This meta-analysis tested the major theoretical assumptions about behavior change by examining the outcomes and mediating mechanisms of different preventive strategies in a sample of 354 HIVprevention interventions and 99 control groups, spanning the past 17 years. There were 2 main conclusions from this extensive review. First, the most effective interventions were those that contained attitudinal arguments, educational information, behavioral skills arguments, and behavioral skills training, whereas the least effective ones were those that attempted to induce fear of HIV. Second, the impact of the interventions and the different strategies behind them was contingent on the gender, age, ethnicity, risk group, and past condom use of the target audience in ways that illuminate the direction of future preventive efforts.
Keywords behavior change; active intervention; HIV; health; communicationThe development of effective health behavior interventions and adequate understanding of the processes that underlie change to risky behavior continues to top the agenda for reducing disease and death among at-risk populations. For example, infection with HIV has been diagnosed in almost 1 million people in the United States (Centers for Disease Control [CDC], 2003) as well as an estimated 40 million worldwide (UNAIDS/ WHO Working Group, 2002). In some countries, the epidemic continues to escalate, and even in nations that have successfully
Copyright 2005 by the American Psychological AssociationCorrespondence concerning this article should be addressed to Dolores Albarracín, Department of Psychology, University of Florida, Gainesville, FL 32611. E-mail: E-mail: dalbarra@ufl.edu.
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NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript curbed the spread of the disease, certain groups still show increases in infection rates (see, e.g., CDC, 2003). Given these distressing figures, it is no surprise that research on HIV prevention has become increasingly important and progressively more sophisticated. Indeed, HIV prevention presently constitutes one of the most significant paradigms for the discovery of health behavior change techniques and for the understanding of the theoretical processes that underlie such change.In fact, the HIV epidemic of the 1980s stimulated the uniting of funds and expertise from various disciplines in the development of a shared behavior-change paradigm. As a key example, in 1992, a group of behavioral researchers joined forces-upon request from the National Institutes of Health-to develop a paradigm for behavior change that would guide research and practice in the prevention of HIV (see Fishbein et al., 1992). Various models were examined, and the key assumptions were condensed into a limited number of premises that illuminated preventive efforts.Although the various models had independently received broad support, this support was derived almost entirely from behavior prediction studies. However, the formulation of these general assumptions contributed to...