Environmental/Behavioral Factors Shaping Circumcision Decisions in Zimbabwe

影响津巴布韦包皮环切决定的环境/行为因素

基本信息

项目摘要

DESCRIPTION (provided by applicant): Male circumcision (MC) has been clearly demonstrated to substantially reduce female to male transmission of HIV, and there is evolving consensus that MC should be included as a strategy in comprehensive HIV prevention programs (WHO/UNAIDS, 2006; WHO/UNAIDS, 2007; MOHCW, 2007). International agencies, programs, and countries are considering how to implement broad-based MC programs. Experts recommend that the countries where implementation should have highest priority are those where HIV is hyperendemic (HIV prevalence > 15%), infection is spread mainly through heterosexual transmission, and where a large proportion of men (e.g., > 80%) are not circumcised. Zimbabwe is such a country and is considering development of an MC program. Critical to the success of such a program is research to determine factors affecting the implementation, while maintaining successful HIV prevention strategies. We propose to use a strong theoretical model as a framework to investigate environmental (capacity, structure, culture) and individual (attitude, normative, personal agency) factors influencing motivation regarding MC-related behaviors among four key groups in Zimbabwe: policy makers, clinicians, adolescent and adult men, and expectant parents and parents of adolescent boys. Applying a framework adapted from Jaccard, et al (2002) and the Integrated Behavioral Model (IBM) we will carry out the research in four main steps: 1) Qualitative interviews conducted with each group will be used to identify salient issues relevant to each construct in the model with respect to MC behaviors; 2) Quantitative surveys, designed based on qualitative results, will be administered to representative samples of each study group, and analyses will identify the most important factors affecting MC-related behavior motivation for each group; 3) Survey results will be used to design educational messages to motivate MC behavior for each study group, and message testing will be carried out to assess acceptability and impact on behavioral motivation; 4) Results provided to Zimbabwe policy-makers will serve as the basis for designing a comprehensive MC program that is likely to be effective. This research will be carried out by a team of investigators who have developed a collaborative research team in Zimbabwe. Data collection will be done in two urban and two rural areas, including both major ethnic groups, and thus will maximize inclusion of all perspectives of people who would be impacted by an MC program. If a policy decision is made to implement an MC program in Zimbabwe, this study will provide key information on how to motivate clinicians to encourage MC among their male patients and parents with adolescent boys. The research will assess the acceptability and potential demand for MC, and determine training needs. It will allow the Ministry of Health and Child Welfare (MOHCW) to prioritize the target groups for MC, based on MC acceptability and health system capacity. In sum, this research will provide vital information for the MOHCW in Zimbabwe to plan the roll out and dissemination of a MC program. PUBLIC HEALTH RELEVANCE: Male circumcision (MC) has been demonstrated to substantially reduce female to male transmission of HIV, so there is evolving consensus that MC should be implemented in countries where HIV is hyperendemic (HIV prevalence > 15%), infection is spread mainly through heterosexual transmission, and where a large proportion of men (e.g., > 80%) are not circumcised. The proposed research will investigate environmental and individual factors influencing motivation for or against MC-related behaviors among four key groups in Zimbabwe: policy makers, clinicians, adolescent and adult men, and expectant parents and parents of adolescent boys. Findings will provide vital information for Zimbabwe policy-makers to plan the roll out and dissemination of a MC program and maximize likelihood of success.
说明(由申请人提供):男性包皮环切术(MC)已被明确证明可以显着减少女性向男性的艾滋病毒传播,并且人们逐渐达成共识,认为包皮环切术应作为一项战略纳入艾滋病毒综合预防规划中(世界卫生组织/联合国艾滋病规划署,2006年;世界卫生组织/联合国艾滋病规划署,2007年;卫生部,2007年)。国际机构、项目和国家正在考虑如何实施基础广泛的 MC 项目。专家建议,最优先实施的国家是艾滋病毒高流行(艾滋病毒感染率> 15%)、感染主要通过异性性传播以及大部分男性(例如> 80%)未接受包皮环切术的国家。津巴布韦就是这样一个国家,正在考虑制定MC计划。该计划成功的关键是研究以确定影响实施的因素,同时保持成功的艾滋病毒预防策略。我们建议使用强大的理论模型作为框架来调查影响津巴布韦四个关键群体MC相关行为动机的环境(能力、结构、文化)和个人(态度、规范、个人代理)因素:政策制定者、临床医生、青少年和成年男性、准父母和青春期男孩的父母。应用改编自 Jaccard 等人 (2002) 的框架和综合行为模型 (IBM),我们将分四个主要步骤进行研究: 1) 对每个小组进行定性访谈,以识别与模型中每个构造有关 MC 行为的显着问题; 2)根据定性结果设计的定量调查将对每个研究组的代表性样本进行分析,并分析确定影响每个组的MC相关行为动机的最重要因素; 3)调查结果将用于设计教育信息以激励每个研究组的MC行为,并进行信息测试以评估可接受性和对行为动机的影响; 4) 向津巴布韦政策制定者提供的结果将作为设计可能有效的全面MC计划的基础。这项研究将由在津巴布韦组建合作研究小组的研究人员团队进行。数据收集将在两个城市和两个农村地区进行,包括两个主要民族,因此将最大限度地包容受 MC 计划影响的人们的所有观点。如果津巴布韦做出实施 MC 计划的政策决定,这项研究将提供有关如何激励临床医生鼓励男性患者和有青春期男孩的父母进行 MC 的关键信息。该研究将评估 MC 的可接受性和潜在需求,并确定培训需求。它将允许卫生和儿童福利部 (MOHCW) 根据 MC 的可接受性和卫生系统的能力,优先考虑 MC 的目标群体。总之,这项研究将为津巴布韦卫生部规划推出和传播 MC 计划提供重要信息。公共卫生相关性:男性包皮环切术 (MC) 已被证明可以大幅减少女性向男性的 HIV 传播,因此,人们逐渐达成共识,认为应在 HIV 高流行(HIV 感染率 > 15%)、感染主要通过异性传播传播以及大部分男性(例如 > 80%)未接受包皮环切术的国家实施 MC。拟议的研究将调查影响津巴布韦四个关键群体支持或反对MC相关行为动机的环境和个人因素:政策制定者、临床医生、青少年和成年男性、准父母和青春期男孩的父母。研究结果将为津巴布韦政策制定者提供重要信息,以规划 MC 计划的推出和传播并最大限度地提高成功的可能性。

项目成果

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DANIEL E MONTANO其他文献

DANIEL E MONTANO的其他文献

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{{ truncateString('DANIEL E MONTANO', 18)}}的其他基金

Tracking Risk Compensation Over Time in a National MC Roll-Out in Zimbabwe
跟踪津巴布韦国家 MC 推广中随时间推移的风险补偿
  • 批准号:
    8209596
  • 财政年份:
    2011
  • 资助金额:
    $ 62.92万
  • 项目类别:
Tracking Risk Compensation Over Time in a National MC Roll-Out in Zimbabwe
跟踪津巴布韦国家 MC 推广中随时间推移的风险补偿
  • 批准号:
    9001425
  • 财政年份:
    2011
  • 资助金额:
    $ 62.92万
  • 项目类别:
Tracking Risk Compensation Over Time in a National MC Roll-Out in Zimbabwe
跟踪津巴布韦国家 MC 推广中随时间推移的风险补偿
  • 批准号:
    8680369
  • 财政年份:
    2011
  • 资助金额:
    $ 62.92万
  • 项目类别:
Tracking Risk Compensation Over Time in a National MC Roll-Out in Zimbabwe
跟踪津巴布韦国家 MC 推广中随时间推移的风险补偿
  • 批准号:
    8877311
  • 财政年份:
    2011
  • 资助金额:
    $ 62.92万
  • 项目类别:
Tracking Risk Compensation Over Time in a National MC Roll-Out in Zimbabwe
跟踪津巴布韦国家 MC 推广中随时间推移的风险补偿
  • 批准号:
    8333346
  • 财政年份:
    2011
  • 资助金额:
    $ 62.92万
  • 项目类别:
Tracking Risk Compensation Over Time in a National MC Roll-Out in Zimbabwe
跟踪津巴布韦国家 MC 推广中随时间推移的风险补偿
  • 批准号:
    8502381
  • 财政年份:
    2011
  • 资助金额:
    $ 62.92万
  • 项目类别:
Environmental/Behavioral Factors Shaping Circumcision Decisions in Zimbabwe
影响津巴布韦包皮环切决定的环境/行为因素
  • 批准号:
    7753143
  • 财政年份:
    2009
  • 资助金额:
    $ 62.92万
  • 项目类别:
Environmental/Behavioral Factors Shaping Circumcision Decisions in Zimbabwe
影响津巴布韦包皮环切决定的环境/行为因素
  • 批准号:
    8207943
  • 财政年份:
    2009
  • 资助金额:
    $ 62.92万
  • 项目类别:
Environmental/Behavioral Factors Shaping Circumcision Decisions in Zimbabwe
影响津巴布韦包皮环切决定的环境/行为因素
  • 批准号:
    7623001
  • 财政年份:
    2009
  • 资助金额:
    $ 62.92万
  • 项目类别:
PRIMARY CARE PROVIDERS' ROLE IN HIV/STD PREVENTION
初级保健提供者在艾滋病毒/性病预防中的作用
  • 批准号:
    2416076
  • 财政年份:
    1995
  • 资助金额:
    $ 62.92万
  • 项目类别:
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