A Randomized Controlled Trial to Evaluate a Structural Intervention to Promote the Female Condom in New York State
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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.
KeywordsFemale condom HIV prevention Structural intervention United States
This research was supported by a grant from NIMH (NIMH; R01-MH078770; Theresa M. Exner, PhD, Principal Investigator). The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University is supported by a center grant from the National Institute of Mental Health (P30-MH43520; Principal Investigator: Anke A. Ehrhardt, PhD). We thank the women and men who participated in this study. We also acknowledge the contributions of our collaborators, particularly Alma R. Candelas and Nkechi Oguaghe of the AIDS Institute, who assisted with agency matching and recruitment; Zena Stein, who facilitated buy-in and contributed conceptually to the study; and the Professional Development Program, Rockefeller College, University at Albany, State University of New York, who were central to intervention development and training, particularly Lisa Skill and Linnaea Scavone. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NationaI Institute of Mental Health, the New York State Department of Health, the New York State Psychiatric Institute, or Columbia University.
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