ABSTRACT
OBJECTIVE: The meta-analysis reported here examined interventions informed by the theory of planned behavior (TPB) or theory of reasoned action (TRA) aimed at reducing heterosexual risk behaviors (prevention of STDs and unwanted pregnancy). METHODS: Studies were eligible for inclusion if they were either randomized control trials or quasi-experimental studies that compared the TPB-based intervention against a control group. Search strategy consisted of articles identified in previous reviews, keyword search through search engines, examination of key journals, and contacting key experts. RESULTS: Forty-seven intervention studies were included in the meta-analysis. Random effects models revealed that pooled effect sizes for TPB-based interventions had small but significant effects on behavior and other secondary outcomes (i.e., knowledge, attitudes, normative beliefs, perceived behavioral control, and intentions). Significant heterogeneity found between effect sizes was explored using metaregression. Larger effects were found for interventions that provided opportunities for social comparison. CONCLUSIONS: The TPB provides a valuable framework for designing interventions to change heterosexual risk behaviors. However, effect sizes varied quite substantially between studies, and further research is needed to explore the reasons why.
Subject(s)
Health Promotion/methods , Heterosexuality/psychology , Psychological Theory , Risk Reduction Behavior , Female , Humans , Pregnancy , Pregnancy, Unwanted , Randomized Controlled Trials as Topic , Sexually Transmitted Diseases/prevention & controlABSTRACT
Gonorrhoea is currently the second most common bacterial sexually transmitted infection in England and Wales (Public Health Laboratory Service, 2002). Early initiation of treatment is important in the reduction of the onward transmission of infection and contributes to the overall control of the spread of gonorrhoea. A central tenet of this is the use of effective antimicrobial treatment. Both global and local surveillance programmes have successfully generated robust data, identifying the prevalence of antimicrobial resistance when using fluoroquinolones, formerly a first-line treatment for genital infection with Neisseria gonorrhoeae. As a result of this evidence base, the first-line treatment recommendations in England and Wales were changed. It is now recommended that anogenital gonorrhoea is treated with third generation cephalosporins, with either a 400 mg single oral dose of cefixime, or a single intramuscular dose of ceftriaxone 250 mg. This change in 2004 in first-line treatment exemplifies the application and delivery of evidence-based treatment and care.
