Skip to main content
Top
Published in: Annals of Behavioral Medicine 3/2015

01-06-2015 | Original Article

A Randomized Controlled Trial to Increase HIV Preventive Information, Motivation, and Behavioral Skills in Ugandan Adolescents

Authors: Michele L. Ybarra, MPH, PhD, Josephine D. Korchmaros, PhD, Tonya L. Prescott, BA, Ruth Birungi, MA

Published in: Annals of Behavioral Medicine | Issue 3/2015

Login to get access

Abstract

Background

One in 25 Ugandan adolescents is HIV positive.

Purpose

The aim of this study is to examine the impact of an Internet-based HIV prevention program on Information-Motivation-Behavioral skills (IMB) Model-related constructs.

Methods

Three hundred and sixty-six sexually experienced and inexperienced students 13–18+ years old in Mbarara, Uganda, were randomly assigned to the five-lesson CyberSenga program or the treatment-as-usual control group. Half of the intervention participants were further randomized to a booster session. Assessments were collected at 3 and 6 months post-baseline.

Results

Participants’ HIV-related information improved over time at a greater rate for the intervention groups compared to the control group. Motivation for condom use changed to a greater degree over time for the intervention group—especially those in the intervention + booster group—compared to the control group. Behavioral skills for condom use, and motivation and behavioral skills for abstinence were statistically similar over time for both groups.

Conclusions

CyberSenga improves HIV preventive information and motivation to use condoms.
Literature
4.
go back to reference Johnson WD, Diaz RM, Flanders WD, et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008: CD001230. Johnson WD, Diaz RM, Flanders WD, et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008: CD001230.
5.
go back to reference Fisher JD, Fisher WA. Theoretical approaches to individual-level change in HIV risk behavior. In: Peterson JL, DiClemente RJ, eds. Handbook of HIV Prevention. New York: Kluwer Academic/Plenum Press; 2000: 3-55.CrossRef Fisher JD, Fisher WA. Theoretical approaches to individual-level change in HIV risk behavior. In: Peterson JL, DiClemente RJ, eds. Handbook of HIV Prevention. New York: Kluwer Academic/Plenum Press; 2000: 3-55.CrossRef
7.
go back to reference Fisher JD, Fisher WA. The information-motivation-behavioral skills model. In: DiClemente RJ, Crosby RA, Kegler MC, eds. Emerging theories in health promotion practice and research: Strategies for improving public health. San Francisco: Jossey-Bass; 2002: 40-70. Fisher JD, Fisher WA. The information-motivation-behavioral skills model. In: DiClemente RJ, Crosby RA, Kegler MC, eds. Emerging theories in health promotion practice and research: Strategies for improving public health. San Francisco: Jossey-Bass; 2002: 40-70.
8.
go back to reference Fisher CM. Adapting the information-motivation-behavioral skills model: Predicting HIV-related sexual risk among sexual minority youth. Health Educ Behav. 2012; 39: 290-302.CrossRefPubMed Fisher CM. Adapting the information-motivation-behavioral skills model: Predicting HIV-related sexual risk among sexual minority youth. Health Educ Behav. 2012; 39: 290-302.CrossRefPubMed
9.
go back to reference Bazargan M, Stein JA, Bazargan-Hejazi S, Hindman DW. Using the information-motivation behavioral model to predict sexual behavior among underserved minority youth. J Sch Health. 2010; 80: 287-295.CrossRefPubMed Bazargan M, Stein JA, Bazargan-Hejazi S, Hindman DW. Using the information-motivation behavioral model to predict sexual behavior among underserved minority youth. J Sch Health. 2010; 80: 287-295.CrossRefPubMed
10.
go back to reference Fisher JD, Fisher WA, Williams SS, Malloy TE. Empirical tests of an information-motivation-behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychol. 1994; 13: 238-250.CrossRefPubMed Fisher JD, Fisher WA, Williams SS, Malloy TE. Empirical tests of an information-motivation-behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychol. 1994; 13: 238-250.CrossRefPubMed
11.
go back to reference Kalichman SC, Picciano JF, Roffman RA. Motivation to reduce HIV risk behaviors in the context of the Information, Motivation and Behavioral Skills (IMB) model of HIV prevention. J Health Psychol. 2008; 13: 680-689.CrossRefPubMed Kalichman SC, Picciano JF, Roffman RA. Motivation to reduce HIV risk behaviors in the context of the Information, Motivation and Behavioral Skills (IMB) model of HIV prevention. J Health Psychol. 2008; 13: 680-689.CrossRefPubMed
12.
go back to reference Walsh J, Senn T, Scott-Sheldon L, Vanable P, Carey M. Predicting condom use using the Information-Motivation-Behavioral Skills (IMB) model: A multivariate latent growth curve analysis. Ann Behav Med. 2011; 42: 235-244.CrossRefPubMedCentralPubMed Walsh J, Senn T, Scott-Sheldon L, Vanable P, Carey M. Predicting condom use using the Information-Motivation-Behavioral Skills (IMB) model: A multivariate latent growth curve analysis. Ann Behav Med. 2011; 42: 235-244.CrossRefPubMedCentralPubMed
13.
go back to reference Anderson ES, Wagstaff DA, Heckman TG, et al. Information-Motivation-Behavioral Skills (IMB) Model: Testing direct and mediated treatment effects on condom use among women in low-income housing. Ann Behav Med. 2006; 31: 70-79.CrossRefPubMed Anderson ES, Wagstaff DA, Heckman TG, et al. Information-Motivation-Behavioral Skills (IMB) Model: Testing direct and mediated treatment effects on condom use among women in low-income housing. Ann Behav Med. 2006; 31: 70-79.CrossRefPubMed
14.
go back to reference Maticka-Tyndale E, Tenkorang EY. A multi-level model of condom use among male and female upper primary school students in Nyanza, Kenya. Soc Sci Med. 2010; 71: 616-625.CrossRefPubMed Maticka-Tyndale E, Tenkorang EY. A multi-level model of condom use among male and female upper primary school students in Nyanza, Kenya. Soc Sci Med. 2010; 71: 616-625.CrossRefPubMed
15.
go back to reference Bryan AD, Fisher JD, Benziger TJ. HIV prevention information, motivation, behavioral skills and behaviour among truck drivers in Chennai, India. AIDS. 2000; 14: 756-758.CrossRefPubMed Bryan AD, Fisher JD, Benziger TJ. HIV prevention information, motivation, behavioral skills and behaviour among truck drivers in Chennai, India. AIDS. 2000; 14: 756-758.CrossRefPubMed
16.
go back to reference Linn JG, Garnelo L, Husaini BA, Brown C, Benzaken AS, Stringfield YN. HIV prevention for indigenous people of the Amazon basin. Cell Mol Biol (Noisy-le-grand). 2001; 47: 1009-1015. Linn JG, Garnelo L, Husaini BA, Brown C, Benzaken AS, Stringfield YN. HIV prevention for indigenous people of the Amazon basin. Cell Mol Biol (Noisy-le-grand). 2001; 47: 1009-1015.
17.
go back to reference Yang X, Xia G, Li X, Latkin C, Celentano D. Social influence and individual risk factors of HIV unsafe sex among female entertainment workers in China. AIDS Educ Pre. 2010; 22: 69-86.CrossRef Yang X, Xia G, Li X, Latkin C, Celentano D. Social influence and individual risk factors of HIV unsafe sex among female entertainment workers in China. AIDS Educ Pre. 2010; 22: 69-86.CrossRef
18.
go back to reference Kalichman SC, Simbayi LC, Cain D, Jooste S, Skinner D, Cherry C. Generalizing a model of health behaviour change and AIDS stigma for use with sexually transmitted infection clinic patients in Cape Town, South Africa. AIDS Care. 2006; 18: 178-182.CrossRefPubMed Kalichman SC, Simbayi LC, Cain D, Jooste S, Skinner D, Cherry C. Generalizing a model of health behaviour change and AIDS stigma for use with sexually transmitted infection clinic patients in Cape Town, South Africa. AIDS Care. 2006; 18: 178-182.CrossRefPubMed
19.
go back to reference Malow RM, Stein JA, McMahon RC, Dévieux JG, Rosenberg R, Jean-Gilles M. Effects of a culturally adapted HIV prevention intervention in Haitian youth. J Assoc Nurses AIDS Care. 2009; 20: 110-121.CrossRefPubMedCentralPubMed Malow RM, Stein JA, McMahon RC, Dévieux JG, Rosenberg R, Jean-Gilles M. Effects of a culturally adapted HIV prevention intervention in Haitian youth. J Assoc Nurses AIDS Care. 2009; 20: 110-121.CrossRefPubMedCentralPubMed
20.
go back to reference Fisher JD, Fisher WA, Bryan AD, Misovich SJ. Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychol. 2002; 21: 177-186.CrossRefPubMed Fisher JD, Fisher WA, Bryan AD, Misovich SJ. Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychol. 2002; 21: 177-186.CrossRefPubMed
21.
go back to reference Ybarra ML, Eaton WW. Internet-based mental health interventions. Ment Health Serv Res. 2005; 7: 75-87.CrossRefPubMed Ybarra ML, Eaton WW. Internet-based mental health interventions. Ment Health Serv Res. 2005; 7: 75-87.CrossRefPubMed
23.
24.
go back to reference Kiapi-Iwa L, Hart GJ. The sexual and reproductive health of young people in Adjumani district, Uganda: Qualitative study of the role of formal, informal, and traditional health providers. AIDS Care. 2004; 16: 339-347.CrossRefPubMed Kiapi-Iwa L, Hart GJ. The sexual and reproductive health of young people in Adjumani district, Uganda: Qualitative study of the role of formal, informal, and traditional health providers. AIDS Care. 2004; 16: 339-347.CrossRefPubMed
25.
26.
go back to reference Ybarra ML, Korchmaros J, Kiwanuka J, Bangsberg D, Bull S. Examining the applicability of the IMB model in predicting condom use among sexually active secondary school students in Mbarara, Uganda. AIDS Behav. 2012; 17: 1116-1128.CrossRef Ybarra ML, Korchmaros J, Kiwanuka J, Bangsberg D, Bull S. Examining the applicability of the IMB model in predicting condom use among sexually active secondary school students in Mbarara, Uganda. AIDS Behav. 2012; 17: 1116-1128.CrossRef
27.
go back to reference Ybarra ML, Biringi R, Prescott T, Bull SS. Usability and navigability of an HIV/AIDS internet intervention for adolescents in a resource-limited setting. Comput Inform Nurs. 2012; 30: 587-595.CrossRefPubMedCentralPubMed Ybarra ML, Biringi R, Prescott T, Bull SS. Usability and navigability of an HIV/AIDS internet intervention for adolescents in a resource-limited setting. Comput Inform Nurs. 2012; 30: 587-595.CrossRefPubMedCentralPubMed
28.
go back to reference Bull S, Nabembezi D, Birungi R, Kiwanuka J, Ybarra ML. Cyber-Senga: Ugandan youth preferences for content in an internet-delivered comprehensive sexuality education programme. East Afr J Publ Health. 2010; 7: 58-63. Bull S, Nabembezi D, Birungi R, Kiwanuka J, Ybarra ML. Cyber-Senga: Ugandan youth preferences for content in an internet-delivered comprehensive sexuality education programme. East Afr J Publ Health. 2010; 7: 58-63.
29.
go back to reference Katz IT, Ybarra ML, Wyatt MA, Kiwanuka JP, Bangsberg DR, Ware NC. Socio-cultural and economic antecedents of adolescent sexual decision-making and HIV-risk in rural Uganda. AIDS Care. 2013; 25: 258-264.CrossRefPubMedCentralPubMed Katz IT, Ybarra ML, Wyatt MA, Kiwanuka JP, Bangsberg DR, Ware NC. Socio-cultural and economic antecedents of adolescent sexual decision-making and HIV-risk in rural Uganda. AIDS Care. 2013; 25: 258-264.CrossRefPubMedCentralPubMed
30.
go back to reference Ybarra ML, Bull SS, Prescott TL, Korchmaros JD, Bangsberg DR, Kiwanuka JP. Adolescent abstinence and unprotected sex in CyberSenga, an Internet-based HIV prevention program: Randomized clinical trial of efficacy. PLoS ONE. 2013; 8: e70083.CrossRefPubMedCentralPubMed Ybarra ML, Bull SS, Prescott TL, Korchmaros JD, Bangsberg DR, Kiwanuka JP. Adolescent abstinence and unprotected sex in CyberSenga, an Internet-based HIV prevention program: Randomized clinical trial of efficacy. PLoS ONE. 2013; 8: e70083.CrossRefPubMedCentralPubMed
32.
go back to reference Gakidou E, Cowling K, Lozano R, Murray C. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: A systemic analysis. Lancet. 2010; 376: 959-974.CrossRefPubMed Gakidou E, Cowling K, Lozano R, Murray C. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: A systemic analysis. Lancet. 2010; 376: 959-974.CrossRefPubMed
33.
go back to reference Bryan A, Aiken L, West S. HIV/STD risk among incarcerated adolescents: Optimism about the future and self-esteem as predictors of condom use self-efficacy. J Appl Soc Psychol. 2004; 34: 912-936.CrossRef Bryan A, Aiken L, West S. HIV/STD risk among incarcerated adolescents: Optimism about the future and self-esteem as predictors of condom use self-efficacy. J Appl Soc Psychol. 2004; 34: 912-936.CrossRef
34.
go back to reference Bryan A, Kagee A, Broaddus M. Condom use among South African adolescents: Developing and testing theoretical models of intentions and behavior. AIDS Behav. 2006; 10: 387-397.CrossRefPubMed Bryan A, Kagee A, Broaddus M. Condom use among South African adolescents: Developing and testing theoretical models of intentions and behavior. AIDS Behav. 2006; 10: 387-397.CrossRefPubMed
35.
go back to reference Puffer E, Meade C, Drabkin A, Broverman S, Ogwang-Odhiambo R, Sikkema K. Individual- and family-level psychosocial correlates of HIV risk behavior among youth in rural Kenya. AIDS Behav. 2010; 15: 1264-1274.CrossRef Puffer E, Meade C, Drabkin A, Broverman S, Ogwang-Odhiambo R, Sikkema K. Individual- and family-level psychosocial correlates of HIV risk behavior among youth in rural Kenya. AIDS Behav. 2010; 15: 1264-1274.CrossRef
37.
go back to reference Muyinda H, Nakuya J, Whitworth JAG, Pool R. Community sex education among adolescents in rural Uganda: Utilizing indigenous institutions. AIDS Care. 2004; 16: 69-79.CrossRefPubMed Muyinda H, Nakuya J, Whitworth JAG, Pool R. Community sex education among adolescents in rural Uganda: Utilizing indigenous institutions. AIDS Care. 2004; 16: 69-79.CrossRefPubMed
39.
go back to reference Ybarra ML, Bull SS, Prescott TL, Birungi R. Acceptability and feasibility of CyberSenga: An Internet-based HIV-prevention program for adolescents in Mbarara, Uganda. AIDS Care. 2014; 26: 441-447.CrossRefPubMedCentralPubMed Ybarra ML, Bull SS, Prescott TL, Birungi R. Acceptability and feasibility of CyberSenga: An Internet-based HIV-prevention program for adolescents in Mbarara, Uganda. AIDS Care. 2014; 26: 441-447.CrossRefPubMedCentralPubMed
41.
go back to reference Uganda Bureau of Statistics (UBOS), ORC Macro: Uganda Demographic and Health Survey 2006. Calverton, MD: UBOS and Macro International Inc., 2007. Uganda Bureau of Statistics (UBOS), ORC Macro: Uganda Demographic and Health Survey 2006. Calverton, MD: UBOS and Macro International Inc., 2007.
42.
go back to reference Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988; 52: 30-41.CrossRef Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988; 52: 30-41.CrossRef
43.
go back to reference Ware JE, Kosinski M. SF-36 Physical and Mental Health Summary Scales: A Manual for Users of Version 1. Lincoln, RI: QualityMetric Inc.; 2001. Ware JE, Kosinski M. SF-36 Physical and Mental Health Summary Scales: A Manual for Users of Version 1. Lincoln, RI: QualityMetric Inc.; 2001.
44.
go back to reference Rosenberg M. Society and the adolescent self-image. Princeton: Princeton University Press; 1965. Rosenberg M. Society and the adolescent self-image. Princeton: Princeton University Press; 1965.
45.
go back to reference StataCorp: Stata Statistical Software. College Station, TX: StataCorp LP, 2009. StataCorp: Stata Statistical Software. College Station, TX: StataCorp LP, 2009.
46.
go back to reference Rubin DB. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987. Rubin DB. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987.
47.
go back to reference Hendriksen ES, Pettifor A, Lee SJ, Coates T, Rees H. Predictors of condom use among young adults in South Africa: The reproductive health and HIV research unit national youth survey. Am J Public Health. 2007; 97: 1241-1248.CrossRefPubMedCentralPubMed Hendriksen ES, Pettifor A, Lee SJ, Coates T, Rees H. Predictors of condom use among young adults in South Africa: The reproductive health and HIV research unit national youth survey. Am J Public Health. 2007; 97: 1241-1248.CrossRefPubMedCentralPubMed
Metadata
Title
A Randomized Controlled Trial to Increase HIV Preventive Information, Motivation, and Behavioral Skills in Ugandan Adolescents
Authors
Michele L. Ybarra, MPH, PhD
Josephine D. Korchmaros, PhD
Tonya L. Prescott, BA
Ruth Birungi, MA
Publication date
01-06-2015
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 3/2015
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-014-9673-0

Other articles of this Issue 3/2015

Annals of Behavioral Medicine 3/2015 Go to the issue