Guide to Effective Programs
for Children and Youth

Video-Based STD Patient Education

OVERVIEW

The video-based STD education program was designed to improve the health behaviors of patients seeking treatment from a STD clinic in the South Bronx. The video-based intervention program included a 20-minute video that modeled ways in which viewers could overcome barriers to consistent condom use. Two versions of the video were made, with each version made to target a different audience: Let’s Do Something Different, which was aimed at a primarily African American audience, and Porque Si, which was aimed at a primarily Latino audience. The studies described below found that the video intervention had a positive impact on condom coupon redemption, knowledge about STDs/HIV and perception of risk, and attitudes about condom use. Condom use was not measured.

DESCRIPTION OF PROGRAM

Target population: Patients seeking treatment for symptoms of a sexually transmitted-disease from a STD clinic in South Bronx.

This video-based intervention program was designed to help patients overcome barriers to condom use. The program consisted of an information session, ranging from 20 minutes to 40 minutes in length depending on whether patients received either the video and facilitator intervention or the video intervention alone. The interventions took place before the participant was evaluated by a doctor at the clinic. In groups of three to eight, patients were shown a culturally-specific video which demonstrated how patients could overcome barriers to condom use. Patients who were assigned to the video-only intervention were then free to go, while patients assigned to the facilitator condition then took part in small group, gender-specific information session. The facilitator sessions were led by members of the research team, who used the video as an introduction to correct misinformation and provide patients with negotiating tactics to use with partners to promote consistent condom use, and condom options.

EVALUATIONS OF PROGRAM

O’Donnell, L.N., San Doval, A., Duran, R., and O’Donnell, C. (1994). Video-based sexually transmitted disease patient education: Its impact on condom acquisition. American Journal of Public Health, 85, 817-822.

Evaluated population: 3,348 African American and Hispanic men and women over the age of 17 who sought treatment from a STD clinic that served the South Bronx were randomly assigned to either the video only intervention or the video and facilitator intervention. Participants were either African American (60%) or Hispanic (40%), with women making up 40 percent of the sample. The average participant age was 29.1 for African American men, 31.5 for Hispanic men, 28.8 for African American women, and 30.2 for Hispanic women. The majority of participants had lived in the US for at least ten years. Fifty-four percent of the participants were diagnosed with a sexually transmitted disease during the study visit.

Approach: Patients were recruited into the study during an initial visit and were invited back to receive more information on a randomly assigned day. As it was difficult for researchers to provide both treatment conditions and the control condition every day that the clinic was open, certain days were designated for each condition and patients were then randomly assigned a condition depending on what day they were told to come to the clinic. All patients, regardless of which condition to which they were assigned, received the routine disease prevention information regularly provided by the clinic.

The researchers collected data using an intake survey that evaluated the participants’ sociodemographic characteristics and sexual-risk behaviors and practice histories. Condom acquisition was measured by a system of coupon redemption. After leaving the clinic, all participants were given a coupon for free condoms at a pharmacy several blocks from the clinic. When coupons were redeemed, the pharmacist on duty noted the race and gender of the participant.

Results: Participants who watched the video and attended a discussion session were more likely to redeem their coupons for condoms (36.9% redemption rate) than participants in the video-only group (27.6% redemption rate) and those in the control group (21.2% redemption rate). This pattern of coupon-redemption was consistent when looking at the data by gender and race, with the exception that African American women were less likely to redeem their coupons after watching the video only than African American women in the control group.

The authors note a few limitations with their study design. First, the study’s authors used condom coupon redemption as a proxy for condom use, which may be problematic as condom redemption may not necessarily translate into actual condom use. Further, the study design did not study the effects of a facilitator-led discussion only. Another limitation is that analyses were not conducted by age, so effectiveness for youth as a subgroup is not known.

O’Donnell, L.N., San Doval, A., Duran, R., and O’Donnell, C. (1994). The effectiveness of video-based interventions in promoting condom acquisition among STD clinic patients. Sexually Transmitted Diseases, 22, 97-103.

Evaluated population: Authors used a subsample of the sample population described above to assess changes in attitudes and knowledge after receiving one of the three interventions. The subsample was comprised of 1653 African American and Hispanic men and women over the age of 17 randomly chosen from the sample described above.

Approach: In addition to the intake survey that evaluated all participants’ sociodemographic characteristics and sexual risk behaviors and practice histories, participants chosen to participate in this subsample study were also administered a survey that evaluated STD- and condom-related knowledge, positive attitudes about condom use, and perceived HIV/STD risk before and after their assigned intervention. The method for measuring condom acquisition is described above.

Results: When compared with the control group, participants who watched the video experienced an approximate 40% gain in STD- and condom-related knowledge, an approximate 27% increase in positive attitudes about condom use, and an approximate 11% gain in perceived HIV/STD risk. Though the group that watched the video and also participated in a facilitator discussion experienced the greatest increase in perceived HIV/STD risk (an approximate 26% increase) and self-efficacy (an approximate 33% increase) over the control group, there were no other significant benefits to knowledge and attitudes about STDs and condoms above and beyond the group that only watched the video.

SOURCES FOR MORE INFORMATION

References

Program categorized in this guide according to the following:

Evaluated participant ages: 12^th grade and above, ages 17 and older. Average age was around 30 years old for participants / Program age ranges in the Guide: 15-21, 22-24

Program components: clinic- or provider-based; community/media component

Measured outcomes: teen pregnancy and reproductive health

Program information last updated 05/3/05.