Program

Oct 21, 2011

OVERVIEW

This experimental evaluation uses a motivational behavioral intervention (MBI)
based on a Transtheoretical Model of Change (TTM) framework to encourage young
women to get sexually transmitted infection screenings and checkups in response
to high-risk sexual behavior. The intervention was evaluated with sexually
active women between the ages of 16 and 22.5 who were patients at a
community-based urban clinic that provided free reproductive healthcare.
Although the intervention was both theory-based and delivered using motivational
interviewing, results showed no significant difference for number or reason for
checkups or consistent condom use between the MBI treatment and standard care
control groups.

Description
of the Program

Target
Population: 
Sexually active women

TTM-guided motivational behavioral intervention aims to encourage sexually
active women to get sexually transmitted infection (STI) checkups in response to
high-risk sexual behavior. TTM has been used to help understand how individuals
can adopt or maintain healthy behaviors for a wide variety of health protective
behaviors and therefore was used as a framework for this intervention. The
motivational-behavioral intervention is based on the constructs from the TTM and
motivational interviewing to promote client-initiated screening for chlamydia
(CT) and gonorrhea (GC). The intervention intends to increase motivation for
screenings for those in preactionof Stages of Change (before engaging in
certain behaviors) and support maintenance in those already seeking STI
screening for other behaviors. The MBI consists of an individual 30 to 50
minute intervention plus a 15 minute booster intervention 6 months later
tailored to her Stages of Change level for target behaviors with a trained
Bachelors- or Masters-level health educator.

EVALUATION OF THE PROGRAM

Chacko, M.R., Wiemann, C.M., Kozinetz, C.A., von Sternberg, K., Velasquez, M.M.,
Smith, P.B., & DiClemente, R. (2010). Efficacy of motivational behavioral
intervention to promote chlamydia and gonorrhea screening in young women: A
randomized controlled trial. Journal of Adolescent Health 46, 152-161.

Evaluated
population: 
Participants
were 376 sexually active, non-pregnant and not trying to conceive,
English-speaking women with a mean age of 18.5 years. All women were patients
at a community-based urban clinic that provided free reproductive health care to
women and were predominantly minorities.

Approach: Of a total of 950 women approached in a clinic waiting area
by research staff, 376 of them met eligibility requirements and gave informed
consent. Participants were randomly assigned to study conditions: intervention
plus standard care (MBI) or standard care only (SC). Women in the MBI group
received intervention and follow-ups by health educators at baseline, 2 weeks
and 6 months later. Both MBI and SC groups received standard care by clinic
staff. Baseline and 6- and 12-month questionnaires were administered to
participants in both groups, and visits to the clinic between scheduled
study-related visits were monitored (participants were asked to fill out
questionnaire to identify reason for visit). Measured outcomes included
client-initiated clinic visits for STI checkups in response to seven high-risk
sexual behaviors, consistent condom use, number of CT and GC episodes, and
movement along the stages of change.

Results:
There were
no group differences at baseline, 6-, or 12-month assessments for distribution
of stage of change across the seven risk behaviors. There were no difference in
mean scores between the processes of change for the two groups at baseline
except for dramatic relief, which was significantly more likely to be endorsed
by the MBI group than the SC group but this was not predictive of STI-related
clinic visits. There were no significant differences between the number of
clinic visits and reason for visit between the MBI and SC groups. Likewise, no
significant differences were found between the two groups at 6- and 12-month
assessments in regards to consistent condom use during the previous three months
or number of episodes of CT and GC cervical infection.

SOURCES FOR MORE INFORMATION

References:

Chacko, M.R., Wiemann, C.M., Kozinetz, C.A., von Sternberg, K., Velasquez, M.M.,
Smith, P.B., & DiClemente, R. (2010). Efficacy of motivational behavioral
intervention to promote chlamydia and gonorrhea screening in young women: A
randomized controlled trial. Journal of Adolescent Health 46, 152-161.

KEYWORDS:Adolescents (12-17), Youth (16+), Young Adults (19-24), Communtiy-Based, Female
Only, African American, Clinic-Based, Condom Use and Contraception, STD/HIV/AIDS

Program information last updated on 10/21/11.

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