The evaluation of the Woman’s Condom marketing approach: What value did peer-led interpersonal communication add to the promotion of a new female condom in urban Lusaka?

Abstract

During a mass media campaign accompanying the launch of the Maximum Diva Woman’s Condom (WC) in Lusaka, Zambia, a cluster-randomized evaluation was implemented to measure the added impact of a peer-led interpersonal communication (IPC) intervention on the awareness and uptake of the new female condom (FC). The WC and mass media campaign were introduced simultaneously in 40 urban wards in April 2016; half of the wards were randomly assigned to the treatment (IPC intervention) with cross-sectional surveys conducted before (n = 2,364) and one year after (n = 2,430) the start of the intervention. A pre-specified intention-to-treat (ITT) analysis measured the impact of randomization to IPC at the community level. In adjusted ITT models, there were no statistically significant differences between intervention and control groups. Due to significant implementation challenges, we also conducted exploratory secondary analyses to estimate effects among those who attended an IPC event (n = 66) using instrumental variable and inverse probability weighting analyses. In addition to increases in FC identification (IPC attendees had higher reported use of any condom, improved perceptions of FC’s, and were more likely to have discussed contraceptive use with their partner as compared to non-attendees). The introduction of a new FC product combined with an IPC intervention significantly increased general knowledge and awareness in the community as compared to media alone, but did not lead to detectable community level impacts on other primary outcomes of interest. Observational evidence from our study suggests that IPC attendance is associated with increased use and negotiation. Future studies should explore the intensity and duration of IPC programming necessary to achieve detectable community level impacts on behavior.Trial Registration: AEARCTR-0000899

The Urban Environment and Disparities in Sexual and Reproductive Health Outcomes in the Global South: a Scoping Review

“…Some programs leveraged behavior change approaches and a range of communication strategies. One evaluation adopted a peer-led interpersonal communication (IPC) approach to increase awareness and uptake of a new inner condom and found that this was a useful strategy to change norms and perceptions to increase acceptability and uptake [69]. Another program found text reminders to be effective in encouraging contraceptive uptake and clinic visits; however, effects were concentrated among women under 25 who may be more digitally engaged [70] though another found no effect of interactive text messages on patient retention for HIV care in Kenya [71].…”