A tailored minimal self-help intervention to promote condom use in young women: results from a randomized trial.
OBJECTIVE
To evaluate the efficacy of a theory-based tailored minimal self-help intervention to increase condom use among young women at risk for HIV/sexually transmitted disease (STD).


METHODS
Randomized controlled trial on an intent-to-treat basis in two managed care plans, in Washington state and North Carolina, with follow-up at 3 and 6 months.


METHODS
A proactively recruited sample of 1210 heterosexually active, non-monogamous, non-pregnant women, aged 18-24 years recruited June 1999-April 2000; 85% completed the 6-month follow-up.


METHODS
Arm 1 received usual care. Arm 2 received a mailed computer-generated self-help magazine, individually tailored on survey items including stage of readiness to use condoms, barriers to condom use, partner type; condom samples and a condom-carrying case were included in the packet; this was followed 3 months later by a tailored 'booster' newsletter. The a priori 6-month main outcomes were percentage of women using condoms during the previous 3 months (overall and by partner type) and proportion of total episodes of intercourse during which condoms were used in the previous 3 months.


RESULTS
Relative to usual care, intervention group women reported significantly more condom use overall [adjusted odds ratio (OR), 1.86; 95% confidence interval (CI), 1.32-2.65; P = 0.0005] and with recent primary partners (OR, 1.97; 95% CI, 1.37-2.86; P = 0.0003). They also reported using condoms for a higher proportion of intercourse episodes (52.7% versus 47.9%; P = 0.05). Significantly more intervention women carried condoms, discussed condoms with partners, and had higher self-efficacy to use condoms with primary partners.


CONCLUSIONS
Tailored cognitive/behavioral minimal self-help interventions hold promise as HIV/STD prevention strategies for diverse populations of young at-risk women.
Scholes
Delia
D
Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA.
McBride
Colleen M
CM
Grothaus
Louis
L
Civic
Diane
D
Ichikawa
Laura E
LE
Fish
Laura J
LJ
Yarnall
Kimberly S
KS
D000328:Adult; D017280:Condoms; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D016015:Logistic Models; D009657:North Carolina; D016017:Odds Ratio; D010174:Pamphlets; D011446:Prospective Studies; D012306:Risk; D012648:Self Care; D016896:Treatment Outcome; D014861:Washington