Behavioral Decision Research Intervention Reduces Risky Sexual Behavior

Abstract

Although adolescents are at disproportionate risk for sexually transmitted infections, most sex education programs have shown little effect on sexual behavior. An interactive video intervention developed by our team has been identified as one of a few programs that have been documented to reduce sexually transmitted infections in this population. Building on behavioral decision research, we used a mental models approach to interview young women about their sexual decisions, finding, among other things, the strong role of perceived social norms. We based our intervention on these results, aiming to help young women identify and implement personally and socially acceptable decision strategies. A randomized controlled trial found that the video reduced risky sexual behavior and the acquisition of chlamydia infection. We recently revised the video to suit more diverse audiences, and upgraded it to modern standards of cinematography and interactivity. It is now in field trial.

New perspectives for motivating better decisions in older adults

“…The second example of a mental models intervention pertains to an interactive video that targeted young women’s sexual decisions ( Downs et al, 2004 , in press ; Bruine de Bruin et al, 2007a ). Among other things, the intervention focused on teaching recipients the skills and confidence needed to negotiate risk mitigation with their sexual partners, because interviews with young women indicated that this was one of their main concerns.…”

Interactive Narrative in a Mobile Health Behavioral Intervention (Tumaini): Theoretical Grounding and Structure of a Smartphone Game to Prevent HIV Among Young Africans

“…Built on the science of decision-making [3], Seventeen Days , like Tumaini , seeks to help adolescents develop proficiency in identifying and evaluating risk situations before their exposure to them. It is distinctive for the emphasis it places on cognitive rehearsal.…”

“…They need help in identifying new risk situations to which they will be exposed and in which gendered pressures—structural, normative, group, and interpersonal—constrain their ability to make healthy choices. Prominent cultural scripts may leave them feeling little control over sexual situations [2,3], and they may need to learn how to exercise agency. Ideally, they need opportunities to prepare for potential risk situations through interventions informed by behavioral theory that allow them to build and practice skills.…”

“…A growing number of group interventions for HIV prevention among adolescents have shown efficacy in a randomized controlled trial (RCT) in a high-resource country. However, such interventions may face adaptation and implementation challenges, including the high cost of facilitator-led group sessions and their poor record of translation from RCT to community setting [3]; these challenges may be magnified in low-resource settings.…”

Reflections on an interdisciplinary collaboration to inform public understanding of climate change, mitigation, and impacts

“…Before she met Granger, Wändi's main interdisciplinary project had focused on developing a video intervention for reducing sexually transmitted infections in female adolescents (10,11). The team, led by psychologist Julie Downs, consisted of social scientists and medical doctors.…”