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O'Leary A, Willis LA, Henny KD, Madden M, Koenig LJ. Development of a Video-Delivered Serial Drama Designed to Reduce Community Homophobia and HIV Stigma, Decrease Sexual Risk Behavior, and Increase HIV Testing Among Black Youth. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:439-451. [PMID: 38096457 PMCID: PMC10877481 DOI: 10.1521/aeap.2023.35.6.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
This article describes the development of a video serial drama intervention that was designed to address factors that influence HIV in the United States among Black youth. These include HIV testing, sexual behaviors not protected by condoms, negative attitudes towards sexual minorities, and HIV stigma. Behavior-change principles (social learning theory and education-entertainment) and input from members of the priority audience formed the basis of this 27-episode (3 minutes each) drama for dissemination on multiple platforms, including in public spaces or privately online. The developmental process, specifically involving members of the population of interest and use of behavioral theory, enriched the narrative elements and likely ensured intervention acceptability, enhancing effectiveness. Public health practitioners and prevention programmers may want to consider using this intervention and/or the narrative communication approach when intervening to change behavior.
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Affiliation(s)
| | - Leigh A Willis
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kirk D Henny
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Linda J Koenig
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Gupta V, Anand S. Making Germs Visible - Assessing the Impact of a School-Based, Low-Cost Intervention on Hand Hygiene Knowledge, Attitude and Practice of Children in Rural India. JOURNAL OF HEALTH COMMUNICATION 2023; 28:25-31. [PMID: 38146154 DOI: 10.1080/10810730.2023.2231869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Handwashing with soap at critical moments is one of the most important factors in controlling the spread of germs and preventing the spread of infection. The objective of this study was to determine the effectiveness of a low-cost, school-based intervention that simulated germs and their spread on hand hygiene knowledge, attitude and practice of primary school children. Five hundred and sixty-two students from 28 rural schools were enrolled in this pre-posttest study. Endline data was collected 4 weeks after conducting the intervention at baseline. The mean scores for knowledge, attitude and practice improved significantly after the intervention (p < .05). Significant positive gains were also observed in children's understanding of germs, the associated illness threat and washing hands with soap as a prevention mechanism. The present study suggests that entertainment-education-based interventions have the potential to improve hygiene behavior among children while being low-cost.
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Affiliation(s)
- Vibha Gupta
- Department of Development Communication and Extension, Lady Irwin College, University of Delhi, New Delhi, India
| | - Sarita Anand
- Department of Development Communication and Extension, Lady Irwin College, University of Delhi, New Delhi, India
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Mason AM, Obi I, Ayodele O, Lambert SA, Fahle S. What makes a good life: using theatrical performance to enhance communication about polygenic risk scores research in patient and public involvement. J Community Genet 2023; 14:453-458. [PMID: 36763324 PMCID: PMC10576689 DOI: 10.1007/s12687-023-00635-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023] Open
Abstract
The aim of this patient and public involvement and engagement (PPIE) work was to explore improvised theatre as a tool for facilitating bi-directional dialogue between researchers and patients/members of the public on the topic of polygenic risk scores (PRS) use within primary or secondary care. PRS are a tool to quantify genetic risk for a heritable disease or trait and may be used to predict future health outcomes. In the United Kingdom (UK), they are often cited as a next-in-line public health tool to be implemented, and their use in consumer genetic testing as well as patient-facing settings is increasing. Despite their potential clinical utility, broader themes about how they might influence an individual's perception of disease risk and decision-making are an active area of research; however, this has mostly been in the setting of return of results to patients. We worked with a youth theatre group and patients involved in a PPIE group to develop two short plays about public perceptions of genetic risk information that could be captured by PRS. These plays were shared in a workshop with patients/members of the public to facilitate discussions about PRS and their perceived benefits, concerns and emotional reactions. Discussions with both performers and patients/public raised three key questions: (1) can the data be trusted?; (2) does knowing genetic risk actually help the patient?; and (3) what makes a life worthwhile? Creating and watching fictional narratives helped all participants explore the potential use of PRS in a clinical setting, informing future research considerations and improving communication between the researchers and lay members of the PPIE group.
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Affiliation(s)
- Amy M Mason
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Medical Research Council Biostatistics Unit, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
- Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
| | | | | | - Samuel A Lambert
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Sarah Fahle
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
- Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK.
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Bose DL, Hundal A, Singh S, Singh S, Seth K, Hadi SU, Saran A, Joseph J, Goyal K, Salve S. Evidence and gap map report: Social and Behavior Change Communication (SBCC) interventions for strengthening HIV prevention and research among adolescent girls and young women (AGYW) in low- and middle-income countries (LMICs). CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1297. [PMID: 36911864 PMCID: PMC9831290 DOI: 10.1002/cl2.1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Adolescent girls and young women (AGYW), aged 15-24 years, are disproportionately affected by HIV and other sexual and reproductive health (SRH) risks due to varying social, cultural, and economic factors that affect their choices and shape their knowledge, understanding, and practices with regard to their health. Socio-Behavioral Change Communication (SBCC) interventions targeted at strengthening the capabilities of individuals and their networks have supported the demand and uptake of prevention services and participation in biomedical research. However, despite growing global recognition of the domain, high-quality evidence on the effectiveness of SBCC remains scattered. This evidence and gap map (EGM) report characterizes the evidence base on SBCC interventions for strengthening HIV Prevention and Research among AGYW in low- and middle-income countries (LMICs), identifying evidence gaps and outlining the scope of future research and program design. OBJECTIVES The objectives of the proposed EGM are to: (a) identify and map existing EGMs in the use of diverse SBCC strategies to strengthen the adoption of HIV prevention measures and participation in research among AGYW in LMICs and (b) identify areas where more interventions and evidence are needed to inform the design of future SBCC strategies and programs for AGYW engagement in HIV prevention and research. METHODS This EGM is based on a comprehensive search of systematic reviews and impact evaluations corresponding to a range of interventions and outcomes-aimed at engaging AGYW in HIV prevention and research - that were published in LMICs from January 2000 to April 2021. Based on guidance for producing a Campbell Collaboration EGM, the intervention and outcome framework was designed in consultation with a group of experts. These interventions were categorized across four broad intervention themes: mass-media, community-based, interpersonal, and Information Communication and Technology (ICT)/Digital Media-based interventions. They were further sub-categorized into 15 intervention categories. Included studies looked at 23 unique behavioral and health outcomes such as knowledge attitude and skills, relationship dynamics, household dynamics, health care services, and health outcomes and research engagement. The EGM is presented as a matrix in which the rows are intervention categories/sub-categories, and the columns are outcome domains/subdomains. Each cell is mapped to an intervention targeted at outcomes. Additional filters like region, country, study design, age group, funding agency, influencers, population group, publication status, study confidence, setting, and year of publication have been added. SELECTION CRITERIA To be eligible, studies must have tested the effectiveness of SBCC interventions at engaging AGYW in LMICs in HIV prevention and research. The study sample must have consisted of AGYW between the ages of 15-24, as defined by UNAIDS. Both experimental (random assignment) and quasi-experimental studies that included a comparison group were eligible. Relevant outcomes included those at the individual, influencer, and institutional levels, along with those targeting research engagement and prevention-related outcomes. RESULTS This EGM comprises 415 impact evaluations and 43 systematic reviews. Interventions like peer-led interactions, counseling, and community dialogues were the most dominant intervention sub-types. Despite increased digital penetration use of media and technology-driven interventions are relatively less studied. Most of the interventions were delivered by peers, health care providers, and educators, largely in school-based settings, and in many cases are part of sex-education curricula. Evidence across geographies was mostly concentrated in Sub-Saharan Africa (70%). Most measured outcomes focused on disease-related knowledge dissemination and enhancing awareness of available prevention options/strategies. These included messaging around consistent condom use, limiting sexual partners, routine testing, and awareness. Very few studies were able to include psychographic, social, and contextual factors influencing AGYW health behaviors and decisions, especially those measuring the impact of social and gender norms, relationship dynamics, and household dynamics-related outcomes. Outcomes related to engagement in the research were least studied. CONCLUSION This EGM highlights that evidence is heavily concentrated within the awareness-intent spectrum of behavior change and gets lean for outcomes situated within the intent-action and the action-habit formation spectrum of the behavior change continuum. Most of the evidence was concentrated on increasing awareness, knowledge, and building risk perception around SRH domains, however, fewer studies focused on strengthening the agency and self-efficacy of individuals. Similarly, evidence on extrinsic factors-such as strengthening social and community norms, relationships, and household dynamics-that determine individual thought and action such as negotiation and life skills were also found to be less populated. Few studies explore the effectiveness of these interventions across diverse AGYW identities, like pregnant women and new mothers, sex workers, and people living with HIV, leading to limited understanding of the use of these interventions across multiple user segments including key influencers such as young men, partners, families, religious leaders, and community elders was relatively low. There is a need for better quality evidence that accounts for the diversity of experiences within these populations to understand what interventions work, for whom, and toward what outcome. Further, the evidence for use of digital and mass-media tools remains poorly populated. Given the increasing penetration of these tools and growing media literacy on one end, with widening gender-based gaps on the other, it is imperative to gather more high-quality evidence on their effectiveness. Timely evidence generation can help leverage these platforms appropriately and enable intervention designs that are responsive to changing communication ecologies of AGYW. SBCC can play a critical role in helping researchers meaningfully engage and collaborate with communities as equal stakeholders, however, this remains poorly evidenced and calls for investigation and investment. A full list of abbreviations and acronyms are available in Supporting Information: Appendix F.
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Logie CH, Okumu M, Loutet MG, Coelho M, Berry I, Gittings L, Odong Lukone S, Kisubi N, Atama M, Kyambadde P. Todurujo na Kadurok (empowering youth): study protocol of an HIV self-testing and edutainment comic cluster randomised trial among refugee youth in a humanitarian setting in Uganda. BMJ Open 2022; 12:e065452. [PMID: 36418143 PMCID: PMC9685005 DOI: 10.1136/bmjopen-2022-065452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Refugees experience HIV vulnerabilities due to the confluence of displacement, violence and poverty. HIV self-testing, understudied with refugees, is a promising method to increase testing uptake, yet challenges remain with linkages to confirmatory testing following a positive HIV self-test. This study aims to evaluate the effectiveness of HIV self-testing kits and 'edutainment' comics in increasing HIV testing and HIV status knowledge among refugee youth aged 16-24 years in Bidi Bidi Refugee Settlement, Uganda. METHODS AND ANALYSIS This study will be conducted in Bidi Bidi. We conducted a qualitative formative phase with focus groups (n=40) to generate knowledge of barriers and facilitators of HIV prevention, testing and care among refugee youth (aged 16-24) in Bidi Bidi. These findings were used to create comic scenarios aligning with edutainment approaches to health promotion and inform a four-arm cluster randomised controlled trial in Bidi Bidi using a 2×2 factorial design: (1) HIV self-testing alongside edutainment comics, (2) HIV self-testing alone, (3) edutainment comic alone and (4) standard of care. The target sample size will be 120 youth (30 per arm), who will be enrolled in the trial and followed for 3 months. Data will be collected at baseline and 3 months after enrolment. The primary outcomes (HIV testing frequency, HIV status knowledge) and secondary outcomes (linkage to confirmatory HIV testing, HIV care linkage, HIV self-test kit use, HIV-related stigma, HIV knowledge, safer sex efficacy, condom use, adolescent sexual and reproductive health (SRH) stigma, sexual relationship power, access to SRH services) will be evaluated using descriptive statistics and regression analyses. ETHICS AND DISSEMINATION This study was approved by the University of Toronto Research Ethics Board, Mildmay Uganda Research Ethics Committee and the Uganda National Council for Science and Technology. Results will be shared in peer-reviewed publications and community knowledge sharing. TRIAL REGISTRATION NUMBER NCT05213689.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Hamilton, Ontario, Canada
- Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada
| | - Moses Okumu
- School of Social Work, University of Illinois-Champaign, Urbana, Illinois, USA
- School of Social Sciences, Uganda Christian University, Mukono, Uganda
| | - Miranda G Loutet
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Madelaine Coelho
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
| | - Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lesley Gittings
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- University of Cape Town, Rondebosch, South Africa
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | | | - Nelson Kisubi
- Uganda Refugee and Disaster Management Council, Yumbe, Uganda
| | - Malon Atama
- Yumbe Regional Referral Hospital, Yumbe, Uganda
| | - Peter Kyambadde
- Most at Risk Population Initiative, Mulago Hospital, Kampala, Uganda
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Suresh S, Walter N, Montoya JA, Plant A, Barker K. Drama, Intrigue, and Discussion: The Role of Telenovelas in Facilitating Conversations about Reproductive Health in Mexican Households. JOURNAL OF HEALTH COMMUNICATION 2022; 27:484-494. [PMID: 36164980 DOI: 10.1080/10810730.2022.2126563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This study examines the role of an entertainment-education intervention in informing Mexican adolescents and parents about sexual and reproductive health-related discussion and information-seeking. A survey of young adult (N = 491) and parent (N = 223) viewers of the Spanish-language program Vencer el Miedo assessed the influence of exposure to the telenovela's storylines regarding these issues. Heavy viewing of the program predicted adolescent information-seeking about contraceptives via three distinct channels. Additionally, some effects were recorded for parent viewers, and parent-child co-viewing emerged as a significant moderator of communication about one reproductive health topic. Overall, these findings suggest that entertainment-education programs tailored to Mexican culture and the experiences of Mexican families can bring about attitudinal and behavioral changes across the age spectrum, an outcome that is particularly important given the relatively low rates of contraceptive knowledge and use among adolescents across the country.
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Affiliation(s)
- Sapna Suresh
- Department of Communication Studies, Northwestern University, Evanston, Illinois, United States
| | - Nathan Walter
- Department of Communication Studies, Northwestern University, Evanston, Illinois, United States
| | | | - Aaron Plant
- Sentient Research, West Covina, California, United States
| | - Kriss Barker
- Population Media Center, South Burlington, Vermont, United States
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Xin M, Coulson NS, Jiang CL, Sillence E, Chidgey A, Kwan NNM, Mak WWS, Goggins W, Lau JTF, Mo PKH. Web-Based Behavioral Intervention Utilizing Narrative Persuasion for HIV Prevention Among Chinese Men Who Have Sex With Men (HeHe Talks Project): Intervention Development. J Med Internet Res 2021; 23:e22312. [PMID: 34528889 PMCID: PMC8485190 DOI: 10.2196/22312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 06/01/2021] [Accepted: 07/05/2021] [Indexed: 01/02/2023] Open
Abstract
Background In the era of potent antiretroviral therapy, a high level of condomless anal intercourse continues to drive increases in HIV incidence in recent years among men who have sex with men. Effective behavior change strategies for promoting HIV-preventive behaviors are warranted. Narrative persuasion is a novel health communication approach that has demonstrated its persuasive advantages in overcoming resistance to counterattitudinal messages. The efficacy of narrative persuasion in promoting health behavior changes has been well documented, but critical research gaps exist for its application to HIV prevention. Objective In this study, we aimed to (1) capitalize on narrative persuasion to design a web-based multisession intervention for reducing condomless anal intercourse among men who have sex with men in Hong Kong (the HeHe Talks Project) by following a systematic development process; and (2) describe the main components of the narrative intervention that potentially determine its persuasiveness. Methods Persuasive themes and subtopics related to reducing condomless anal intercourse were initially proposed based on epidemiological evidence. The biographic narrative interview method was used to elicit firsthand experiential stories from a maximum variation sample of local men who have sex with men with diverse backgrounds and experiences related to HIV prevention; different types of role models were established accordingly. Framework analysis was used to aggregate the original quotations from narrators into collective narratives under 6 intervention themes. A dedicated website was finally developed for intervention delivery. Results A series of video-based intervention messages in biographic narrative format (firsthand experiential stories shared by men who have sex with men) combined with topic-equivalent argumentative messages were produced and programmed into 6 intervention sessions. The 6-week intervention program can be automatically delivered and monitored online. Conclusions We systematically created a web-based HIV prevention intervention derived from peer-generated stories. Strategies used to enhance the efficacy of the narrative intervention have been discussed within basic communication components. This paper describes the methods and experiences of the rigorous development of a narrative communication intervention for HIV prevention, which enables replication of the intervention in the future.
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Affiliation(s)
- Meiqi Xin
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Neil S Coulson
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Crystal Li Jiang
- Department of Media and Communication, City University of Hong Kong, Hong Kong, Hong Kong
| | - Elizabeth Sillence
- Department of Psychology, Northumbria University, Newcastle, United Kingdom
| | | | - Norman Nok Man Kwan
- Health and Care Service Department, Hong Kong Red Cross, Hong Kong, Hong Kong
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - William Goggins
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Joseph Tak Fai Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Phoenix Kit Han Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Mushamiri I, Mnisi Z, Nkambule M, Justman J. A Longitudinal Analysis of the Impact of Health Behavior Campaigns on HIV-Risk Behaviors and HIV Incidence in Eswatini. AIDS Behav 2021; 25:2767-2778. [PMID: 34389891 PMCID: PMC8482811 DOI: 10.1007/s10461-021-03316-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 11/29/2022]
Abstract
Between 2010 and 2015, Eswatini conducted mass media health behavior campaigns (HBCs) designed to avert new HIV infections. Using longitudinal data from the nationally representative Swaziland HIV Incidence Measurement Survey of 2011, we describe the impact of exposure to HBCs on selected HIV risk behaviors and HIV incidence among sexually active, HIV-negative adults (n = 11,232). Exposure to partner reduction HBCs was significantly associated with reporting fewer (i.e., 1 versus 2, or 2 versus ≥ 3) sexual partners in the prior 6 months at baseline among women (aOR = 3.02; 95% CI 1.38, 6.62); and at both baseline and at 6-months follow-up for men (aOR = 2.26; 95% CI 1.49, 3.44; aOR = 1.95, 95% CI [1.26-3.00], respectively). Despite these reported partner reductions, there was no association between HBC exposure and prospectively observed HIV seroconversions (n = 121). This analysis strengthens the evidence that HIV prevention at the population level requires integrated strategies.
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Affiliation(s)
- Ivy Mushamiri
- Department of Epidemiology, Mailman School of Public Health, Columbia University, C/O ICAP, 722 W 168th St, New York, NY, 10032, USA.
| | - Zandi Mnisi
- Eswatini Ministry of Health, Mbabane, Eswatini
| | - Muziwethu Nkambule
- Eswatini National Emergency Response Council on HIV/AIDS, Mbabane, Eswatini
| | - Jessica Justman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, C/O ICAP, 722 W 168th St, New York, NY, 10032, USA
- ICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY, USA
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Finley C, Dugan MJ, Carney JK, Davis WS, Delaney TV, Hart VC, Holmes BW, Stein GS, Katrick R, Morehouse H, Cole B, Bradford LS, Boardman MB, Considine H, Kaplan NC, Plumpton M, Schadler L, Smith JJ, McAllister K. A Peer-Based Strategy to Overcome HPV Vaccination Inequities in Rural Communities: A Physical Distancing-Compliant Approach. Crit Rev Eukaryot Gene Expr 2021; 31:61-69. [PMID: 33639056 DOI: 10.1615/critreveukaryotgeneexpr.2021036945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The human papilloma virus (HPV) vaccine is the world's first proven and effective vaccine to prevent cancers in males and females when administered pre-exposure. Like most of the US, barely half of Vermont teens are up-to-date with the vaccination, with comparable deficits in New Hampshire and Maine. The rates for HPV vaccine initiation and completion are as low as 33% in rural New England. Consequently, there is a compelling responsibility to communicate its importance to unvaccinated teenagers before their risk for infection increases. Messaging in rural areas promoting HPV vaccination is compromised by community-based characteristics that include access to appropriate medical care, poor media coverage, parental and peer influence, and skepticism of science and medicine. Current strategies are predominantly passive access to literature and Internet-based information. Evidence indicates that performance-based messaging can clarify the importance of HPV vaccination to teenagers and their parents in rural areas. Increased HPV vaccination will significantly contribute to the prevention of a broadening spectrum of cancers. Reducing rurality-based inequities is a public health priority. Development of a performance-based peer-communication intervention can capture a window of opportunity to provide increasingly effective and sustained HPV protection. An effective approach can be partnering rural schools and regional health teams with a program that is nimble and scalable to respond to public health policies and practices compliant with COVID-19 pandemic-related modifications on physical distancing and interacting in the foreseeable future.
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Affiliation(s)
| | | | | | | | | | | | - Breena W Holmes
- Vermont Department of Health, Vermont, USA; Vermont Child Health Improvement Program, Vermont, USA
| | - Gary S Stein
- Department of Biochemistry, Robert Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | | | | | | | | | - Maureen B Boardman
- Dartmouth-Northern New England Practice-Based Research Network CO-OP, New Hampshire, USA
| | - Heidi Considine
- University of Vermont, Vermont, USA; Vermonters Taking Action Against Cancer, Vermont, USA
| | - Nancy C Kaplan
- University of Vermont, Vermont, USA; Vermonters Taking Action Against Cancer, Vermont, USA
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Riley AH, Sood S, Sani M. Narrative Persuasion and Social Norms in Entertainment-Education: Results from a Radio Drama in Mozambique. HEALTH COMMUNICATION 2020; 35:1023-1032. [PMID: 31025883 DOI: 10.1080/10410236.2019.1606137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Narrative persuasion and social norms are part of the most recent theorizing behind the health communication strategy known as entertainment-education. There is little research, however, that compares these theoretical constructs from Mozambique, a setting that has not been researched to the same extent as other EE practice locations. This study uses mixed methods data from the midline evaluation of Ouro Negro (English translation: Black Gold), an EE radio program for individual health and social change in Mozambique to answer two research questions: what is the relationship between exposure to Ouro Negro and narrative persuasion?, and what is the relationship between narrative persuasion with Ouro Negro and social norms? Quantitative results related to the first question indicated that exposure significantly predicted three narrative persuasion constructs in multivariate regression models, results confirmed by a storytelling activity in focus groups. Quantitative results for the second question, which utilized propensity score matching, were not significant, and findings from a qualitative 2 × 2 table activity confirmed that behaviors were not normative in the directions promoted by the radio drama. Implications and recommendations for future entertainment-education research are discussed.
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Affiliation(s)
- Amy Henderson Riley
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health
| | - Suruchi Sood
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health
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Orozco-Olvera V, Shen F, Cluver L. The effectiveness of using entertainment education narratives to promote safer sexual behaviors of youth: A meta-analysis, 1985-2017. PLoS One 2019; 14:e0209969. [PMID: 30753185 PMCID: PMC6372167 DOI: 10.1371/journal.pone.0209969] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 12/16/2018] [Indexed: 11/22/2022] Open
Abstract
Background Risky sexual behaviors are associated with the transmission of sexually transmitted infections (STIs) and unwanted pregnancies, both major health concerns for youth worldwide. This review studies the effectiveness of narrated mass media programs in promoting safer sexual practices among youth in developed and developing countries. Methods Electronic and manual searches were conducted to identify experimental and quasi-experimental studies with robust counterfactual designs published between 1985 and the first quarter of 2017. Effect sizes were meta-analyzed using mixed-effects models. Results Eight experimental and two quasi-experimental studies met our inclusion criteria. The aggregated sample size was 23,476 participants, with a median of 902 participants per study. Entertainment education narratives had small but significant effects for three sexual behaviors. It reduced the number of sexual partners [standardized mean difference, (SMD) = 0.17, 95% confidence interval (CI) = 0.02–0.33, three effect sizes], reduced unprotected sex (SMD = 0.08, 95% CI = 0.03–0.12, nine effect sizes), and increased testing and management for STIs (SMD = 0.29, 95% CI = 0.11–0.46, two effect sizes). The interventions were not effective in reducing inter-generational sex, measured through the age-gap with sexual partners (SMD = 0.06, 95% CI = -0.06–0.19, four effect sizes). Entertainment education had medium-size effects on knowledge outcomes (SMD = 0.67, 95% CI = 0.32–1.02, seven effect sizes), where a time-decay relationship is observed. No effects were found on attitudes. Conclusion Although mass media entertainment had small effects in promoting safer sexual practices, its economies of scales over face-to-face interventions suggest its potential to be a cost-effective tool above an audience threshold. The use of study participants from the general youth population and the use of mostly effectiveness trials mitigate concerns regarding its scalability. The overall paucity of high-quality studies affirms the need for strengthening the evidence base of entertainment education. Future research should be undertaken to understand the moderator effects for different subgroups and intervention characteristics.
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Affiliation(s)
- Victor Orozco-Olvera
- Development Research Group, The World Bank, Washington DC, United States of America
- * E-mail:
| | - Fuyuan Shen
- Bellisario College of Communications, The Pennsylvania State University, State College, Pennsylvania, United States of America
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
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Isberner MB, Richter T, Schreiner C, Eisenbach Y, Sommer C, Appel M. Empowering Stories: Transportation into Narratives with Strong Protagonists Increases Self-Related Control Beliefs. DISCOURSE PROCESSES 2018; 56:575-598. [PMID: 32104164 PMCID: PMC6999344 DOI: 10.1080/0163853x.2018.1526032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several studies have shown that narratives can influence readers’ beliefs about themselves. In the present study, our goal was to investigate whether stories portraying a strong protagonist can positively influence recipients’ beliefs of being in control of events in their own lives (self-related control beliefs). Experiment 1 showed that narratives in both written text and video form with protagonists displaying high versus low self-efficacy can, at least temporarily, affect recipients’ own self-related control beliefs when they experience strong transportation into the stories. In addition, the results suggest that recipients’ perceived ability to generate vivid mental imagery affects their transportation into and identification with characters in texts versus films. Experiment 2 manipulated transportation and identification experimentally and showed that the effect of this manipulation on self-related control beliefs was indeed mediated by experienced transportation and identification. The results are discussed within the framework of the Transportation Imagery Model of narrative persuasion.
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Affiliation(s)
| | - Tobias Richter
- Department of Psychology IV, University of Würzburg, Würzburg, Germany
| | | | | | - Christin Sommer
- Department of Psychology, University of Kassel, Kassel, Germany
| | - Markus Appel
- Human Computer Media Institute, University of Würzburg, Würzburg, Germany
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Li J, Tang J, Liu X, Ma L. How do users adopt health information from social media? The narrative paradigm perspective. Health Inf Manag 2018; 48:116-126. [PMID: 30246551 DOI: 10.1177/1833358318798742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION A recent trend in health information seeking and sharing is the use of social media. Although there are several benefits to the use of social media for health communication, the quality of health information exchanged on social media is troubling due to its informal, unregulated mechanisms for information collection, sharing and promotion. Therefore, it is important to understand how users adopt health information from social media. METHOD Considering the user-generated and storytelling nature of social media messages, this research employed the narrative paradigm perspective to explain the social media health information adoption phenomenon. Specifically, narrative coherence (NC) and narrative fidelity (NF) were hypothesised to have positive effects on the intention to adopt (IA). Additionally, socio-economic status (SES) was viewed as a proxy variable to cognitive capability and was hypothesised to moderate the effects of NC and NF. A scenario-based survey was conducted to test the proposed research model. RESULTS We obtained a total of 257 valid questionnaires. The results indicated that NF (p < 0.001) had a positive effect on the IA social media health information. The NC (p < 0.01) had no impact on the low SES users but a positive impact on the high SES users. Further, the effect of NF (p < 0.01) on the IA was higher for high SES users than low SES users. CONCLUSIONS NC and NF are two major driving forces in social media health information adoption, and the effect of both narrative paradigm variables depends on the SES users. IMPLICATIONS Results of this study show how the narrative paradigm, with a focus on the storytelling method of communication rather than logical scientific argument, can not only explain the uptake of health messages from social media, but also provide guidance as to how to create health messages on social media that more effectively target end users.
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Affiliation(s)
- Jia Li
- East China University of Science and Technology, China
| | - Jie Tang
- East China University of Science and Technology, China
| | - Xuan Liu
- East China University of Science and Technology, China
| | - Ling Ma
- East China University of Science and Technology, China
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Kennedy MG, McClish D, Jones RM, Jin Y, Wilson DB, Bishop DL. Effects of an entertaining, culturally targeted narrative and an appealing expert interview on the colorectal screening intentions of African American women. JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 46:925-940. [PMID: 30565740 PMCID: PMC6343673 DOI: 10.1002/jcop.21983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/22/2018] [Indexed: 05/24/2023]
Abstract
Universal screening for colorectal cancer (CRC) is recommended for individuals 50-75 years of age, but screening uptake is suboptimal and African Americans have suffered persistent racial disparities in CRC incidence and deaths. We compared a culturally tailored fictional narrative and an engaging expert interview on the ability to increase intentions to be screened for CRC among African American women. In a post-only experiment, women (N = 442) in face-to-face listening groups in African American churches heard audio recordings of either a narrative or an expert interview. Questionnaires were completed immediately afterward and 30 days later. Women who heard narratives reported stronger intentions to be screened with a home stool blood test than women who heard the interview; the effect lasted at least 30 days. Culturally tailored, fictional narratives appear to be an effective persuasive strategy for reducing racial disparities in CRC outcomes.
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Affiliation(s)
| | | | - Resa M Jones
- Virginia Commonwealth University School of Medicine
| | - Yan Jin
- Virginia Commonwealth University School of Medicine
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15
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The future of health debates? A design thinking sketch of the VR Health Arena. HEALTH AND TECHNOLOGY 2018. [DOI: 10.1007/s12553-018-0220-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Fischer M, Heinrichs H. Dimensions, Dialectic, Discourse. Three Political Perspectives on the Sustainability of the German Healthcare System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1526. [PMID: 30029496 PMCID: PMC6068714 DOI: 10.3390/ijerph15071526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 07/15/2018] [Accepted: 07/17/2018] [Indexed: 12/01/2022]
Abstract
This review article deals with the topic of sustainability in the German healthcare system and presents an overview of how the six articles of our research relate to one another. After introducing to the context of the research, its internal principles, and the methods applied, three perspectives are presented, each also discussed in terms of the respective literature in sustainability science and political science. The review concludes by presenting a circular model and by discussing the general limitations as well as the practical implications of our research.
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Affiliation(s)
- Matthias Fischer
- Comparative Politics and German Government, Institute of Political Science and Sociology, University of Würzburg, Wittelsbacherplatz 1, 97074 Würzburg, Germany.
| | - Harald Heinrichs
- Sustainability and Politics, Institute of Sustainability Governance, Leuphana University of Lüneburg, Universitätsallee 1, 21335 Lüneburg, Germany.
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17
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DebRoy S, Prosper O, Mishoe A, Mubayi A. Challenges in modeling complexity of neglected tropical diseases: a review of dynamics of visceral leishmaniasis in resource limited settings. Emerg Themes Epidemiol 2017; 14:10. [PMID: 28936226 PMCID: PMC5604165 DOI: 10.1186/s12982-017-0065-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 08/30/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Neglected tropical diseases (NTD), account for a large proportion of the global disease burden, and their control faces several challenges including diminishing human and financial resources for those distressed from such diseases. Visceral leishmaniasis (VL), the second-largest parasitic killer (after malaria) and an NTD affects poor populations and causes considerable cost to the affected individuals. Mathematical models can serve as a critical and cost-effective tool for understanding VL dynamics, however, complex array of socio-economic factors affecting its dynamics need to be identified and appropriately incorporated within a dynamical modeling framework. This study reviews literature on vector-borne diseases and collects challenges and successes related to the modeling of transmission dynamics of VL. Possible ways of creating a comprehensive mathematical model is also discussed. METHODS Published literature in three categories are reviewed: (i) identifying non-traditional but critical mechanisms for VL transmission in resource limited regions, (ii) mathematical models used for dynamics of Leishmaniasis and other related vector borne infectious diseases and (iii) examples of modeling that have the potential to capture identified mechanisms of VL to study its dynamics. RESULTS This review suggests that VL elimination have not been achieved yet because existing transmission dynamics models for VL fails to capture relevant local socio-economic risk factors. This study identifies critical risk factors of VL and distribute them in six categories (atmosphere, access, availability, awareness, adherence, and accedence). The study also suggests novel quantitative models, parts of it are borrowed from other non-neglected diseases, for incorporating these factors and using them to understand VL dynamics and evaluating control programs for achieving VL elimination in a resource-limited environment. CONCLUSIONS Controlling VL is expensive for local communities in endemic countries where individuals remain in the vicious cycle of disease and poverty. Smarter public investment in control programs would not only decrease the VL disease burden but will also help to alleviate poverty. However, dynamical models are necessary to evaluate intervention strategies to formulate a cost-effective optimal policy for eradication of VL.
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Affiliation(s)
- Swati DebRoy
- Department of Mathematics and Computational Science, University of South Carolina, Beaufort, SC USA
| | - Olivia Prosper
- Department of Mathematics, University of Kentucky, Lexington, KY USA
| | - Austin Mishoe
- Department of Mathematics and Computational Science, University of South Carolina, Beaufort, SC USA
| | - Anuj Mubayi
- Simon A. Levin-Mathematical Computational and Modeling Science Center, School of Human Evolution and Social Change, Arizona State University, Tempe, AZ USA
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18
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Kriss JL, Frew PM, Cortes M, Malik FA, Chamberlain AT, Seib K, Flowers L, Ault KA, Howards PP, Orenstein WA, Omer SB. Evaluation of two vaccine education interventions to improve pertussis vaccination among pregnant African American women: A randomized controlled trial. Vaccine 2017; 35:1551-1558. [PMID: 28216190 DOI: 10.1016/j.vaccine.2017.01.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/13/2017] [Accepted: 01/17/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Vaccination coverage with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in pregnancy or immediately postpartum has been low. Limited data exist on rigorously evaluated interventions to increase maternal vaccination, including Tdap. Tailored messaging based on the Elaboration Likelihood Model (ELM) framework has been successful in improving uptake of some public health interventions. We evaluated the effect of two ELM-based vaccine educational interventions on Tdap vaccination among pregnant African American women, a group of women who tend to have lower vaccine uptake compared with other groups. METHODS We conducted a prospective randomized controlled trial to pilot test two interventions - an affective messaging video and a cognitive messaging iBook - among pregnant African American women recruited during routine prenatal care visits. We measured Tdap vaccination during the perinatal period (during pregnancy and immediately postpartum), reasons for non-vaccination, and intention to receive Tdap in the next pregnancy. RESULTS Among the enrolled women (n=106), 90% completed follow-up. Tdap vaccination in the perinatal period was 18% in the control group; 50% in the iBook group (Risk Ratio [vs. control group]: 2.83; 95% CI, 1.26-6.37), and 29% in the video group (RR: 1.65; 95% CI, 0.66-4.09). From baseline to follow-up, women's reported intention to receive Tdap during the next pregnancy improved in all three groups. Among unvaccinated women, the most common reason reported for non-vaccination was lack of a recommendation for Tdap by the woman's physician. CONCLUSIONS Education interventions that provide targeted information for pregnant women in an interactive manner may be useful to improve Tdap vaccination during the perinatal period. However, larger studies including multiple racial and ethnic groups are needed to evaluate robustness of our findings. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01740310.
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Affiliation(s)
- Jennifer L Kriss
- Emory University, Department of Epidemiology and Laney Graduate School, Atlanta, GA, United States.
| | - Paula M Frew
- Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, and Division of Infectious Diseases, Department of Medicine, Atlanta, GA, United States; Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States
| | - Marielysse Cortes
- Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States
| | - Fauzia A Malik
- Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States
| | - Allison T Chamberlain
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States
| | - Katherine Seib
- Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States
| | - Lisa Flowers
- Emory University, School of Medicine, Department of Gynecology and Obstetrics, Atlanta, GA, United States
| | - Kevin A Ault
- University of Kansas Medical Center, Department of Obstetrics and Gynecology, Kansas City, KS, United States
| | - Penelope P Howards
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States
| | - Walter A Orenstein
- Emory University, Emory Vaccine Center and School of Medicine, Atlanta, GA, United States
| | - Saad B Omer
- Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States; Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States; Emory University, Department of Pediatrics, Atlanta, GA, United States
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Riley AH, Sood S, Mazumdar PD, Choudary NN, Malhotra A, Sahba N. Encoded Exposure and Social Norms in Entertainment-Education. JOURNAL OF HEALTH COMMUNICATION 2017; 22:66-74. [PMID: 28060582 DOI: 10.1080/10810730.2016.1250843] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Entertainment-education is an effective health communication strategy that combines or embeds educational messages into entertainment programs to bring about social and behavior change. For years, scholars have considered how entertainment-education works. Some contemporary theories posit that entertainment-education does not engender behavior change directly but does so through mediating variables. This study adds to the literature on this topic by exploring the direct relationship between exposure and social norms instead of their relationship through behavior as a mediator. Novel to this study is the use of encoded exposure, a continuous and recognition-based measure of exposure that includes ever watching, recall, involvement, and dose in its operationalization. Using cross-sectional data from Kyunki … Jeena Issi Ka Naam Hai, an entertainment-education program in India, this exploratory analysis indicates a positive and significant relationship between encoded exposure and social norms. How can this finding be applied to future programs? Questions remain, and replication is needed, but if it is not essential to go through behavior in order to change social norms, then implications emerge for the theory and practice of entertainment-education.
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Affiliation(s)
- Amy Henderson Riley
- a Department of Community Health and Prevention, School of Public Health , Drexel University , Philadelphia , Pennsylvania , USA
| | - Suruchi Sood
- a Department of Community Health and Prevention, School of Public Health , Drexel University , Philadelphia , Pennsylvania , USA
| | | | | | | | - Naysan Sahba
- e Division of Communications and Public Information , United Nations Environment Programme , Nairobi , Kenya
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20
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Daniels J, Komarek A, Forgreive B, Pahl K, Stafford S, Bruns LC, Coates T. Shout-It-Now: A Mobile HCT Model Employing Technology and Edutainment in South Africa. J Int Assoc Provid AIDS Care 2016; 16:506-511. [PMID: 27903950 DOI: 10.1177/2325957416680296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mobile HIV counseling and testing (HCT) has been effective in reaching men, women, and adolescents in South Africa. However, there is limited understanding of effective mobile HCT programs utilizing tools like technology and edutainment to increase HIV counseling and testing rates. The authors examine data from the Shout-It-Now (S-N) program that uses such tools in South Africa. METHODS The S-N program utilizes various forms of technology and ongoing telephonic counseling within a 6-step program of HIV testing and linkage-to-care support, and program data were analyzed over an 18-month period. Data were analyzed from women, men, and adolescent program participants. Summative statistics was conducted on participant registration, HIV risk assessment, and HIV testing profiles. HIV prevalence were estimated along with the related 95% confidence intervals using the Clopper-Pearson method. RESULTS Over an 18-month period, there were 72 220 program participants with high representation of men, women, and adolescents and 40% of the participants being men at each site. There were 3343 participants who tested HIV positive, and a higher proportion of women tested positive. DISCUSSION Integrating technology, quality assurance measures, and edutainment with mobile HCT has the potential to increase the number of those who test within communities. Research is needed to understand the effectiveness of this model in facilitating regular testing and linkage to care.
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Affiliation(s)
- Joseph Daniels
- 1 Department of Community Health Sciences, University of California, Los Angeles, CA, USA
| | - Arnost Komarek
- 2 Department of Probability and Mathematical Statistics, Charles University, Prague, Czech Republic
| | | | | | | | - Laurie Campbell Bruns
- 4 Center for World Health, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Thomas Coates
- 4 Center for World Health, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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21
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Rogers EM, Singhal A, Thombre A. Indian Audience Interpretations of Health-Related Content in the Bold and the Beautiful. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/0016549204045921] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article explores the meanings given by Indian viewers to a series of health-related episodes dealing with ‘Tony’s HIV’ in the Hollywood television soap opera, The Bold and the Beautiful. Forty-two respondents in six focus group interviews and in 17 in-depth personal interviews were asked for their interpretations of this television health content. Indian respondents interpreted the sexual explicitness and the assertiveness of female characters as characteristic of the US, but not as a part of Indian reality. The sexual openness in The Bold and the Beautiful ‘shocked’ Indian viewers, and led some to watch the episodes only in private. Indian respondents generally had positive reactions to the ‘Tony’s HIV’ episodes, although they felt that self-disclosure of HIV/AIDS status could not happen in India, where HIV/AIDS is highly stigmatized. In general, Indian respondents felt that ‘Tony’s HIV’ showed an ideal situation regarding HIV/AIDS, but one that was far removed from Indian reality.
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Affiliation(s)
- Everett M. Rogers
- Department of Communication and Journalism, University of New Mexico, Albuquerque,
| | - Arvind Singhal
- School for Communication Studies, Ohio University, Athens, OH,
| | - Avinash Thombre
- University of New Mexico, and Department of Speech Communication, University of Arkansas at Little Rock,
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22
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Sood S, Singh PK, Sarwal R. Reaching the Underserved: Measuring the Impact of a Community Media Intervention, Uttar Pradesh, India. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016. [DOI: 10.2190/vhqb-8tca-ha5v-c7ey] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article examines the impact of a community-based health promotion initiative implemented in the state of Uttar Pradesh in North India in measurably improving knowledge, interpersonal communication, and practices related to HIV/AIDS and STIs among rural audiences with low or no access to mass media. Using a panel study design and logistic regression analysis, results indicate that at endline the exposed panel of respondents report significantly higher levels of knowledge and interpersonal communication regarding HIV/AIDS and STIs in comparison to the reports from the same set of respondents at baseline and also the respondents not exposed at endline. Some control variables—such as gender, education, and media access—display some interaction effects with the dependent variables. The findings suggest that community-based media initiatives are a strong vehicle in promoting changes in knowledge and producing positive behavioral outcomes especially by reaching out to underserved communities that have relatively fewer alternative sources of information on sensitive sexual health issues.
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Terry PE, Mhloyi M, Masvaure TB, Adlis SA. Gender Equity and HIV/AIDS Prevention: Comparing Gender Differences in Sexual Practice and Beliefs among Zimbabwe University Students. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016; 24:29-43. [PMID: 17690049 DOI: 10.2190/f5vv-jpne-71at-8fuh] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We assess gender differences in HIV prevention knowledge, attitudes and practices with a focus on cultural, sociological, and economic variables. A randomized cross-sectional study was used in order to achieve high participation and broad comparative assessment. An eight-page questionnaire was administered to 933 randomly selected students at the University of Zimbabwe. Survey items addressed sexual decision-making, condom use, limiting sexual partners, cultural power dynamics and access to HIV testing. We found marked gender differences with men reporting beliefs of entitlement to dominate women, an assumed leadership in decision-making concerning condom use and an attitude that when a woman says “no” to sex, really, “it depends.” Women acknowledged gender-based cultural attitudes but are much more likely to support women's rights to sexual expression. A multi-faceted approach to gender equity training is needed to challenge men and women to change attitudes and increase social awareness that respects cultural traditions while still inspiring both men and women to champion justice and equality between genders.
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Affiliation(s)
- Paul E Terry
- Park Nicollet Institute, Minneapolis, MN 55416, USA.
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Perrier MJ, Martin Ginis KA. Changing health-promoting behaviours through narrative interventions: A systematic review. J Health Psychol 2016; 23:1499-1517. [PMID: 27387514 DOI: 10.1177/1359105316656243] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this review was to summarize the literature supporting narrative interventions that target health-promoting behaviours. Eligible articles were English-language peer-reviewed studies that quantitatively reported the results of a narrative intervention targeting health-promoting behaviours or theoretical determinants of behaviour. Five public health and psychology databases were searched. A total of 52 studies met inclusion criteria. In all, 14 studies found positive changes in health-promoting behaviours after exposure to a narrative intervention. The results for the changes in theoretical determinants were mixed. While narrative appears to be a promising intervention strategy, more research is needed to determine how and when to use these interventions.
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McDermott LJ, Lowe JB, Stanton WR, Clavarino AM. Suntans and Sun Protection in Australian Teen Media: 1999 to 2000. HEALTH EDUCATION & BEHAVIOR 2016; 32:504-13. [PMID: 16009747 DOI: 10.1177/1090198105276214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, the portrayal of tanned skin and sun protection in magazines, television programs, and movies popular with Australian adolescents were analyzed. Images of models in magazines ( n = 1,791), regular/supporting characters in television programs ( n = 867), and regular/supporting characters in cinema movies ( n = 2,836)for the 12-monthperiod August 1999to July 2000were coded and analyzed. A light tan was the most predominant tan level, and protective clothing was the most common sun protection measure displayed across all forms of media. There were significant associations between gender and tan levels in the television and movie samples. Although it is important to monitor the portrayal of tan levels and sun protection measures in media targeting adolescents, overall, the authors’ findings revealed a media environment generally supportive of sun protection objectives.
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Affiliation(s)
- Liane J McDermott
- Cancer Prevention Research Centre, School of Population Health, University of Queensland, Brisbane, Australia.
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Abstract
This article presents an agentic theory of human development, adaptation, and change. The evolutionary emergence of advanced symbolizing capacity enabled humans to transcend the dictates of their immediate environment and made them unique in their power to shape their life circumstances and the courses their lives take. In this conception, people are contributors to their life circumstances, not just products of them. Social cognitive theory rejects a duality between human agency and social structure. People create social systems, and these systems, in turn, organize and influence people's lives. This article discusses the core properties of human agency, the different forms it takes, its ontological and epistemological status, its development and role in causal structures, its growing primacy in the coevolution process, and its influential exercise at individual and collective levels across diverse spheres of life and cultural systems.
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Wang H, Singhal A. East Los High: Transmedia Edutainment to Promote the Sexual and Reproductive Health of Young Latina/o Americans. Am J Public Health 2016; 106:1002-10. [PMID: 27077336 DOI: 10.2105/ajph.2016.303072] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Latina/o Americans are at high risk for sexually transmitted infections and adolescent pregnancies. Needed urgently are innovative health promotion approaches that are engaging and culturally sensitive. East Los High is a transmedia edutainment program aimed at young Latina/o Americans. It embeds educational messages in entertainment narratives across digital platforms to promote sexual and reproductive health. We employed online analytics tracking (2013-2014), an online viewer survey (2013), and a laboratory experiment (El Paso, TX, 2014) for season 1 program evaluation. We found that East Los High had a wide audience reach, strong viewer engagement, and a positive cognitive, emotional, and social impact on sexual and reproductive health communication and education. Culturally sensitive transmedia edutainment programs are a promising health promotion strategy for minority populations and warrant further investigation.
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Affiliation(s)
- Hua Wang
- Hua Wang is with the Department of Communication and the Department of Community Health and Health Behavior, University at Buffalo, The State University of New York. Arvind Singhal is with the Department of Communication, The University of Texas at El Paso, and the Faculty of Business Administration, Hedmark University College, Rena, Norway
| | - Arvind Singhal
- Hua Wang is with the Department of Communication and the Department of Community Health and Health Behavior, University at Buffalo, The State University of New York. Arvind Singhal is with the Department of Communication, The University of Texas at El Paso, and the Faculty of Business Administration, Hedmark University College, Rena, Norway
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28
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Zebregs S, van den Putte B, de Graaf A, Lammers J, Neijens P. The effects of narrative versus non-narrative information in school health education about alcohol drinking for low educated adolescents. BMC Public Health 2015; 15:1085. [PMID: 26499061 PMCID: PMC4619486 DOI: 10.1186/s12889-015-2425-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 10/16/2015] [Indexed: 12/29/2022] Open
Abstract
Background Traditionally most health education materials are written in an expository non-narrative format. Scholars have argued that the effectiveness of materials may increase when these texts are replaced by narrative texts, and that the non-narrative texts should be replaced by narrative texts. However, no previous studies have tested these claims in the context of school health education for low educated adolescents. This study aims to do so for an existing preventive health education intervention about alcohol for low educated adolescents. Based on the empirical findings of previous studies, it is expected that the claims about narratives being more effective than non-narrative texts are not true for effects on knowledge. Instead non-narrative texts are expected to have a stronger impact on this outcome variable. For attitude towards alcohol and intention to drink alcohol the claims are expected to be true, because participants are expected to be less aware of the persuasive intent of the narrative texts, which would make them less resistant. As a result, narrative texts are expected to have a stronger effect on attitude and intention. Methods This study compares the effects on knowledge, attitude towards alcohol, and intention to drink alcohol of both information formats in a two-condition (non-narrative vs. narrative information) experiment with repeated measures (pre-measurement, immediate post-measurement, and delayed post-measurement). The experiment was conducted amongst 296 students of the two lowest levels of the Dutch secondary education system. Results The results showed immediate effects on knowledge and attitude towards alcohol, which did not differ between conditions and school levels. These effects did not persist over time. There were no effects on intention to drink alcohol. Conclusion It is concluded non-narrative and narrative information are equally effective in the context of school health education, suggesting the claims that scholars have made about the superior effects of narrative texts are not true. Given the fact that narrative texts are more expensive to develop, policy makers may not be advised to prefer these types of texts over the traditionally used non-narrative texts.
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Affiliation(s)
- Simon Zebregs
- The Amsterdam School of Communication Research ASCoR, Department of Communication Science, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands.
| | - Bas van den Putte
- The Amsterdam School of Communication Research ASCoR, Department of Communication Science, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands. .,Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Postbus 725, 3500 AS, Utrecht, The Netherlands.
| | - Anneke de Graaf
- Centre for Language Studies, Faculty of Arts, Radboud University Nijmegen, Postbus 9103, 6500 HD, Nijmegen, The Netherlands.
| | - Jeroen Lammers
- Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Postbus 725, 3500 AS, Utrecht, The Netherlands.
| | - Peter Neijens
- The Amsterdam School of Communication Research ASCoR, Department of Communication Science, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands.
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Sakellari M. Cinematic climate change, a promising perspective on climate change communication. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2015; 24:827-841. [PMID: 24916195 DOI: 10.1177/0963662514537028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Previous research findings display that after having seen popular climate change films, people became more concerned, more motivated and more aware of climate change, but changes in behaviors were short-term. This article performs a meta-analysis of three popular climate change films, The Day after Tomorrow (2005), An Inconvenient Truth (2006), and The Age of Stupid (2009), drawing on research in social psychology, human agency, and media effect theory in order to formulate a rationale about how mass media communication shapes our everyday life experience. This article highlights the factors with which science blends in the reception of the three climate change films and expands the range of options considered in order to encourage people to engage in climate change mitigation actions.
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Abstract
A public health approach to combination HIV prevention is advocated to contain the epidemic in sub-Saharan Africa. We explore the implications of universal access to treatment along with HIV education scale-up in the region. We develop an HIV transmission model to investigate the impacts of universal access to treatment, as well as an analytical framework to estimate the effects of HIV education scale-up on the epidemic. We calibrate the model with data from South Africa and simulate the impacts of universal access to treatment along with HIV education scale-up on prevalence, incidence, and HIV-related deaths over a course of 15 years. Our results show that the impact of combined interventions is significantly larger than the summation of individual intervention impacts (super-additive property). The combined strategy of universal access to treatment and HIV education scale-up decreases the incidence rate by 74% over the course of 15 years, whereas universal access to treatment and HIV education scale up will separately decrease that by 43% and 8%, respectively. Combination HIV prevention could be notably effective in transforming HIV epidemic to a low-level endemicity. Our results suggest that in designing effective combination prevention in sub-Saharan Africa, priorities should be given to achieving universal access to treatment as quickly as possible and improving compliance to condom use.
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Affiliation(s)
- Amin Khademi
- From the Department of Industrial Engineering, Clemson University, Clemson (AK, SA); and Anmed Health Medical Center, Anderson, South Carolina, USA (DP)
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Ndugwa Kabwama S, Berg-Beckhoff G. The association between HIV/AIDS-related knowledge and perception of risk for infection: a systematic review. Perspect Public Health 2015; 135:299-308. [PMID: 26253643 DOI: 10.1177/1757913915595831] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This systematic review tries to elucidate the association between what people know about HIV/AIDS and how they perceive their risk of infection. The initial search for articles yielded 1,595 abstracts, 16 of which met the inclusion criteria. Five studies found a positive correlation, four reported a negative correlation and seven found no association between knowledge and risk perception. It was found that the existing psychometrically sound measure of HIV/AIDS risk perception had not been used in any of the studies. The context in which the risk is assessed is pivotal to whether an association between knowledge and the perceived risk is found. Biases in judgement such as optimistic bias, psychological distancing, anchoring bias and overconfidence also explain how knowledge may fail to predict risk perception. It was concluded that the association between HIV/AIDS knowledge and risk perception might follow a continuum from positive to no association and finally to negative. The hypothesis, however, still needs to be studied further.
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Affiliation(s)
- Steven Ndugwa Kabwama
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
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Bastien S, Leshabari MT, Klepp KI. Exposure to information and communication about HIV/AIDS and perceived credibility of information sources among young people in northern Tanzania. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2015; 8:213-22. [PMID: 25875572 DOI: 10.2989/ajar.2009.8.2.9.861] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Young people in sub-Saharan Africa constitute an important group for HIV prevention efforts. Determining their exposure to HIV/AIDS information and communication and their perceived credibility of information sources is imperative to the development of interventions. However, the majority of studies on this topic have been conducted among school-based populations, with few focused on those out of school or on comparing the two groups. A structured face-to-face interview was completed by 993 young people out of school, between the ages of 13 and 18, in Kilimanjaro, Tanzania; additionally, the questionnaire was self-administered by 1 007 students attending either their last year of primary or first year of secondary school. Significant factors associated with the frequency of exposure to HIV/AIDS information and frequency of communication about HIV/AIDS included urban/rural location, sex, socio-economic status, and educational attainment. Both groups ranked the radio as the most frequent source of HIV/AIDS information. The in-school group reported significantly more frequent exposure to all sources of HIV/ AIDS information and they communicated more frequently about the topic than did the out-of-school group. Among both groups, exposure to HIV/AIDS information occurred more frequently than discussing the topic. The in-school group gave high credibility ratings to medical doctors, the radio and parents as sources of information, while the out-of-school group attributed the most credibility to the mass media. Irrespective of school attendance, the young people ranked friends, parents and doctors as preferred communicators of sexual and reproductive health information. Interventions that address the determinants of educational attainment are needed, as well as ones specifically intended to reach girls or those out of school. The preferences and credibility rankings for sources of HIV/AIDS information suggest the need for evidence-based programmes that utilise peers and promote the involvement of parents or doctors. Particularly needed are interventions that explicitly aim to stimulate discussion among young people about HIV/AIDS and that foster the development of interpersonal skills.
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Affiliation(s)
- Sheri Bastien
- a Institute for Educational Research, Faculty of Education , University of Oslo , PO Box 1092 , Blindern , Oslo , 0317 , Norway
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Forster M, Allem JP, Mendez N, Qazi Y, Unger JB. Evaluation of a telenovela designed to improve knowledge and behavioral intentions among Hispanic patients with end-stage renal disease in Southern California. ETHNICITY & HEALTH 2015; 21:58-70. [PMID: 25650806 PMCID: PMC5508717 DOI: 10.1080/13557858.2015.1007119] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Culturally relevant education is needed to improve rates of successful kidney transplantation among Hispanic patients with end-stage renal disease (ESRD). This study examined whether patients' knowledge about kidney disease, postoperative care, and proactive health practices improved after watching a telenovela series about ESRD. DESIGN 334 ESRD patients and 94 family members/caregivers were assigned to watch a telenovela ('Fixing Paco,' a bilingual health education film) or receive standard of care at a transplant center or at a dialysis clinic. Outcomes for pre-transplant patients assigned to standard of care at dialysis centers or at a transplant center were compared to pre-transplant patients in the treatment condition (standard of care + telenovela). RESULTS Knowledge and behavioral intention scores at baseline across conditions and locations were similar, suggesting that assignment resulted in comparable groups at baseline. Using linear regression, this study found statistically significant improvements in knowledge scores among the telenovela group as compared to the standard of care groups. The telenovela group also had greater improvements in behavioral intention scores compared to the standard of care groups. Family members assigned to the telenovela group had significant improvements in knowledge scores as compared to the standard of care groups. CONCLUSION Being well informed about ESRD and adopting proactive health behaviors are important mechanisms in improving transplantation outcomes. These findings suggest that knowledge about kidney disease, postoperative care, and proactive health practices could be improved by viewing a telenovela. Implications, limitations, and directions for future research are discussed.
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Affiliation(s)
- Myriam Forster
- Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA. (323) 442-8201
| | - Jon-Patrick Allem
- Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA. (323) 442-8201
| | - Nicole Mendez
- Mendez National Institute of Transplantation, 2222 Ocean View Ave. Los Angeles, CA, 90057 USA. (213) 457-7495
| | - Yasir Qazi
- Kidney Pancreas Transplant Center, Keck Medical Center of USC, Los Angeles, CA, USA. (323) 442-5908
| | - Jennifer B. Unger
- Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA. (323) 442-8201
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Reinsma K, Bolima N, Fonteh F, Okwen P, Siapco G, Yota D, Montgomery S. Bobbi Be Best: the development and evaluation of an audio program and discussion guide to promote exclusive breastfeeding in Cameroon, Central Africa. Glob Health Promot 2015; 23:14-26. [PMID: 25564250 DOI: 10.1177/1757975914556786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 09/01/2014] [Indexed: 11/15/2022]
Abstract
One risk factor for infant and childhood morbidity is not exclusive breastfeeding (EBF) during the first six months of life. Entertainment Education (EE) is a communication strategy consisting of placing educational information into television, movies, and radio programs. In developing countries this form of behavioral change communication has proven effective in addressing health-related issues; however, no research has determined if EE is effective in promoting EBF. The objective of this research was to develop an EE audio program and discussion guide and to determine if a series of four 15-minute episodes and post-listening discussion improved knowledge, perceived benefits, self-efficacy, and intention and decreased misconceptions and perceived barriers toward EBF in the Kumbo West Health District, Cameroon. Pregnant women and their partners were assigned to either the control group (N = 116; 74 women, 42 partners) or intervention group (N = 148; 99 women, 49 partners) based on expected date of delivery. All control and intervention group participants completed a questionnaire prior to listening to the first and after the last episode. Pre- and post-listening questionnaires were used to determine changes in the EBF knowledge, misconceptions, perceived barriers, self-efficacy, and intention variables as a result of exposure to the audio program. The Wilcoxon Sign Rank test showed significant improvement in all of the variables, except perceived barriers, within the intervention group (p < 0.05) and the Mann-Whitney test indicated significant differences between the control and intervention group in all of the variables (p < 0.05), indicating that using an audio program and discussion guide based on the EE model is an effective tool for promoting EBF in this setting. The strength of this approach is that it goes beyond simply telling women about what constitutes EBF, but addresses misconceptions and perceived barriers that may prevent women from practicing EBF for six months.
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Affiliation(s)
- Kathryn Reinsma
- School of Health Sciences, Liberty University, USA Cameroon Baptist Convention Health Services, Cameroon
| | - Nancy Bolima
- National Coordinator for Health Education and Development Consultancy Services, Bamenda, Cameroon
| | - Florence Fonteh
- Department of Biomedical Sciences, University of Dschang, Cameroon
| | - Patrick Okwen
- Northwest Special Fund for Health, Bamenda, Cameroon
| | - Gina Siapco
- Nutrition Department, School of Public Health, Loma Linda University, USA
| | - Daniel Yota
- Kumbo West Health District Medical Officer, Cameroon
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Nan X, Dahlstrom MF, Richards A, Rangarajan S. Influence of evidence type and narrative type on HPV risk perception and intention to obtain the HPV vaccine. HEALTH COMMUNICATION 2015; 30:301-8. [PMID: 25061715 DOI: 10.1080/10410236.2014.888629] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This research examines the influence of evidence type (statistical, narrative, or hybrid) and narrative type (first-person or third-person) on risk perception about human papillomavirus (HPV) and behavioral intention to get the HPV vaccine. In total, 174 college students who had not received the HPV vaccine participated in a controlled experiment. Results show that the hybrid message containing both statistical and narrative descriptions of HPV resulted in greater perceived risk of getting HPV than either of the messages containing just one type of evidence--statistical or narrative. Moreover, the first-person narrative message led to greater risk perception about HPV than the third-person narrative message. Both evidence type and narrative type had an indirect effect on intention to get the HPV vaccine free of cost through HPV risk perception. Implications of the findings for vaccine risk communication are discussed.
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Affiliation(s)
- Xiaoli Nan
- a Department of Communication , University of Maryland
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36
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Ayala GX, Ibarra L, Horton L, Arredondo EM, Slymen DJ, Engelberg M, Rock CL, Hernandez E, Parada H, Elder JP. Evidence supporting a promotora-delivered entertainment education intervention for improving mothers' dietary intake: the Entre Familia: Reflejos de Salud Study. JOURNAL OF HEALTH COMMUNICATION 2014; 20:165-176. [PMID: 25375276 DOI: 10.1080/10810730.2014.917747] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Entertainment education and the promotora model are 2 evidence-based health communication strategies. This study examined their combined effect on promoting healthy eating among mothers in a family-based intervention. Participants were 361 Mexican-origin families living in Imperial County, California, who were randomly assigned to an intervention or delayed treatment condition. The intervention involved promotoras (community health workers) who delivered 11 home visits and 4 telephone calls. Home visits included a 12-minute episode of a 9-part situation comedy depicting a family struggling with making healthy eating choices; an accompanying family workbook was reviewed to build skills and left with the family. Baseline and immediate postintervention data were collected from the mothers, including the primary outcome of daily servings of fruits and vegetables. Other dietary and psychosocial factors related to healthy eating were examined. At postintervention, mothers in the intervention reported increases in daily vegetable servings (p ≤ .05); however, no changes were observed in fruit consumption. Improvements were observed in behavioral strategies to increase fiber (p ≤ .001) and to decrease fat intake (p ≤ .001), unhealthy eating behaviors (p ≤ .001), and individual (p ≤ .05) and family-related (p ≤ .01) perceived barriers to healthy eating. Entertainment education and promotoras engaged families and improved mothers' diets. Further research should examine the dose needed for greater changes.
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Using narratives and storytelling to communicate science with nonexpert audiences. Proc Natl Acad Sci U S A 2014; 111 Suppl 4:13614-20. [PMID: 25225368 DOI: 10.1073/pnas.1320645111] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Although storytelling often has negative connotations within science, narrative formats of communication should not be disregarded when communicating science to nonexpert audiences. Narratives offer increased comprehension, interest, and engagement. Nonexperts get most of their science information from mass media content, which is itself already biased toward narrative formats. Narratives are also intrinsically persuasive, which offers science communicators tactics for persuading otherwise resistant audiences, although such use also raises ethical considerations. Future intersections of narrative research with ongoing discussions in science communication are introduced.
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Strengthening nonrandomized studies of health communication strategies for HIV prevention. J Acquir Immune Defic Syndr 2014; 66 Suppl 3:S271-7. [PMID: 25007196 DOI: 10.1097/qai.0000000000000232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is growing interest in impact evaluations of health communication (HC) interventions for HIV prevention. Although cluster randomized trials may be optimal in terms of internal validity, they are often unfeasible for political, practical, or ethical reasons. However, a common alternative, the observational study of individuals who do and do not self-report HC intervention exposure, is prone to bias by confounding. Cluster-level quasi-experimental study designs offer promising alternatives to these extremes. METHODS We identified common rollout strategies for HC initiatives. We mapped these scenarios against established quasi-experimental evaluation designs. We identified key issues for implementers and evaluators if these designs are to be more frequently adopted in HC intervention evaluations with high internal validity. RESULTS Stronger evaluations will document the planned intervention components in advance of delivery and will implement interventions in clusters according to a predefined systematic allocation plan. We identify 4 types of allocation plan and their associated designs. Where some places get the HC intervention, whereas others do not, a nonrandomized controlled study may be feasible. Where HC is introduced everywhere at a defined point in time, an interrupted time series may be appropriate. Where the HC intervention is introduced in phases, a nonrandomized phased implementation or stepped-wedge design may be used. Finally, where there is variation in strength of implementation of HC, a nonrandomized, dose-response study can be planned. DISCUSSION Our framework will assist teams planning such evaluations by identifying critical decisions for the implementers and for the evaluators of HC interventions.
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Effectiveness of mass media interventions for HIV prevention, 1986-2013: a meta-analysis. J Acquir Immune Defic Syndr 2014; 66 Suppl 3:S329-40. [PMID: 25007204 DOI: 10.1097/qai.0000000000000230] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This meta-analysis was conducted to synthesize evaluations of mass media-delivered HIV prevention interventions, assess the effectiveness of interventions in improving condom use and HIV-related knowledge, and identify moderators of effectiveness. STUDY SELECTION We systematically searched electronic databases, relevant Web sites, related journals, and reference lists of previous reviews and included studies. Studies that quantitatively evaluated the effectiveness of mass media-delivered HIV prevention using pre-/post-campaign assessments, targeted the general population, reported outcomes of interest, and were available as of September 30, 2013 were eligible for inclusion. DATA EXTRACTION AND SYNTHESIS Raters coded report, intervention, and sample characteristics. The standardized mean difference, d, comparing pretest and posttest assessments was calculated for each study sample. Effect sizes were analyzed incorporating random-effects assumptions. RESULTS Of the 433 obtained and screened reports, 54 reports containing evaluations of 72 interventions using 93 samples (N = 142,196) met the selection criteria and were included. Campaigns were associated with increases in condom use [d+ = 0.25, 95% confidence interval (CI) = 0.18 to 0.21], transmission knowledge (d+ = 0.30, 95% CI = 0.18 to 0.41), and prevention knowledge (d+ = 0.39, 95% CI = 0.25 to 0.52). Increases in condom use were larger for longer campaigns and in nations that scored lower on the human development index. Increases in transmission knowledge were larger to the extent that respondents reported greater campaign exposure, for more recent campaigns, and for nations that scored lower on the human development index. CONCLUSIONS Mass media interventions may be useful in reducing global HIV/AIDS disparities because of their reach and effectiveness.
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Schouten B, Vlug-Mahabali M, Hermanns S, Spijker E, van Weert J. To Be Involved or Not to Be Involved? Using Entertainment-Education in an HIV-Prevention Program for Youngsters. HEALTH COMMUNICATION 2014; 29:762-772. [PMID: 24299216 DOI: 10.1080/10410236.2013.781938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The purpose of this study is to gain insight into factors that are associated with youngsters' involvement with dance4life, a global HIV-prevention program. The Youth Engagement Framework, which includes factors impacting youngsters' involvement on three levels (individual, social, and system), was used as a theoretical base. In total, 67 youngsters participated, with 21 of them still involved in dance4life's program, and 46 not. They either were individually interviewed or took part in subsequent online or face-to-face focus groups. Results show that both individual, social, and system-level factors are associated with youngsters' involvement. Involved youngsters have higher intrinsic motivation to prevent HIV, receive more social support from parents and friends, and are stimulated more by dance4life to remain part of their program than youngsters who are no longer involved. Hence, HIV-prevention programs should focus on all three levels simultaneously to successfully stimulate youngsters' involvement.
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Affiliation(s)
- Barbara Schouten
- a Department of Communication, Amsterdam School of Communication Research , University of Amsterdam
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41
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Bandura A. A Social Cognitive perspective on Positive Psychology. INTERNATIONAL JOURNAL OF SOCIAL PSYCHOLOGY 2014. [DOI: 10.1174/021347411794078444] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Rahmanian F, Simbar M, Ramezankhani A, Zayeri F. Gender Sensitive STIs/HIV/AIDS Prevention Policies: A Qualitative Study. Health (London) 2014. [DOI: 10.4236/health.2014.611153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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43
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Ghosh S, Saha M. Health Communication and Behavioural Change: An Exploratory Study among Marginalized Communities in Rural West Bengal, India. JOURNAL OF HEALTH MANAGEMENT 2013. [DOI: 10.1177/0972063413492038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A small-scale research/intervention project that aimed to develop and test an integrated package of communication campaign on health awareness among women belonging to the marginalized community was implemented in an underdeveloped setting of West Bengal, India during 2010–11. A quasi-experimental research design, with cross-sectional surveys conducted in six intervention and control villages at the baseline and endline, was used to evaluate the outcome of intervention among 1,196 respondents. This article examines the impact of behaviour change communication intervention on knowledge, reporting of illnesses and treatment-seeking of symptoms of general and gynaecological morbidity. Analyses included multiple, binary logistic and multinomial logistic regressions using a Difference-in-Difference estimator. Results of the evaluation suggest that the net effect of exposure to the intervention had a positive and significant impact on most of the indicators reflecting an increased level of awareness about signs and symptoms of general and reproductive complications. However, the net effect of exposure was mixed for the indicators of reporting of illnesses, pattern and sources of seeking treatment. The experience of implementing the project demonstrates that it is possible to improve women’s general and reproductive health awareness and practices which could have resulted in positive health outcomes in the long run.
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Jones R, Hoover DR, Lacroix LJ. A randomized controlled trial of soap opera videos streamed to smartphones to reduce risk of sexually transmitted human immunodeficiency virus (HIV) in young urban African American women. Nurs Outlook 2013; 61:205-215.e3. [PMID: 23743482 DOI: 10.1016/j.outlook.2013.03.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/27/2013] [Accepted: 03/31/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Love, Sex, and Choices (LSC) is a soap opera video series created to reduce HIV sex risk in women. METHODS LSC was compared to text messages in a randomized trial in 238 high-risk mostly Black young urban women. 117 received 12-weekly LSC videos, 121 received 12-weekly HIV prevention messages on smartphones. Changes in unprotected sex with high risk partners were compared by mixed models. RESULTS Unprotected sex with high risk men significantly declined over 6 months post-intervention for both arms, from 21-22 acts to 5-6 (p < 0.001). This reduction was 18 % greater in the video over the text arm, though this difference was not statistically significant. However, the LSC was highly popular and viewers wanted the series to continue. CONCLUSION This is the first study to report streaming soap opera video episodes to reduce HIV risk on smartphones. LSC holds promise as an Internet intervention that could be scaled-up and combined with HIV testing.
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Affiliation(s)
- Rachel Jones
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, MA, USA.
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Berkley-Patton J, Thompson CB, Martinez DA, Hawes SM, Moore E, Williams E, Wainright C. Examining church capacity to develop and disseminate a religiously appropriate HIV tool kit with African American churches. J Urban Health 2013; 90:482-99. [PMID: 22815053 PMCID: PMC3665971 DOI: 10.1007/s11524-012-9740-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Increasingly, African American churches have been called upon to assist in efforts to address HIV/AIDS in underserved communities. African Americans churches may be well-positioned to provide HIV education, screening, and support services, particularly if they are equipped with church-appropriate, easy-to-deliver HIV tools that can be implemented through the naturalistic church environment. To inform the development of a church-based HIV tool kit, we examined church capacity with African American church leaders (N = 124 participants; n = 58 churches represented by senior pastors). Nearly all participants (96%) wanted to learn more about HIV and how to discuss it with their parishioners. Regarding church capacity, most of their representative churches held three regular services each week, facilitated various inreach and community outreach ministries, and had paid staff and computers. Also, many of their churches facilitated HIV/AIDS education/prevention and adolescent sex education activities. Guided by church capacity findings, an ecological framework, and a CBPR approach, we describe the resulting church-based HIV Tool Kit that "fits" naturalistically within a multilevel church infrastructure, builds upon churches' HIV-related experience, and equips faith leaders to efficiently promote HIV services with the communities they serve.
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Jesmin SS, Chaudhuri S, Abdullah S. Educating women for HIV prevention: does exposure to mass media make them more knowledgeable? Health Care Women Int 2013; 34:303-31. [PMID: 23394327 DOI: 10.1080/07399332.2012.736571] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Mass media is an important vehicle for health promotion in developing countries. In Bangladesh multiple media campaigns are being carried out to educate people about HIV/AIDS. We examined the extent of HIV/AIDS knowledge and the association of exposure to mass media among women in Bangladesh. The Bangladesh Demographic and Health Survey (BDHS) provides data for this article. We found that media exposure (combined index of television, radio, and newspaper) was a highly significant predictor of women's knowledge about HIV and AIDS. Other significant predictors of HIV knowledge include women's education, age, employment, and urban residence.
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Affiliation(s)
- Syeda S Jesmin
- Department of Sociology and Psychology, Division of Liberal Arts and Life Sciences, University of North Texas at Dallas, Dallas, TX 75241, USA.
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Siegler AJ, Mbwambo JK, DiClemente RJ. Applying the Dynamic Social Systems Model to HIV prevention in a rural African context: the Maasai and the esoto dance. HEALTH EDUCATION & BEHAVIOR 2013; 40:683-93. [PMID: 23372030 DOI: 10.1177/1090198112474004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study applied the Dynamic Social Systems Model (DSSM) to the issue of HIV risk among the Maasai tribe of Tanzania, using data from a cross-sectional, cluster survey among 370 randomly selected participants from Ngorongoro and Siha Districts. A culturally appropriate survey instrument was developed to explore traditions reportedly coadunate with sexual partnership, including "wife sharing", fertility rituals, and various traditional dances. One dance, esoto, accounted for more than two thirds of participants' lifetime sexual partners (n = 10.5). The DSSM, combining structural and systems theories, was applied to systematize complex multilevel factors regarding esoto practice. Participants reported multifaceted beliefs regarding esoto; a majority viewed the dance as exciting and essential, yet most men feared social stigma and three quarters of women had experienced physical punishment for nonattendance. In multivariate logistic regression, esoto attendance was predicted by female gender (adjusted odds ratio [AOR] = 4.67, 95% confidence interval [CI] = 1.6-13.2), higher positive beliefs regarding esoto (AOR = 2.84, 95% CI = 1.9-4.2), and Maasai life cycle events (AOR = 0.06, 95% CI = 0.01-0.47). The DSSM proved useful for characterizing esoto and for revealing feedback loops that maintain esoto, thus indicating avenues for future interventions.
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Affiliation(s)
- Aaron J Siegler
- 1Emory University Rollins School of Public Health, Atlanta, GA, USA
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Mago VK, Bakker L, Papageorgiou EI, Alimadad A, Borwein P, Dabbaghian V. Fuzzy cognitive maps and cellular automata: An evolutionary approach for social systems modelling. Appl Soft Comput 2012. [DOI: 10.1016/j.asoc.2012.02.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Peltzer K, Parker W, Mabaso M, Makonko E, Zuma K, Ramlagan S. Impact of national HIV and AIDS communication campaigns in South Africa to reduce HIV risk behaviour. ScientificWorldJournal 2012; 2012:384608. [PMID: 23213285 PMCID: PMC3504395 DOI: 10.1100/2012/384608] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 10/11/2012] [Indexed: 11/17/2022] Open
Abstract
In South Africa social and behavioural communication interventions are a critical component of HIV/AIDS prevention, and numerous communication campaigns have been implemented intensively across the country through government initiatives and nongovernmental organisations over the past decade. The aim of this paper is to assess the reach of HIV and AIDS communication campaigns in conjunction with contributions to knowledge, attitudes, and HIV risk behaviours in the general population in South Africa. The sample included in this nationally representative cross-sectional survey was 13234 people aged 15–55 years. Overall, the study found that there was high exposure to 18 different HIV communication programmes (median 6 programmes and 14 programmes more than 30%) across different age groups. Most programmes were more often seen or heard by young people aged between 15 and 24 years. In multivariate analysis, greater exposure to HIV mass communication programmes was associated with greater HIV knowledge, condom use at last sex, having tested for HIV in the past 12 months, and less stigmatizing attitude toward PLWHA.
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Affiliation(s)
- Karl Peltzer
- HIV/AIDS, STIs and TB-HAST, Human Sciences Research Council, Private Bag X41, Pretoria 0001, South Africa.
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The promise of multimedia technology for STI/HIV prevention: frameworks for understanding improved facilitator delivery and participant learning. AIDS Behav 2012; 16:1949-60. [PMID: 22223296 DOI: 10.1007/s10461-011-0106-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
There is increasing excitement about multimedia sexually transmitted infection (STI) and HIV prevention interventions, yet there has been limited discussion of how use of multimedia technology may improve STI/HIV prevention efforts. The purpose of this paper is to describe the mechanisms through which multimedia technology may work to improve the delivery and uptake of intervention material. We present conceptual frameworks describing how multimedia technology may improve intervention delivery by increasing standardization and fidelity to the intervention material and the participant's ability to learn by improving attention, cognition, emotional engagement, skills-building, and uptake of sensitive material about sexual and drug risks. In addition, we describe how the non-multimedia behavioral STI/HIV prevention intervention, Project WORTH, was adapted into a multimedia format for women involved in the criminal justice system and provide examples of how multimedia activities can more effectively target key mediators of behavioral change in this intervention.
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