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9 YEAR AIDS SURVIVOR AT GEORGE MASON UNIVERSITY
PHOTO: Virginia Nguyen STORY: Christina Mennella . (April 30, 2007). Beating the Odds: Struggling With AIDS While Balancing School. Broadside, p. G12.
EPPM THEORY AND HIV PREVENTION
COURSE WORK:
BIS 490 HEALTH COMUNICATION PROJECT
JACK TURNER, GEORGE MASON UNIVERSITY
MENTORS:Dr. Nithya Muthuswamy
Dr. Xiaoquan Zhoa
READER : Dr. Michael Hurley
STATISTICS: Dr. Michael Hurley
Hillary Mcshea, TA
COURSE WORK:
HEALTH SCIENCES AND
COMMUNICATION
Accurate, Clear Communication about Health Issues
Design Persuasive Health Messages
Test Health Promotion on a Target Audience
MAIN POINTS
Background
Undergraduate Perceptions about HIV / AIDS
Promoting HIV / AIDS prevention
The Extended Parallel Process Model (EPPM)
Project Description
Health Communication Experiment DesignPurposeParticipants Procedure
Results of the Experiment
Limitations and Implications
Undergraduate Perceptions about
HIV / AIDS
Eight studies,1995-2007(Cambell & Babrow, 2004; Davis et al., 2007; Desiderado &
Crawford, 1995; Gagnon & Gidon, 2000; Grello et al., 2006; Labrie et al., 2002; Lance, 1999; Rothman, 1999)
Statistics may be outdated (Hightow et al., 2005).
Promoting HIV / AIDS Prevention
“Even with successful treatment, HIV is a debilitating and fatal disease.”
(Masur, 2002, Yuan, L’Italien, Mukherjee, &Iloeje, 2006 )
Use condoms every timeDe Vincenzi, I. (1994 )
Witte’s Extended Parallel Process Model (EPPM)
Witte, K. (. Putting the fear back in fear appeals. Communication
Monographs 59, 1992.
Figure: Witte, K., (1992)
▲▬▬▬►
▬▬▬►
▼
▬▬▬▬▬►
PHOTOS: Googleimages.com
PROCESS
PERCEIVED EFFICACY
COGNITIVE / LOGICAL
PERCEIVED THREAT
CAN I DEAL WITH IT?
CAN IT HURT ME?
▬▬▬▬▬►
DANGER CONTROL PROCESS
CARTOONS: Calvin & Hobbes Copyright 1988 Bill Watterson
FEAR CONTROL PROCESS
MESSAGE
FEARMESSAGE REJECTION
MESSAGE ACCEPTANCE
OUTCOME▬▬▬▬▬▬▬▬▬►MESSAGE PROCESSING▬▬▬►
Figure: Turner, J. (2008)
Purpose: Test an HIV / AIDS Fear Appeal
Measure Undergraduates’ Response
Six variables: Perceived severity and susceptibility Perceived response efficacy and self – efficacy Perceived fear Condom use intentions
Participants
Procedure: Poster Design and Questionnaire
Participants
PHOTO: Googleimages.com
High Efficacy Poster
DEALING WITH EMBARRASSMENT: IT HELPS TO KNOW WHERE TO BUY CONDOMS AND WHAT THEY ARE LIKE TO HANDLE. BUY SOME WITH A FRIEND. MAKE IT A GAME. LAUGH
ACCORDING TO DE VINCENZI'S STUDY, CONDOMS WERE 100% EFFECTIVE AGAINST HIV TRANSMISSION FROM AN INFECTED PARTNER 1
1 20 MONTH STUDY, 124 COUPLES. DIVENZI STUDY,1994
YOU CAN PREVENT HIV/AIDS
FEMALE CONDOMS ALSO AVAILABLE. MALE CONDOM SHOWN
TIPS FOR TALKING ABOUT CONDOMS:
CONDOMS: SIMPLE EASY AND HIGHLY EFFECTIVE AGAINST HIV
WHEN USED EVERYTIME 1
MIRROR
"I don't know how to use one."
"I do. I want us both to be safe. No glove, no
YOU CAN SAY:IF YOUR PARTNER SAYS:
" I don't use condoms"
START BY ACKNOWLEDGING EMBARRASSMENT: "THIS IS DIFFICULT FOR ME TO TALK ABOUT, BUT I WANT TO BE PROTECTED AGAINST SEXUALLY TRANSMITTED DISEASES
FOR MORE INFO ABOUT USING CONDOMS AND TALKING ABOUT CONDOMS: USE SEARCH TERM "TALKING ABOUT C
"I don't have any condoms." "The drugstore is around the corner."I do. Let me put it on for you."
"I wouldn't give you a disease. Don't you trust me?" "Either one of us could have an STD and not know it. I'm trusting you to care about our health."
THESE TIPS CAN HELP YOU PLAN YOUR TALK ABOUT CONDOMS. MAKE IT CLEAR
THAT YOU WON'T HAVE SEXUAL INTERCOURSE WITH
Besides, you're not going to feel anything without a condom."
"I can't feel anything. There's no sensitivity.""There are new designs that provide more sensation. We can have fun trying different kinds.
Poster Design: Turner, J. (2008)
High Threat Poster
MIRROR
TO YOUNG TO DIE FROM AIDS? THINK AGAIN:
COLLEGE-AGE DEATHS FROM AIDS IN THE
U.S. IN ONE YEAR: 1,386 2
ONE MILLION AMERICANS HAVE HIV.
250,000 OF THEM DO NOT KNOW IT1
CRYPTOCOCCOSIS / AIDS WASTING SYNDROME /AIDS
THIS COULD HAPPEN TO YOU: MAYBE IT’S HAPPENING ALREADY
YOU CAN BE INFECTED WITH HIV, THE VIRUS THAT CAUSES AIDS,
AND NOT HAVE SYMPTOMS 1
2 Center for Disease Control, Basic Statistics, 2005
AIDS: ACQUIRED IMMUNODEFIENCY SYNDROME, A DISEASE
AIDS IS A DEBILITATING, FATAL DISEASE 1
COLLEGE-AGE HIV INFECTIONS IN THE U.S. IN ONE YEAR: 3, 876 2
HIV: HUMAN IMMUNODEFICIENCY VIRUS. HIV CAUSES AIDS1
THAT DESTROYS THE IMMUNE SYSTEM.1
SEXUAL INTERCOURSE (NOT USING A CONDOM).1HIV IS TRANSMITTED PRIMARILY BY UNPROTECTED
1 National Institute of Allergy and Infectious Diseases ,2007
Poster Design: Turner, J. (2008)
Low Threat Poster
4 Gagnon and Gidon 2000 5 De Vincenzi Study,1994
3 National Institute of Allergy and Infectious Diseases ,2007
FOR MORE INFORMATION ON HEALTHY LIVING, CONTACT OR VISIT GEORGE MASON'S STUDENT HEALTH SERVICES, SUB I, ROOM 214
CONDOMS ARE HIGHLY EFFECTIVE AGAINST HIV INFECTION,
WHEN USED PROPERLY AND EVERY TIME, ACCORDING TO DEVINCENZI RESEARCH. 5
COLLEGE STUDENTS USE CONDOMS FREQUENTLY, ACCORDING TO GAGNON AND GIDON STUDY
1 Gayle, H.D., (1990). The New England Journal of Medicine
Kotloff, K.L, . (1991). American Journal of Epidemiology
REPORTED BY THE NEW ENGLAND JOURNAL OF MEDICINE AND AMERICAN JOURNAL OF EPIDEMIOLOGY 1
COLLEGE STUDENTS ARE SEVEN TIMES LESS LIKELY TO BE INFECTED THAN THE REST OF THE U.S. POPULATION , ACCORDING TO THE
NATIONAL HEALTH AND NUTRITION EXAMINATION STUDY 2
2National Health and Nutrition Examination Study, 2002
Mirror
Medical Research New Quick Test Devices
LOW HIV INFECTION RATE IN COLLEGE STUDENTS
HIV: HUMAN IMMUNODEFICIENCY VIRUS. HIV CAUSES AIDS3
AIDS: ACQUIRED IMMUNODEFIENCY SYNDROME3
Poster Design: Turner, J. (2008)
Fear Appeal
YOU CAN PREVENT HIV/AIDS
FEMALE CONDOMS ALSO AVAILABLE. MALE CONDOM SHOWN
TIPS FOR TALKING ABOUT CONDOMS:
CONDOMS: SIMPLE EASY AND HIGHLY EFFECTIVE AGAINST HIV
WHEN USED EVERYTIME 1
DEALING WITH EMBARRASSMENT: IT HELPS TO KNOW WHERE TO BUY CONDOMS AND WHAT THEY ARE LIKE TO HANDLE. BUY SOME WITH A FRIEND. MAKE IT A GAME. LAUGH
ACCORDING TO DE VINCENZI'S STUDY, CONDOMS WERE 100% EFFECTIVE AGAINST HIV TRANSMISSION FROM AN INFECTED PARTNER 1
1 20 MONTH STUDY, 124 COUPLES. DIVENZI STUDY,1994
MIRROR
FOR MORE INFO ABOUT USING CONDOMS AND TALKING ABOUT CONDOMS: USE SEARCH TERM "TALKING ABOUT C
"I don't have any condoms." "The drugstore is around the corner."I do. Let me put it on for you."
"I wouldn't give you a disease. Don't you trust me?" "Either one of us could have an STD and not know it. I'm trusting you to care about our health."
THESE TIPS CAN HELP YOU PLAN YOUR TALK ABOUT CONDOMS. MAKE IT CLEAR
THAT YOU WON'T HAVE SEXUAL INTERCOURSE WITH
Besides, you're not going to feel anything without a condom."
"I can't feel anything. There's no sensitivity.""There are new designs that provide more sensation. We can have fun trying different kinds.
"I don't know how to use one."
"I do. I want us both to be safe. No glove, no
YOU CAN SAY:IF YOUR PARTNER SAYS:
" I don't use condoms"
START BY ACKNOWLEDGING EMBARRASSMENT: "THIS IS DIFFICULT FOR ME TO TALK ABOUT, BUT I WANT TO BE PROTECTED AGAINST SEXUALLY TRANSMITTED DISEASES
MIRROR
2 Center for Disease Control, Basic Statistics, 2005
AIDS: ACQUIRED IMMUNODEFIENCY SYNDROME, A DISEASE
AIDS IS A DEBILITATING, FATAL DISEASE 1
COLLEGE-AGE HIV INFECTIONS IN THE U.S. IN ONE YEAR: 3, 876 2
HIV: HUMAN IMMUNODEFICIENCY VIRUS. HIV CAUSES AIDS1
THAT DESTROYS THE IMMUNE SYSTEM.1
SEXUAL INTERCOURSE (NOT USING A CONDOM).1HIV IS TRANSMITTED PRIMARILY BY UNPROTECTED
1 National Institute of Allergy and Infectious Diseases ,2007
ONE MILLION AMERICANS HAVE HIV.
250,000 OF THEM DO NOT KNOW IT1
CRYPTOCOCCOSIS / AIDS WASTING SYNDROME /AIDS
THIS COULD HAPPEN TO YOU: MAYBE IT’S HAPPENING ALREADY
YOU CAN BE INFECTED WITH HIV, THE VIRUS THAT CAUSES AIDS,
AND NOT HAVE SYMPTOMS 1
TO YOUNG TO DIE FROM AIDS? THINK AGAIN:
COLLEGE-AGE DEATHS FROM AIDS IN THE
U.S. IN ONE YEAR: 1,386 2
High Efficacy High Threat
Sample EPPM Questions
Perceived Severity of ThreatI think AIDS is a fatal disease.
Perceived Response Efficacy
I am protected against HIV infection if I use a condom during sex
1 2 3 4 5 Strongly Disagree Neutral Agree Strongly Disagree Agree
Muthuswamy, N. (2006); Witte, K.,
Meyer, A., & Martell, A. (2001).
Results of the Experiment
No Statistically Significant DifferenceSix variables Means and Differences
Gender and HIV SusceptibilitySignificant differenceP<.011
Sample Statistic: Means
CHART: Turner, J. (2008)
High Threat / High Efficacy
3.31
4.39
2.15
4.22
3.95
3.65
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
5.00
1
Six Variables
Med
ian S
core
ss
Fear
Severity
Susceptibility
Response Efficacy
Self-efficacy
Condom Intentions
Low Threat / Low Efficacy
2.9
4.3
2.1
4.1
3.73.6
Implications Posters alone may have little effect
Gender and perceived susceptibilityFemales are at much higher risk(National Institute of Allergy and Infectious Diseases [NIAID],
2006).
Longer duration HIV / AIDS programs
Posters can play an important role
GMU sample compared to others High perception of the severity of HIV / AIDSPartners and sexual activity
Limitations
Expected low fear / low concern population
Convenience sample
Short duration exposure
Male to female ratio
CDC REPORT AUGUST 2008
Hall, H.I. et al. (2008)
REFERENCESCampbell, R.G, & Babrow, A.S. (2004). The role of empathy in responses to
persuasive risk communication: overcoming resistance to HIV prevention messages. Health Communication 16.2, 159-182.
Dahl, D. W., Frankenberger, K, & Manchanda, R (2003). Does it pay to shock? of Advertising Research. 43.3, 268-280.
Davis, C., Sloan, M., MacMaster, S., & Kilbourne, B. (2007). HIV/AIDS knowledge and sexual activity: an examination of racial differences in a college sample. Healthand social work 32.3, 211-218.
Desiderato, L.L., & Crawford, H. (1995). Risky sexual behavior in college students: Relationships between number of sexual partners, disclosure of previous risky behavior, and alcohol use. Journal of Youth and Adolescence 24.1, 55-68.
De Vincenzi, I. (1994). A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. New England Journal of Medicine 331.6, 341-346.
Gagnon, M., & Godin, G. (2000). The impact of new retroviral treatments on college students’ intention to use a condom with a new sexual partner. AIDS Education and Prevention 12.3, 239-251.
Gayle, H.D., Keeling, R.P., Garcia-Tunon, M., Kilbourne, B.W., Narkunas, J.P., Ingram, F.R., & Rogers, M.F., et al. (1990). Prevalence of the human immunodefeciency virus among university students. The New England Journal of Medicine 323.22, 1538-1541.
REFERENCESGrello, C., Welsh, ED., & Harper, M. (2006). No strings attached: The nature of
casual sex in college students. The Journal of Sex Research 43.3, 255-267.
Hall, H.I. et al. (2008). Estimation of HIV incidence in the United States. Journal of the American Medical Association (JAMA) 300.5, 520-529.
Hightow, L.B., Macdonald, P.D., Pilcher, C.D., Kaplan, A.H., Foust, E., & Nguyen, T.Q., et al. (2005). The unexpected movement of HIV epidemic in the Southeastern United States. Journal of Acquired Immune Deficiency Syndrome 38.5, 531-537.
Kotloff, K.L., Tacket, C.O., Clemens, J.D., Wasserman, S.S., Cowan, J.E., & Bridwell, M.W., et al. (1991). Assessment of the prevalence and risk factors for human immunodeficiency virus type 1 (HIV-1) infection among college students using three survey methods. American Journal of Epidemiology 133. 1, 2-8.
Lance, Larry (2001). HIV/AIDS perceptions and knowledge heterosexual college students within the context of sexual activity: suggestions for the future. College Student Journal 35, 401-409.
Masur,H. (2002). Acquired immunodeficency syndrome in the intensive care unit: Will human immunodefiency virus-related admissions continue to decline? American Journal of Respiratory Critical Care. 166, 258-261.
Mennella, C. (April 30, 2007). Beating the odds: Struggling with AIDS while balancing school. Broadside, p. G12.
REFERENCESMcQuillan, G., Kottiri, B., & Kruszon-Moran, D. (2002). The prevalence of HIV in the
United States household population: The national health and nutrition examination surveys, 1988 to 2002.12th Conference on Retroviruses and Opportunistic Infections. February 22-25, 2005. Boston, MA. Abstract no. 166.
National Institute of Allergy and Infectious Diseases (NIAID) (2006). HIV infection in women. NIAID Fact Sheet, May 2006. Retrieved from NAIAD database November 22, 2008.http://www.niaid.nih.gov/factsheets/womenhiv.htm
Rothman, A., Kelly, K., Weinstein, N., O’Leary, A. (1999). Increasing the salienceof risky sexual behavior: Promoting interest in HIV-antibodies among heterosexually active young adults. Journal of Applied Psychology 29.3, 531-555.
Turk. T., Ewing, T.M., & Newton, F.J. (2006). Using ambient media to promote HIV/AIDS protective behavior change. International Journal of Advertising 25.3333-359.
Witte, K. (1992, December). Putting the fear back into fear appeals: The extended parallel process model. Communication Monographs 59.
Witte, K. (1994). Fear control and danger control: A test of the extended parallel process model (EPPM): Communication Monographs. 61,113-134.
Witte, K., Meyer, A., & Martell, A. (2001). Effective health risk messages. Thousand Oaks, CA: Sage Publications, Inc.
Yuan, Y., L’Italian, G., Mukherjee, J., Iloeje, UH (2006, April). HIV Medicine 7.3, 156-162,