Barcelona 2013
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| Abstract #559 - Theory-and evidence based messageing for male circumcision uptake | ||||
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Session: 30.2: Theory-and evidence based messageing for male circumcision uptake (Lunchtime) on Tuesday @ 13.15-14.15 in Auditorium Chaired by Dr Danuta Kasprzyk, Dr Daniel Montano Authors: Presenting Author: Dr. Daniel Montano - Battelle, United States |
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| Additional Authors: Dr. Fulgentius Baryarama, | ||||
| Aim: Male circumcision (MC) reduces HIV transmission, and there is a consensus that MC should be included in prevention programs. A national MC program was implemented in Zimbabwe to circumcise 80% of men by 2015, but uptake has been lower than desired. To date, < 10% of the men have been circumcised, showing a failure of the current communication campaign. There is clearly a need for evidence-based MC communications strategies to motivate men to get circumcised. The Integrated Behavioral Model (IBM) was applied to design and implement a study to identify and understand the factors that best explain motivation to uptake MC. Using a system we created that is replicable, results were subsequently translated into evidence-based messages to motivate MC uptake. This study systematically tested those posters and messages. | ||||
| Method / Issue: Sixteen groups of 8 to 10 university students were recruited into a longitudinal study to test the acceptability, recall, and effect of the posters and messages developed to increase MC motivation. A total of 32 posters and messages were randomized across 16 groups of students. Each poster and message was presented to 4 groups. Students were selected as an initial exposure group because they are accessible, articulate, and fit into the target age group. The study consisted of 3 waves. At baseline, respondents completed a questionnaire to assess the beliefs (behavioral, normative, personal agency) that the messages and posters were designed to target. They were then exposed to 8 posters for 30 seconds each, and 8 messages, evaluating each using qualitative and quantitative instruments. The quantitative instrument included scales rating emotional appeal and provided a cognitive assessment. The qualitative instrument included 3 open-ended questions eliciting first impressions, and positive and negative aspects of each posters and messages. Three days post-exposure, respondents returned and were asked to recall each poster and message they were exposed to and write them down in the order they came to mind. Two months after the initial exposure, respondents repeated the questionnaire to assess behavioral, normative, and personal agency beliefs that the posters and messages were designed to target. | ||||
| Results / Comments: There was a significant correlation between emotional and cognitive responses to the posters and messages. There were significant differences among the posters and messages on these ratings clearly identifying appealing and unappealing posters and messages. Among the males there were significant changes in motivation to uptake MC (p<.05), and Behavioral beliefs (p<.05), and Self-efficacy beliefs (p<.1) associated with MC, but no significant changes in Injunctive or Descriptive norms or Perceived control beliefs. | ||||
| Discussion: There is a clear need for evidence-based messaging to greater motivate MC uptake. By applying the IBM framework to this research, we created a systematic way of identifying key beliefs significantly associated with MC intention, translated them to messages that we could differentiate on appeal. We also demonstrated that evidence-based posters and messages can change key beliefs that drive MC motivation. Further research is needed to refine the posters and messages and assess whether the increased motivation results in greater MC uptake. | ||||
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