title: A randomized controlled trial to evaluate a structural intervention to promote the female condom in New York state.
abstract: We conducted a structural intervention to promote the female condom (FC), comparing 44 agencies randomized to a Minimal Intervention (MI) [developing action plans for promotion and free access] or an Enhanced Intervention (EI) [with the addition of counselor training]. Intervention effects were evaluated via surveys with agency directors, counselors and clients at baseline and 12 months. Agency-level outcomes of the FC did not differ between the two interventions at follow-up. Counselors in the EI showed significantly greater gains in FC knowledge and positive attitudes, although there was no difference in the proportion of clients counseled on the FC, which significantly increased in both conditions. There was a greater increase in intention to use the FC among clients in EI agencies. Intervention effects were stronger in medical agencies. Findings suggest that making subsidized FCs available and assisting agencies to formulate action plans led to increased FC promotion. Limitations and implications for future research and intervention efforts are discussed.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive (Unit 15), New York, NY 10032, USA.
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Exner
authors.forename: James M
authors.initials: JM
authors.lastname: Tesoriero
authors.forename: Haven B
authors.initials: HB
authors.lastname: Battles
authors.forename: Susie
authors.initials: S
authors.lastname: Hoffman
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mantell
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Correale
authors.forename: Jessica
authors.initials: J
authors.lastname: Adams-Skinner
authors.forename: Dara A
authors.initials: DA
authors.lastname: Shapiro
authors.forename: Kirsten
authors.initials: K
authors.lastname: Rowe
authors.forename: Richard A
authors.initials: RA
authors.lastname: Cotroneo
authors.forename: Cheng-Shiun
authors.initials: CS
authors.lastname: Leu
authors.forename: Joyce
authors.initials: J
authors.lastname: Hunter
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D019111:Single-Use Internal Condom; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009518:New York / Q000453:epidemiology; D040242:Risk Reduction Behavior; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult