HEALTH BELIEF MODEL INTERVENTION

TO INCREASE CONDOM USE AMONG HIGH-RISK FEMALE ADOLECENTS

OVERVIEW

An intervention based on the Health Belief Model was developed to increase condom use among high-risk female adolescents.  Females diagnosed with Chlamydia at health clinics in Indiana were randomly assigned to receive traditional information about STDs and condom use or to engage in this intervention, designed to increase their perception of vulnerability to STDs and decrease barriers to condom use.  Among the 54% of clients who returned for a six-month follow-up, those who received the HBM intervention increased their condom use to a greater extent than those who received traditional information, but all clients remained inconsistent users.  In spite of increased condom use, clients who received the HBM intervention were not any less likely than clients who did not to become re-infected with Chlamydia during a six-month follow-up period.

DESCRIPTION OF PROGRAM

Target population: high-risk adolescent females

The Health Belief Model posits that STD avoidance behaviors are influenced by an individual's perception of the threat of acquiring an STD, the benefits of altering behavior to prevent acquisition of an STD, and the barriers to adopting less risky behaviors.  In line with this model, an intervention was developed to increase condom use among females being treated for Chlamydia.  This intervention consisted of a research assistant discussing the Chlamydia infection with the client being treated and then helping her to develop condom use and negotiation skills.  The research assistant demonstrated proper condom use and gave the client a chance to practice.  The research assistant also led the client through a scenario in which the client played the part of a young woman trying to get her sexual partner to use a condom.  The intervention lasted from 10-20 minutes.

EVALUATION(S) OF PROGRAM

Orr, D.P., Langefeld, C.D., Katz, B.P., & Caine, V.A.  (1996).  Behavior Intervention to Increase Condom Use Among High-Risk Female Adolescents.  The Journal of Pediatrics, 128(2), 288-295.

Evaluated population: Two family planning clinics and a county STD clinic in Indiana were selected to participate in this study.  Each clinic screened sexually active female patients for Chlamydia.  Those patients who tested positive for the infection were invited to participate in the study.  209 females, ages 14 to 19, agreed to participate and 112 (54%) returned for a six-month follow-up visit.  Although attrition was high, the rate did not differ between treatment and control groups.  54% of the sample was black.

Approach: All subjects got free antibiotic treatment for Chlamydia and were encouraged to have their partners treated.  Following their treatment, study participants completed a survey on their sexual knowledge, beliefs, attitudes, and behaviors.  Those clients screened at the STD clinic were randomly assigned to the treatment group or to the control group.  In the case of the family planning clinics, it was the clinic that was randomly assigned and not the individual, so all clients screened at one clinic were part of the treatment group and all clients screened at the other clinic were part of the control group.

Clients assigned to the control group engaged in a discussion with the clinic nurse about STDs and condom use, as is usual clinic procedure.  Clients assigned to the treatment group received the Health Belief Model intervention.  Both groups of clients received printed information on Chlamydia.

Clients returned to the clinic two weeks later for a test-of-cure culture and again six months later to complete a second survey and receive a gynecological check-up. 

Results: Compared with clients in the control group, clients in the treatment group significantly increased their condom usage over the six-month follow-up period, but remained inconsistent users.  In spite of this increase in condom use, clients in the treatment group were not any less likely than clients in the control group to become re-infected with Chlamydia during the six-month follow-up period.  No impacts were found for knowledge, beliefs, or attitudes.

SOURCES FOR MORE INFORMATION

Program materials are not available for purchase.

References:

Orr, D.P., Langefeld, C.D., Katz, B.P., & Caine, V.A.  (1996).  Behavior Intervention to Increase Condom Use Among High-Risk Female Adolescents.  The Journal of Pediatrics, 128(2), 288-295.

Program categorized in this guide according to the following:

Evaluated participant ages: 14-19

Program age ranges in the guide: Adolescence, Youth

Program components: Clinic-Based

Measured outcomes: Reproductive Health

KEYWORDS: Reproductive Health, Risky Sex, STD/HIV/AIDS, Gender Specific (Female Only), High Risk, Adolescence (12-17), Black or African American, White or Caucasian, Hispanic or Latino, Youth, Clinic-Based, Community-Based.

Program information last updated on 5/7/07.

© Child Trends 2004