Program

May 07, 2007

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

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 materials are not available for purchase.

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

Program information last updated on
5/7/07.

Subscribe to Child Trends

Short weekly updates of recent research on children and youth.