Long Live Love. The implementation of a school-based sex-education program in The Netherlands.

Implementation of health education programs is often inadequately considered or not considered at all in planning, developing and evaluating interventions. With the focus being predominantly on the adoption stage, little is known about the factors influencing the implementation and continuation stages of the diffusion process. This study contributes to the understanding of factors that promote or impede each stage of the diffusion process in the school setting using the sex education program Long Live Love (LLL) as an example.

Cost-effectiveness of a nurse-based intervention (AIMS) to improve adherence among HIV-infected patients: design of a multi-centre randomised controlled trial.

Background: Non-adherence to HIV-treatment can have a negative impact on patients treatment success rates, quality of life, infectiousness, and life expectancy. Few adherence interventions have shown positive effects on adherence and/or virologic outcomes. The theory- and evidence-based Adherence Improving self-Management Strategy (AIMS) is an intervention that has been demonstrated to improve adherence and viral suppression rates in a randomised controlled trial.

Factors contributing to inconsistent condom use among heterosexual men in Curaçao.

This study explored, from a public health perspective, factors that contribute to inconsistent condom use by men in Curaçao through semi-structured face-to-face interviews with 21 heterosexual men. The findings show that there is an important disconnect between what is considered culturally appropriate sexual behaviour for men and women and condom use, that diverging from prescribed notions of masculinity and femininity in order to use condoms consistently is difficult, and that condom use is particularly problematic in the context of concurrent partnerships and sexual economic exchanges. Participants further reported that Caribbean family structures, whereby mothers assume the role as primary caregiver and fathers contribute biologically but, to a much lesser extent socially, also have an impact on condom use.

Predicting having condoms available among adolescents: the role of personal norm and enjoyment.

Objectives: Having condoms available has been shown to be an important predictor of condom use. We examined whether or not personal norm and goal enjoyment contribute to predicting having condoms available in the context of cognition specified by the theory of planned behaviour (TPB).

Design: Prospective survey study, with a baseline and follow-up measurement (at 3 months).

Evaluation of the Dutch AIDS STI information helpline: differential outcomes of telephone versus online counseling.

Objective: Health information helplines have an important function in health education, prevention and counseling. Information and help services are increasingly provided online. This study focuses on the differences and similarities between online help services and telephone services.

Bedtime stories: the effects of self-constructed risk scenarios on imaginability and perceived susceptibility to sexually transmitted infections.

Various authors (e.g. Kahnemann, D.

Are lapsed donors willing to resume blood donation, and what determines their motivation to do so?

Background: This study investigated the possibility of rerecruiting lapsed blood donors. Reasons for donation cessation, motivation to restart donation, and modifiable components of donation motivation were examined. We distinguished between lapsed donors who had passively withdrawn by merely not responding to donation invitations and donors who had contacted the blood bank to actively withdraw.

Psychological and social correlates of HIV status disclosure: the significance of stigma visibility.

HIV-related stigma, psychological distress, self-esteem, and social support were investigated in a sample comprising people who have concealed their HIV status to all but a selected few (limited disclosers), people who could conceal but chose to be open (full disclosers), and people who had visible symptoms that made concealing difficult (visibly stigmatized). The visibly stigmatized and full disclosers reported significantly more stigma experiences than limited disclosers, but only the visibly stigmatized reported more psychological distress, lower self-esteem, and less social support than limited disclosers. This suggests that having a visible stigma is more detrimental than having a concealable stigma.

The development of an adolescent smoking cessation intervention--an Intervention Mapping approach to planning.

The objective of this project was to develop a theory- and evidence-based adolescent smoking cessation intervention using both new and existing materials. We used the Intervention Mapping framework for planning health promotion programmes. Based on a needs assessment, we identified important and changeable determinants of cessation behaviour, specified change objectives for the intervention programme, selected theoretical change methods for accomplishing intervention objectives and finally operationalized change methods into practical intervention strategies.

HIV-related stigma in African and Afro-Caribbean communities in the Netherlands: manifestations, consequences and coping.

HIV-related stigma in African and Afro-Caribbean diaspora communities in the Netherlands was investigated. Interviews with HIV-positive and HIV-negative community members demonstrated that HIV-related stigma manifests as social distance, physical distance, words and silence. The psychological consequences of HIV-related stigma among those diagnosed with HIV reported were emotional pain, sadness, loneliness, anger, frustration and internalised stigma.

The World Starts With Me: a multilevel evaluation of a comprehensive sex education programme targeting adolescents in Uganda.

Background: This paper evaluates the effect of the World Starts With Me (WSWM), a comprehensive sex education programme in secondary schools in Uganda. The aim of the present study was to assess the effects of WSWM on socio-cognitive determinants of safe sex behaviour (delay; condom use and non-coercive sex).

Methods: A survey was conducted both before and immediately after the intervention among students in intervention (N = 853) and comparison (N = 1011) groups.

Justify your love: testing an online STI-risk communication intervention designed to promote condom use and STI-testing.

The efficacy of a tailored, web-based intervention communicating the risks of sexually transmitted infections (STI) for heterosexual young adults was examined in a randomised, controlled trial. The main aims of the relationship-oriented intervention were to influence risk perceptions and to promote (maintenance of) condom use and STI-testing among young adults who reported being recently engaged in a heterosexual relationship. The intervention addressed risk perceptions, attitudes, normative beliefs, self-efficacy and skills related to condom use and STI-testing.

HIV status disclosure among HIV-positive African and Afro-Caribbean people in the Netherlands.

HIV status disclosure is often characterized as a dilemma. On the one hand, disclosure can promote health, social support, and psychological well-being. On the other, disclosure can lead to stigmatization, rejection, and other negative social interactions.

Motivating blood donors to recruit new donors: experimental evaluation of an evidence-based behavior change intervention.

Objective: A sustainable, evidence-based intervention to motivate current blood donors to recruit new donors was evaluated using a quasi-experimental, in-service trial at three donation centers.

Design: Participating blood donors in three conditions (N = 734), received (1) an evidence-based leaflet designed to enhance recruitment motivation and five postcards facilitating recruitment and donor registration, (2) five postcards alone, or (3) no materials.

Main Outcome Measures: Self-reported donor recruitment by donors was measured at 1-week and 6-week follow-up.

Cardiovascular risk profile: cross-sectional analysis of motivational determinants, physical fitness and physical activity.

Background: Cardiovascular risk factors are associated with physical fitness and, to a lesser extent, physical activity. Lifestyle interventions directed at enhancing physical fitness in order to decrease the risk of cardiovascular diseases should be extended. To enable the development of effective lifestyle interventions for people with cardiovascular risk factors, we investigated motivational, social-cognitive determinants derived from the Theory of Planned Behavior (TPB) and other relevant social psychological theories, next to physical activity and physical fitness.

An exploratory study of Muslim adolescents' views on sexuality: Implications for sex education and prevention.

Background: This paper describes the results of an exploratory qualitative study on Muslim adolescents' views on sexuality in the Netherlands.

Methods: Data were gathered from an Internet forum on which 44 Muslim and 33 non-Muslim adolescents discussed sexuality as it relates to Islam. These discussions were subsequently analyzed for content using Nvivo 2.

Testing implicit assumptions and explicit recommendations: the effects of probability information on risk perception.

When people underestimate a risk, often probability information is communicated because of the implicit assumption that it will raise people's risk estimates as a result of these objective facts. Also, scientific literature suggested that stressing the cumulative aspects of a risk might lead to higher susceptibility perceptions than only emphasizing the single incident probability. Empirical evidence that supports the effectiveness of these strategies, however, is lacking.

Behavioural intentions in response to an influenza pandemic.

Background: Little is known regarding which behavioural responses can be expected if an influenza pandemic were to occur.

Methods: A survey comprising questions based on risk perception theories, in particular PMT, was conducted with a Dutch sample.

Results: Although fear that an influenza pandemic may occur was high, participants do not feel well informed.

The effects of scenario-based risk information on perceptions of susceptibility to Chlamydia and HIV.

The simulation heuristic of Kahnemann and Tversky (1982) suggests that the subjective ease by which a risky situation can be mentally construed, positively influences the person's perceived susceptibility to the presented threat. Assuming that a detailed outline of how a risky event can end up negatively increases the ease of imagination, we tested the hypothesis that scenario-based risk information enhances perceived susceptibility towards contracting a sexually transmitted infection (STI). In an experimental design, undergraduate students were exposed to one or two risk scenario messages or no scenario message (control).

Decoding health education interventions: the times are a-changin'.

The development of theory- and evidence-based health education interventions is a complex process in which interventionists in collaboration with priority groups and stakeholders make many decisions about objectives, change techniques, intervention materials and activities, delivery modes and implementation issues. In this development process, interventionists have to find a balance between employing change techniques that should be effective in an ideal world, and intervention activities and materials that match the reality of priority populations and intervention contexts. Intervention descriptions providing information about what behaviour change techniques have been employed, do not reflect the complexity of this decision-making process.

Standard care impact on effects of highly active antiretroviral therapy adherence interventions: A meta-analysis of randomized controlled trials.

Background: Poor adherence to medication limits the effectiveness of treatment for human immunodeficiency virus. Systematic reviews can identify practical and effective interventions. Meta-analyses that control for variability in standard care provided to control groups may produce more accurate estimates of intervention effects.

Standard care quality determines treatment outcomes in control groups of HAART-adherence intervention studies: implications for the interpretation and comparison of intervention effects.

Objective: Clinical trials of behavioral interventions seek to enhance evidence-based health care. However, in case the quality of standard care provided to control conditions varies between studies and affects outcomes, intervention effects cannot be directly interpreted or compared. The objective of the present study was to examine whether standard care quality (SCQ) could be reliably assessed, varies between studies of highly active antiretroviral HIV-adherence interventions, and is related to the proportion of patients achieving an undetectable viral load ("success rate").

Correlates of intention to use condoms among Sub-Saharan African youth: the applicability of the theory of planned behaviour.

Aims: To test the applicability of an extended version of the theory of planned behaviour for the study of condom use intentions among large samples of young people in South Africa and Tanzania.

Methods: Baseline data of a randomized controlled trial of school-based HIV/AIDS prevention programmes were used. The setting comprised secondary schools in the regions of Cape Town, Polokwane and Dar es Salaam.

Process evaluation of a school-based HIV/AIDS intervention in South Africa.

Aims: This paper presents a process evaluation that assessed the fidelity and quality of implementation, as well as the acceptability and subjective evaluations of a HIV/AIDS intervention among students and teachers.

Methods: The process evaluation was conducted as part of a cluster randomized controlled trial of a theory- and evidence-based school HIV/AIDS intervention in Cape Town. The intervention was designed for grade 8 high school students and delivered by teachers over a six-month period.

The application of Intervention Mapping in developing and implementing school-based sexuality and HIV/AIDS education in a developing country context: the case of Tanzania.

Aims: Effective sexuality and HIV/AIDS education programmes are needed to protect young people against HIV/AIDS and teenage pregnancy in Tanzania and other Sub-Saharan African countries. Using a theory- and evidence-based approach and adapting the programmes to local contexts, increases the effectiveness of these programmes. This paper describes and discusses the challenges and opportunities concerning the application of Intervention Mapping (IM) in the development and implementation of a sexuality and HIV/AIDS education programme targeting young people aged 12-14 in Tanzania.