Prevention Options for Women Equals Rights POWER Summary of the Prevention Options for Women Equals Rights Project Sheana Bull Tom Evans Samuel Posner Charlene Ortiz Jana Sczersputowski Sherri Varnell Stephanie Phibbs Lili Whittaker Lillian Lin Brenda Beaty Lee Sherman James Ortiz

POWER Summary POWER tests the efficacy of a condom social marketing campaign to increase knowledge of, improve attitudes towards and increase use of female as well as male condoms for women aged 15-25 (primarily African American and Latina)

POWER Summary We have a pre post design in 12 neighborhoods in four cities; six neighborhoods were randomly selected to implement the campaign. We completed cross-sectional baseline data collection in all 12 neighborhoods in 2004. The campaign ran in six communities starting in October 2004 and continuing through April 2005

POWER sampling We used a time-space sampling approach, one that yields a probability sample. For data collection, we identified 363 likely places to find and intercept 15-25 year old African American and Latina women across all neighborhoods; we generated 622 unique Venue-Day-Time increments (VDT) We randomly selected VDTs and attended those venues at that time to recruit and enroll women in the data collection efforts.

POWER field staff Walking the Talk! Lived in study neighborhoods Baseline: 46 Follow-up: 32 Diverse: age, gender, ethnicity Referrals from community ‘Gatekeepers’ Referrals from staff Walking the Talk!

Baseline findings Recruitment: “Clicked” 16,478 women Approached 10,136 women 6122 (60%) agreed to complete eligibility screener 4032 were eligible; 3437 (85%) completed a survey; 3407 were useable

Baseline Demographics Characteristic Proportion (%) Age 15-17 42 18-19 20 20-25 38 Race African American 34 Ethnicity Latino/Hispanic Age appropriate years in school 66

Campaign Activities East LA Ingle-wood Las Vegas Ocean-side Lake-view Mission Total # Displays 111 120 115 45 51 125 561 # Brochures distributed 8814 9755 8529 9494 3590 6420 46,602 # purses redeemed 209 361 217 244 266 344 1641 Purses/ brochures 2.3 3.7 2.5 7.4 5.3 3.5

Follow-up findings Recruitment: 12,183 women “clicked” 6682 approached (55% of those clicked) 4228 screened (64% of those approached) 3290 eligible (70% of those screened) 3036 agreed to survey 3130 completed a survey; 3007 were useable

Follow-up demographics Characteristic Proportion (%) Age 15-17 42 18-19 19 20-25 40 Race African American 35 Ethnicity Latino/Hispanic Age appropriate years in school 79

Primary outcomes We saw no neighborhood effects--there were no differences in awareness, attitudes or use of male and female condoms between women in campaign neighborhoods and comparison There was no change in awareness, attitudes and use from baseline to follow-up across neighborhoods

Exposure to Campaign

Awareness of Female Condoms Women who had seen our posters had more frequently seen and read information on female condoms

Awareness of Male Condoms Women who had seen our posters had more frequently read information on male condoms--no differences observed in having seen male condoms * *differences not significant

Use of Female Condoms More women seeing our posters had ever used a Female Condom and more had used one the last time they had sex

Use of Male Condoms More women seeing our posters had ever used a Male Condom and more had used one the last time they had sex

Use of Condoms Last Sex Variable OR P-value Seen POWER 1.55 0.01 Age 20-25 0.56 <0.0001 Condom Intention 1.24 0.003 Positive Expectations 1.23 0.0004 Negative Expectations 0.75 Other variables in this model that were not significant included younger age and race/ethnicity

POWER exposure and outcomes Awareness of POWER (0=none, 4+=most) 1 2 3 4+ N 307 272 410 210 205 Seen info on Female Condoms 25.3 67.4 72.0 83.3 88.3 Seen Female Condom 43.6 76.3 75.5 85.6 86.3 Read info on Male Condoms 79.9 90.6 93.2 97.1 97.0 Ever Used Male Condom 88.1 90.4 91.4 94.6 93.9 Positive Outcome Expectancies 3.22 3.21 3.3 3.4

Additional findings Although a larger proportion of women in campaign neighborhoods saw the campaign than women in comparison neighborhoods (14% vs. 9%), we believe many women from comparison neighborhoods were exposed to the campaign

Making sense of it all Campaign appears to work at the individual but not the neighborhood level Increase campaign coverage to get saturation? What other secular trends are occurring? So what now? Dissemination? Further Research?