Meta-Analyses of Communication Theories

Report: Assesses the validity of several current assumptions of behavior change theories on condom use, estimates impact of persuasive messages that recommend condom use, and presents knowledge on the impact of the different types of persuasive arguments (Albarracin, 2004).

This paper:

  • Investigates the effects of persuasive communications on psychological and behavioral changes
  • Distinguishes between the effect of message-based intervention on condom use from other interventions
  • Utilizes a large sample size to explore assumptions of behavior-change theories
  • Presents a systematic analysis of how communications designed to increase condom use influence different populations
  • Tests the validity of methodological recommendations relevant to behavior-change theories

Methods:

Authors 46 reports, published around 1991, which yielded 82 independent treatment groups and 29 independent control groups:

  • PsycINFO, Medline, Social Science Citation Index, and Dissertation Abstracts International were searched
  • 20 Journals available after 1985 and relevant to HIV and communication were assessed

Results:

  • Communications had no general effect on condom use
  • Effects of communication on condom use was heterogeneous across studies
    • There is a possibility that some arguments were effective at increasing condom use
  • Attitudes, norms, perceived control, and behavioral skills are likely to increase condom use
  • Factual information and arguments to induce perceived severity and vulnerability may have had little effect.
  • Use of behavioral processes increased linearly for most health problems.
  • Presenting information about HIV mechanism negatively correlated with change in condom use
  • Change in condom use was positively associated with:
    • Percentage male participants
    • Mean age
    • City population
    • Random (vs. nonrandom) assignment to conditions
    • Amount of payment received
    • Time between treatment and postest
    • Conducting formative research prior to the intervention
    • Targeting specific (vs. general) populations
    • Self-selection bias
    • Attrition rate
  • Change in condom use was negatively associated with:
    • Baseline level of condom use
    • Inclusion of middle or high school students
    • Percentage of non-sexually active participants
    • Presenting communication in schools (vs. other places)
    • Presenting communications in brochures, posters or print (vs. face-to-face or use of video)
  • Neither informing participants about the risks of HIV infection nor increasing their experience of HIV threat had a positive influence on condom use.
  • Messages that taught people condom-using skills had more effect than those that didn't.
    • It is unclear if increasing skills led to overcoming barriers related to condom use or if increasing skills increased self-efficacy and hence intentions.
  • Communication effectiveness was greater when participants had lower rates of condom use at baseline.

Results Summary:

  • Communications designed to increase condom use have psychological influences.
  • Communications produced small increases in desired attitudes and intentions toward condom use.
  • HIV-prevention communications had no generalized impact on perceived severity, susceptibility, negotiation skills or actual condom use.

Implications:

  • Communication content matters
  • Both communication practice and research benefit from explication of benefits of the effects of specific components of preventive interventions.
    • More complex experimental designs to allow conclusions about types of messages and interventions are needed.
  • Effectiveness of HIV-prevention communications depends on methodological factors of the intervention itself.