold School of Public Health, University of South Carolina, Columbia SC
| | - Bonita F. Stanton
- Department of Pediatrics, Wayne State University School of Medicine, Detroit MI
| | | | | | - Naomi Farber
- Arnold School of Public Health, University of South Carolina, Columbia SC
| | - Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia PA
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Rochon D, Ross MW, Looney C, Nepal VP, Price AJ, Giordano TP. Communication strategies to improve HIV treatment adherence. HEALTH COMMUNICATION 2011; 26:461-467. [PMID: 21432703 DOI: 10.1080/10410236.2011.554168] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Although antiretroviral therapy has increased the survival of HIV-positive patients, traditional approaches to improving medication adherence have failed consistently. Acknowledging the role of communication in health behavior, we conducted a qualitative study to learn about patients' HIV treatment adherence experiences and to identify which communication strategies might influence adherence. Findings indicate that five constructs--cultural beliefs/language, stigma, cues to action, self-efficacy, and mood state--are potentially modifiable by improved communication. Results will be used to create a direct marketing campaign targeted to HIV-infected patients.
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Affiliation(s)
- Donna Rochon
- Department of Family & Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA.
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15
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Tung WC, Cook DM, Lu M. Sexual behavior, stages of condom use, and self-efficacy among college students in Taiwan. AIDS Care 2011; 23:113-20. [DOI: 10.1080/09540121.2010.498863] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Wei-Chen Tung
- a Orvis School of Nursing , University of Nevada-Reno , Reno , NV , USA
| | - Daniel M. Cook
- b School of Community Health Sciences , University of Nevada , Reno , NV , USA
| | - Minggen Lu
- b School of Community Health Sciences , University of Nevada , Reno , NV , USA
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Martínez-Donate AP, Zellner JA, Sañudo F, Fernandez-Cerdeño A, Hovell MF, Sipan CL, Engelberg M, Carrillo H. Hombres Sanos: evaluation of a social marketing campaign for heterosexually identified Latino men who have sex with men and women. Am J Public Health 2010; 100:2532-40. [PMID: 21068423 PMCID: PMC2978169 DOI: 10.2105/ajph.2009.179648] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2010] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the effectiveness of Hombres Sanos [Healthy Men] a social marketing campaign to increase condom use and HIV testing among heterosexually identified Latino men, especially among heterosexually identified Latino men who have sex with men and women (MSMW). METHODS Hombres Sanos was implemented in northern San Diego County, California, from June 2006 through December 2006. Every other month we conducted cross-sectional surveys with independent samples of heterosexually identified Latino men before (n = 626), during (n = 752), and after (n = 385) the campaign. Respondents were randomly selected from 12 targeted community venues to complete an anonymous, self-administered survey on sexual practices and testing for HIV and other sexually transmitted infections. About 5.6% of respondents (n = 98) were heterosexually identified Latino MSMW. RESULTS The intervention was associated with reduced rates of recent unprotected sex with both females and males among heterosexually identified Latino MSMW. The campaign was also associated with increases in perception of HIV risk, knowledge of testing locations, and condom carrying among heterosexual Latinos. CONCLUSIONS Social marketing represents a promising approach for abating HIV transmission among heterosexually identified Latinos, particularly for heterosexually identified Latino MSMW. Given the scarcity of evidence-based HIV prevention interventions for these populations, this prevention strategy warrants further investigation.
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Affiliation(s)
- Ana P Martínez-Donate
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA.
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Tung WC, Lu M, Cook DM. Condom use and stages of change among college students in Taiwan. Public Health Nurs 2010; 27:474-81. [PMID: 21087300 DOI: 10.1111/j.1525-1446.2010.00890.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To explore the correlates for nonuse of condoms and the factors that affect stages of change for regular condom use among college students in Taiwan. DESIGN AND SAMPLE Cross-sectional, quantitative survey design. A total of 996 college students were recruited from two universities in Northern Taiwan. MEASURES Questionnaires collected data on demographic information, condom use, HIV/AIDS knowledge, confidence in using condoms in different situations, and perceived benefits and barriers to using condoms. RESULTS The common reasons for not using condoms were trust in the partner (21.30%), partner dislike for condoms (19.49%), and perception of low risk (18.77%). Most sexually active students (52.4%) were in the earliest 2 stages of readiness to change (i.e., precontemplation, contemplation). Participants in action/maintenance were (a) 43.4% less likely to show a high knowledge score, (b) 4.08 times more likely to present high self-efficacy, and (c) 2.24 times more likely to be more religious than those in contemplation/preparation. CONCLUSIONS Among a highly literate group, college students, condom use is inconsistent and readiness to change is not imminent. This study reveals that preventive steps targeted at young adults should address other concerns related to condom use such as trust in partners and the alleged appeal of unprotected sex.
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Affiliation(s)
- Wei-Chen Tung
- Orvis School of Nursing, University of Nevada-Reno, Reno, Nevada 89557, USA.
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Romer D, Sznitman S, DiClemente R, Salazar LF, Vanable PA, Carey MP, Hennessy M, Brown LK, Valois RF, Stanton BF, Fortune T, Juzang I. Mass media as an HIV-prevention strategy: using culturally sensitive messages to reduce HIV-associated sexual behavior of at-risk African American youth. Am J Public Health 2009; 99:2150-9. [PMID: 19833995 DOI: 10.2105/ajph.2008.155036] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The evidence base and theoretical frameworks for mass media HIV-prevention campaigns in the United States are not well-developed. We describe an intervention approach using culturally sensitive mass media messages to enhance protective beliefs and behavior of African American adolescents at risk for HIV. This approach exploits the potential that mass media messages have, not only to reach a large segment of the adolescent population and thereby support normative change, but also to engage the most vulnerable segments of this audience to reduce HIV-associated risk behaviors. The results from an ongoing HIV-prevention trial implemented in 2 medium-sized cities in the United States illustrate the effectiveness of this intervention approach.
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Affiliation(s)
- Daniel Romer
- Adolescent Risk Communication Institute, Annenberg Public Policy Center, University of Pennsylvania, 202 South 36th Street, Philadelphia, PA 19104-3806, USA.
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Martínez-Donate AP, Zellner JA, Fernández-Cerdeño A, Sañudo F, Hovell MF, Sipan CL, Engelberg M, Ji M. Hombres Sanos: exposure and response to a social marketing HIV prevention campaign targeting heterosexually identified Latino men who have sex with men and women. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2009; 21:124-136. [PMID: 19824840 DOI: 10.1521/aeap.2009.21.5_supp.124] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study examined the reach and impact of a social marketing intervention to reduce HIV risk among heterosexually identified (HI) Latino men who have sex with men and women (MSMW). Repeated cross-sectional intercept surveys were conducted in selected community venues during and after the campaign with 1,137 HI Latino men. Of them, 6% were classified as HI Latino MSMW. On average, 85.9% of the heterosexual respondents and 86.8% of the HI MSMW subsample reported exposure to the campaign. Responses to the campaign included having made an appointment for a male health exam that included HIV testing and using condoms. Campaign exposure was significantly associated with HIV testing behavior and intentions and with knowledge of where to get tested. The campaign reached its underserved target audience and stimulated preventive behaviors. Social marketing represents a promising approach for HIV prevention among HI Latinos, in general, and HI Latino MSMW, in particular.
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Affiliation(s)
- Ana P Martínez-Donate
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726-2397, USA.
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Noar SM, Palmgreen P, Chabot M, Dobransky N, Zimmerman RS. A 10-year systematic review of HIV/AIDS mass communication campaigns: Have we made progress? JOURNAL OF HEALTH COMMUNICATION 2009; 14:15-42. [PMID: 19180369 DOI: 10.1080/10810730802592239] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of the current study was to conduct a 10-year systematic review of HIV/AIDS mass communication campaigns focused on sexual behavior, HIV testing, or both (1998-2007) and to compare the results with the last comprehensive review of such campaigns, conducted by Myhre and Flora (2000). A comprehensive search strategy yielded 38 HIV/AIDS campaign evaluation articles published in peer-reviewed journals, representing 34 distinct campaign efforts conducted in 23 countries. The articles were coded on a variety of campaign design and evaluation dimensions by two independent coders. Results indicated that compared with the previous systematic review (1986-1998 period), campaigns increasingly have employed the following strategies: (1) targeted defined audiences developed through audience segmentation procedures; (2) designed campaign themes around behavior change (rather than knowledge change); (3) used behavioral theories; (4) achieved high message exposure; (5) used stronger research designs for outcome evaluation; and (6) included measures of behavior (or behavioral intentions) in outcome assessments. In addition, an examination of 10 campaign efforts that used more rigorous quasi-experimental designs revealed that the majority (8 of 10) demonstrated effects on behavior change or behavioral intentions. Despite these positive developments, most HIV/AIDS campaigns continue to use weak (i.e., preexperimental) outcome evaluation designs. Implications of these results for improved design, implementation, and evaluation of HIV/AIDS campaign efforts are discussed.
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Affiliation(s)
- Seth M Noar
- Department of Communication, University of Kentucky, Lexington, Kentucky 40506-0042, USA.
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21
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Bull SS, Posner SF, Ortiz C, Beaty B, Benton K, Lin L, Pals SL, Evans T. POWER for reproductive health: results from a social marketing campaign promoting female and male condoms. J Adolesc Health 2008; 43:71-8. [PMID: 18565440 DOI: 10.1016/j.jadohealth.2007.12.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Revised: 12/10/2007] [Accepted: 12/21/2007] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate effects of a 6-month social marketing campaign on awareness of, attitudes toward and use of female as well as male condoms for 15-25 year-old-women. METHODS Using a time-space sampling methodology, we conducted a cross-sectional survey of 3407 women at pre-campaign in 12 western U.S. neighborhoods on female and male condom awareness, attitudes, and use. Six of the 12 study neighborhoods were randomly selected to receive the POWER social marketing campaign designed to impact condom knowledge, attitudes, and use. The campaign was followed with another cross-sectional survey of 3,003 women in all 12 study neighborhoods on condom knowledge, attitudes, use and awareness of POWER materials. We compared pre-and post-campaign surveys to determine the efficacy of POWER and conducted post hoc analyses on post-campaign data to determine if exposure to POWER was related to higher levels of positive condom attitudes and norms and condom use. RESULTS We found no differences between neighborhoods with and without the POWER campaign with regard to our primary outcomes. To diagnose reasons for this null effect, we examined outcomes post hoc examining the influence of POWER exposure. Post hoc analyses show some evidence that exposure to POWER was associated with condom use. In the context of the nested trial, this raises concerns that post test only evaluations are limited. CONCLUSIONS Establishing the efficacy of a social marketing campaign is challenging. This group randomized trial showed a null effect. Social marketing campaigns may need to have more media channels and saturation before they can show behavioral effects. Using a nested design with randomization at the community level and probability sampling introduces rigor not commonly seen in evaluations of social marketing campaigns.
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Affiliation(s)
- Sheana S Bull
- Colorado Health Outcomes Program, University of Colorado Health Sciences Center, Aurora, Colorado 80045-0508, USA.
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Sumartojo E, Lyles C, Choi K, Clark L, Collins C, Guenther Grey C, Lin LS, Peterson JL, Remafedi G, CITY STUDY TEAM. Prevalence and correlates of HIV testing in a multi-site sample of young men who have sex with men. AIDS Care 2008; 20:1-14. [DOI: 10.1080/09540120701450425] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- E. Sumartojo
- a National Center for HIV, STD, and TB Prevention , Centers for Disease Control and Prevention , Atlanta , Georgia
| | - C. Lyles
- a National Center for HIV, STD, and TB Prevention , Centers for Disease Control and Prevention , Atlanta , Georgia
| | - K. Choi
- b Center for AIDS Prevention Studies, School of Medicine , University of California , San Francisco
| | - L. Clark
- c Community, Health Outcomes, and Intervention Research (CHOIR) Program , Saban Research Institute, Childrens Hospital , Los Angeles
- d Division of Research on Children, Youth, and Families, Department of Pediatrics , Keck School of Medicine/University of Southern California
| | - C. Collins
- e School of Public Health , University of Alabama at Birmingham
| | - C. Guenther Grey
- a National Center for HIV, STD, and TB Prevention , Centers for Disease Control and Prevention , Atlanta , Georgia
| | - L. S. Lin
- a National Center for HIV, STD, and TB Prevention , Centers for Disease Control and Prevention , Atlanta , Georgia
| | - J. L. Peterson
- f Department of Psychology , Georgia State University , Atlanta , Georgia
| | - G. Remafedi
- g Youth and AIDS Project, Department of Pediatrics , University of Minnesota , Minneapolis , Minnesota
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Lombardo AP, Léger YA. Thinking about "Think Again" in Canada: assessing a social marketing HIV/AIDS prevention campaign. JOURNAL OF HEALTH COMMUNICATION 2007; 12:377-97. [PMID: 17558789 DOI: 10.1080/10810730701328875] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The Canadian "Think Again" social marketing HIV/AIDS prevention campaign, adapted from an American effort, encourages gay men to rethink their assumptions about their partners' HIV statuses and the risks of unsafe sex with them. To improve future efforts, existing HIV/AIDS prevention initiatives require critical reflection. While a formal evaluation of this campaign has been carried out elsewhere, here we use the campaign as a social marketing case study to illustrate its strengths and weaknesses, as a learning tool for other campaigns. After describing the campaign and its key results, we assess how it utilized central tenets of the social marketing process, such as formative research and the marketing mix. We then speak to the importance of theoretical influence in campaign design and the need to account for social-contextual factors in safer sex decision making. We conclude with a summary of the lessons learned from the assessment of this campaign.
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24
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Katz I. Explaining the increase in condom use among South African young females. JOURNAL OF HEALTH COMMUNICATION 2006; 11:737-53. [PMID: 17190780 DOI: 10.1080/10810730600934674] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Since 1998 South Africa has experienced stability in HIV prevalence among its 15 to 19 year olds, and to a lesser extent among its 20 to 24 year olds. While a few studies point to behavioural change, mainly an increase in condom use, none has established the reasons. This article explores the influence of various information sources about AIDS upon the use of condoms among rural and urban South African young females, using the South Africa Demographic Health Survey of 1998 (1998 SADHS), while controlling for various socioeconomic and cultural parameters. The results show that condom use among urban residents was positively correlated with mass media exposure, television as a source of information about AIDS, and the number of mass media sources from which the respondent received information about AIDS. Condom use among rural residents was associated with the number of sources of information about AIDS, exposure to mass media, and the language and education of the respondent. Among urban residents condom use was almost twice as high as among rural residents. The results from the article indicate that three elements influenced the increase in condom use among females: the threat of AIDS, mass media, and receptiveness to condom use. The receptiveness was culturally dependent.
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Affiliation(s)
- Itamar Katz
- Department of Geography, Cambridge University, Cambridge, United Kingdom.
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Myklestad I, Rise J. Predicting Willingness to Engage in Unsafe Sex and Intention to Perform Sexual Protective Behaviors Among Adolescents. HEALTH EDUCATION & BEHAVIOR 2006; 34:686-99. [PMID: 16885507 DOI: 10.1177/1090198106289571] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article examines the sociocognitive processes contributing to intention to use contraception and willingness to engage in unsafe sex, using extended versions of the theory of planned behavior (TPB) and the Prototype/Willingness model (Gibbons & Gerrard, 1995, 1997). Data were obtained from a questionnaire delivered to all the pupils in ninth grade ( N = 196) at three schools in Oslo. Hierarchical multiple regression analysis was used to predict intention and willingness. The results showed that subjective norm was the most important predictor of intentions for girls, whereas moral norm was most important for boys' intentions and willingness. Prototypes were the most important predictor for girls' willingness. Implications of the findings are discussed.
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26
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Rothman EF, Decker MR, Silverman JG. Evaluation of a teen dating violence social marketing campaign: Lessons learned when the null hypothesis was accepted. ACTA ACUST UNITED AC 2006. [DOI: 10.1002/ev.185] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Social marketing, the use of marketing to design and implement programs to promote socially beneficial behavior change, has grown in popularity and usage within the public health community. Despite this growth, many public health professionals have an incomplete understanding of the field. To advance current knowledge, we provide a practical definition and discuss the conceptual underpinnings of social marketing. We then describe several case studies to illustrate social marketing's application in public health and discuss challenges that inhibit the effective and efficient use of social marketing in public health. Finally, we reflect on future developments in the field. Our aim is practical: to enhance public health professionals' knowledge of the key elements of social marketing and how social marketing may be used to plan public health interventions.
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Affiliation(s)
- Sonya Grier
- The University of Pennsylvania, Colonial Penn Center, Philadelphia, 19104, USA.
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29
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Crosby RA, DiClemente RJ, Wingood GM, Salazar LF, Harrington K, Davies SL, Oh MK. Identification of strategies for promoting condom use: a prospective analysis of high-risk African American female teens. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2004; 4:263-70. [PMID: 14598998 DOI: 10.1023/a:1026020332309] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Condom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14-18 years old, were recruited from schools and health clinics. Adolescents completed an in-depth survey and interview at baseline and again 6 months later. Analyses were limited to adolescents with steady partners who reported sexual activity between the baseline and 6-month follow-up assessment periods (N = 179). At baseline, five-scale measures and a single-item measure were used to assess predictive constructs. At follow-up, adolescents were asked about their frequency of condom use over various periods of recall. Multivariate models were created to control for the confounding influence of pregnancy status. The findings were remarkably distinct. The evidence strongly supported the predictive role of perceived barriers toward condom use and peer norms. The measure of sexual communication achieved significance for two of the six assessed outcomes. Alternatively, measures of attitudes toward condom use, condom negotiation self-efficacy, and knowledge about STD/HIV-prevention were consistently nonsignificant. The findings suggest that to improve effectiveness of individual-level STD/HIV prevention programs, designed for this population, program emphasis should be on reducing barriers to condom use, teaching partner communication skills, and fostering positive peer norms relevant to condom use.
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Affiliation(s)
- Richard A Crosby
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Atlanta, Georgia 30322, USA.
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30
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Bull SS, Posner SF, Ortiz C, Evans T. Knowledge of, attitudes toward, and stage of change for female and male condoms among Denver inner-city women. J Urban Health 2003; 80:658-66. [PMID: 14709713 PMCID: PMC3456220 DOI: 10.1093/jurban/jtg072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Despite availability for a decade and documented acceptability among some groups of women for the method, female condom use is still rare. We surveyed 198 young women (15-25 years old) living in the inner city of Denver about their knowledge of, attitudes toward, and practices regarding female and male condoms. Most (75%) women had ever considered using male condoms; 32% had ever considered using female condoms; and use of either was sporadic. We examined predictors for being in either precontemplation or a later stage along the change continuum at both the bivariate and multivariate levels. Our findings suggest that African Americans and younger women are more likely to contemplate using female condoms. Both lack of knowledge and positive attitudes toward female condoms in this sample suggest that programs designed to raise awareness and knowledge of female condoms while improving their image are needed.
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Affiliation(s)
- Sheana Salyers Bull
- Colorado Health Outcomes Program, University of Colorado Health Sciences Center, Aurora, Colorado, USA.
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Abstract
Alarming numbers of teens engage in behaviors that place them at risk for pregnancy and sexually transmitted infections (STIs) including AIDS. Intervention studies targeted toward reducing risky sexual behavior and improving school retention and literature about variables that affect risky sexual behavior and school performance were reviewed to develop the Social-Cognitive Model for Sexual Behavior During Adolescence. Interventions that target change in the family and school environments in addition to building the personal capacities of each teen have the potential to be effective. Many environmental factors cannot be altered, but the intervention can help reframe the situation and provide the knowledge, specific skills, role models, and rehearsal that promote change. The 13-week school-based intervention assists students identify how personal strengths and family, school, and neighborhood environmental factors can reinforce health behaviors and choices.
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Affiliation(s)
- Marie L Talashek
- Department of Public Health, Mental Health, and Administrative Nursing, College of Nursing, University of Illinois at Chicago, USA
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32
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Fisman DN, Lipsitch M, Hook EW, Goldie SJ. Projection of the future dimensions and costs of the genital herpes simplex type 2 epidemic in the United States. Sex Transm Dis 2002; 29:608-22. [PMID: 12370529 DOI: 10.1097/00007435-200210000-00008] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Infection with herpes simplex virus type 2 (HSV-2) currently affects approximately 22% of adult Americans and increased markedly in prevalence between the late 1970s and early 1990s. Although some estimates of the costs of prevalent disease due to HSV-2 are available, selection of interventions to prevent HSV-2 infection, as well as evaluation of their potential cost-effectiveness, should take into account projected future costs that will result if the epidemic is left unchecked. GOAL The goal was to estimate the future health and economic consequences attributable to the HSV-2 epidemic in the absence of interventions to slow the epidemic. STUDY DESIGN A mathematical model was constructed to project future increases in HSV-2 seroprevalence in the United States. The probability of heterosexual transmission of HSV-2 was estimated from cross-sectional estimates of infection prevalence reported by the National Health and Nutrition Examination Survey (NHANES). Per-infection expected costs were calculated on the basis of data obtained from the published medical literature. RESULTS Without intervention, the prevalence of HSV-2 infection among individuals aged 15 to 39 years was projected to increase to 39% among men and 49% among women by 2025. Annual incidence was projected to increase steadily between 2000 and 2025, from 9 to 26 infections per 1,000 men and from 12 to 32 infections per 1,000 women in this age group. The cost of incident infections in the year 2000 were estimated to be $1.8 billion; the cost of incident infections was predicted to rise to $2.5 billion by 2015 and $2.7 billion by 2025. The projected cumulative cost of incident HSV-2 infections occurring over the next 25 years was estimated to be $61 billion; at a 3% discount rate, this sum has a present value of $43 billion. CONCLUSION The costs of incident HSV-2 infection in the United States are substantial and can be expected to increase as both the incidence and prevalence of this disease increase in the first half of the century. The level of resource allocation for HSV-2 prevention strategies should reflect the economic benefits that would result from control of this epidemic.
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Affiliation(s)
- David N Fisman
- City of Hamilton Social and Public Health Services Department, McMaster University, Hamilton, Ontario, Canada.
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Rietmeijer CA, Lansky A, Anderson JE, Fichtner RR. The current good should precede the future best: a response to a response. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2002; 14:348-350. [PMID: 12212721 DOI: 10.1521/aeap.14.5.348.23868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- Cornelis A Rietmeijer
- Denver Public Health Department, University of Colorado Health Sciences Center, 80204, USA.
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Bull SS, Cohen J, Ortiz C, Evans T. The POWER campaign for promotion of female and male condoms: audience research and campaign development. HEALTH COMMUNICATION 2002; 14:475-491. [PMID: 12375772 DOI: 10.1207/s15327027hc1404_4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this study, we conducted and content analyzed 12 focus groups with women aged 15-25 living in inner city Denver as a process of audience research to develop a male and female condom promotion campaign. We recruited 89 women from school and community sites in central Denver neighborhoods to discuss their knowledge, attitudes, and practices regarding both male and female condoms, then solicited opinions about how to increase knowledge about and familiarity with female condoms, increase positive attitudes toward both male and female condoms, and how to increase access to and use of both male and female condoms. Opinions on these topics drove the development of a targeted media campaign promoting condom use in this population. We report here on the general findings from focus groups and provide details about the campaign the participants helped to develop.
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