Intervention Description
Intervention Package Information
Evaluation Study and Results
References and Contact Information
Intervention Description
Target Population
African American and Hispanic STD clinic patients
Goals of Intervention
- Prevent new STD infections
- Increase condom use
Brief Description
VOICES/VOCES is a single-session,
culturally specific, video-based
intervention for STD clinic patients.
The small group session (3-8 patients)
is gender and ethnic matched and is
conducted by a gender-matched
facilitator in either English or
Spanish. Groups of participants first
review one of the culturally appropriate
STD prevention videos, “Let’s Do
Something Different” for African
Americans and “Porque Si” for
Hispanics. Both videos provide accurate
risk information and corrected
misinformation, portray positive
attitudes about condom use, and model
gender- and culturally-specific
strategies for encouraging condom use.
Interactive group discussions following
the video reinforce the STD and HIV
prevention message. Participants are
encouraged to talk about problems they
have experienced when trying to use
condoms and discuss strategies to
increase condom use. All participants
are offered a selection of free condoms
at the clinic and a coupon for free
condoms at an area pharmacy. |
Theoretic Basis
- Health Belief Model
- Theory of Reasoned Action
Intervention Duration
One 20-minute video followed by one
25-minute group discussion session
Intervention Settings
Inner-city public STD clinic
Deliverer
Gender-matched facilitators
Delivery Methods
- Video
- Group Discussion
- Risk Reduction Supplies
(condoms)
- Printed Materials
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Intervention Package Information
An intervention package was developed with funding from CDC’s Replicating
Effective Programs (REP) Project. The intervention package and training are
available through CDC’s
Diffusion of
Effective Behavioral Interventions (DEBI) project.
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Evaluation Study and Results
The original evaluation study was
conducted in the South Bronx, New York City
between 1991 and 1994.
Key Intervention Effects
- Reduced new STD infections
Study Sample
The baseline study sample of 3,348 STD clinic patients is characterized by
the following:
- 62% African American, 38%
Hispanic
- 60% Male, 40% Female
- Mean age of 30 years
- 56% completed high school
education
Recruitment Settings
Inner-city public STD Clinic
Eligibility Criteria
STD clinic patients were eligible if they
were over the age of 17 and were registered
at the clinic during the study period
Assignment Method
Clinic days were randomized to 1 of 3 groups: Video + Group
Discussion intervention, Video Only
intervention, or comparison. The resulting
proportions of participants assigned to each
group were 30%, 30% and 40%, respectively.
Comparison Group
The comparison group received regular
STD clinic services, free condoms, and a
condom coupon which could be redeemed at an
area pharmacy.
Relevant Outcomes Measured and Follow-up Time
New STD infections were monitored
using the disease surveillance database for
a period of 1 to 24 months with an average
of 17 months follow-up.
Participant Retention
Passive follow-up was conducted by matching patient record to the
notifiable disease surveillance database
maintained by the New York City Department
of Health, suggesting approximate 100%
success rate of matching records.
Significant Findings
Analyses pooled data from both
VOICES/VOCES interventions (Video +
Group Discussion and Video Only) to test
intervention effects:
- The rate of new STD infections over
a 24-month period was significantly
lower among men receiving the
intervention than men in the comparison
group (p < .04).
- Among men who had multiple sex
partners at baseline, the intervention
groups had a significantly lower rate of
new STD infections over a 24-month
period compared to the comparison group
(p < .025).
Considerations
- Both Video Only and Video + Group Discussion interventions are highlighted
here because the analyses combined both groups when compared to the
comparison group and there were no significant differences in rates of new
STD infections between the two intervention groups.
- The VOICES/VOCES interventions are effective in reducing new STD
infections among men, but not among women. However, a more recent
effectiveness trial of the VOICES/VOCES Video + Group Discussion
intervention demonstrated a significant intervention effect on reducing new
STD infections among men and women combined (p < .01), and particularly for
women (p < .001).
- VOICES/VOCES participants were significantly more likely to
redeem their coupon for free condoms at a private pharmacy than comparison
participants (p < .05). The intervention effect on condom redemption was
found to be significant when comparing Video Only and Video + Discussion
intervention groups separately to the comparison group.
- When comparing Video Only and Video + Discussion intervention groups
separately to the comparison group, the significant intervention effect on
condom redemption was observed for each of the following subgroups:
African-American men, African-American women, Hispanic men, and Hispanic
women (all p’s < .05).
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References and Contact Information
- O'Donnell, C. R., O'Donnell, L., San Doval, A., Duran, R., & Labes, K. (1998). Reductions in STD infections subsequent to an STD clinic visit: Using video-based patient education to supplement provider interactions. Sexually Transmitted Diseases, 25, 161-168.
- O'Donnell, L. N., San Doval, A., Duran, R., & O'Donnell, C. (1995). Video-based sexually transmitted disease patient education: Its impact on condom acquisition. American Journal of Public Health, 85, 817-822.
- Neumann, M.S., O'Donnell, L., Schillinger, J., San Doval, A., Blank, S., & O'Donnell, C. (2007). Results of an Effectiveness Trial to Evaluate a Replication of the VOICES/VOCES/VOCES HIV Prevention Intervention. [Abstract]. 2007 National HIV Prevention Conference.
Researcher: Dr. Lydia O'Donnell
Education Development Center Inc.
55 Chapel Street
Newton, MA 02458-1060
email: lodonnell@edc.org
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