Adaptation, acceptability, and piloting of “Usando Condón”. An intervention for increasing perceived male condom use self-efficacy among Mexican adolescents

Abstract

Introduction: Adolescents are a vulnerable group to acquire sexually transmitted infections and to experience a pregnancy. This can be prevented through theory-based interventions on male condom use self-efficacy. The goal of the present study is the adaptation, acceptability evaluation and pilot testing of an intervention, to increase perceived male condom use self-efficacy among Mexican adolescents.

Method: A three-stage intervention adaptation model (evaluation, preparation and implementation) compounded of five steps (completed up to the four step) was used: 1) reviewing the literature to identify theory-based interventions for increasing condom use perceived self-efficacy, and authors contact; 2) two interventions were selected for the adaptation process; 3) preparation of the interventions content to be applicable to Mexican adolescents (language, activities and information modification); the intervention “Usando Condón” was piloted in a sample of 56 adolescents belonging to a public high school in Puebla. Intervention acceptability was qualitatively assessed and analyzed through thematic analysis. The outcome variable (self-efficacy) was measured through a specific Mexican adolescent’s scale. Self-efficacy levels were compared after the intervention (test and re-test).                      

Results: The adapted intervention used the core components of the interventions that served as basis for the adaptation process (HIV/AIDS, condom use [beliefs, negotiation, access, benefits, consequences of using it, modeling] and gender roles). Cognitive mapping, story examples and condom use modeling through anatomical penis models were used. Information was updated and information on emergency contraception was added. Scenarios and doses of the primary interventions were modified, resulting in “Usando Condón” a 2-sessions intervention of 90 minutes each for Mexican adolescents, implemented by nurses. The intervention assistance was 100%. The intervention was qualitatively acceptable by the participants, suggesting minor modifications regrading to the technological support tools, content, and activities. Student's t test showed significant changes between measurements before and after the intervention exposition (p <.05).                       

Discussion or Conclusion: “Usando Condón” can be implemented by previously trained health professionals and in similar contexts, considering that it needs constant evaluation and adaptation according to the population’s characteristics. Additionally, preliminary results suggest that the intervention increases the male condom use perceived self-efficacy levels among Mexican adolescents.