VOICES/VOCES: Video Opportunities for Innovative Condom Education

The Research

The Science Behind the Package

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VOICES/VOCES is a single-session, video-based HIV/STD prevention program designed to encourage condom use and improve condom negotiation skills. The program is based on the theory of reasoned action, which explains how behaviors are guided by attitudes, beliefs, experiences, and expectations of other persons’ reactions. VOICES/VOCES is grounded in extensive formative research exploring the culture- and gender-based factors that can facilitate behavior change. An evaluation of the intervention showed that VOICES/VOCES is effective when delivered at a “teachable moment,” for instance when a visit to an STD clinic may motivate a person to change behavior.

Target Population
African-American and Latino adult men and women clinic clients

Health educators convene groups of 4-8 clinic patients in a room that allows privacy for discussion. Groups are gender- and ethnic-specific, so that participants can develop prevention strategies appropriate for their culture. Information on HIV risk behaviors and condom use is delivered by videos, facilitated group discussion, and a poster board presenting features of various condom brands in English and Spanish. Two culturally specific videos are used: one for African American participants and a bilingual video for Latinos. Skills in condom use and negotiation are modeled in the videos, then role-played and practiced by participants during the discussion that follows. At the end of the single 45-minute session, participants are given samples of the types of condoms they have identified as best meeting their needs.

Research Results
After the VOICES/VOCES intervention participants had:

  • Increased knowledge about the transmission of HIV and other STDs
  • A more realistic assessment of their personal risk
  • Greater likelihood of getting condoms and intending to use them regularly
  • Fewer repeat STD infections

For Details on the Research Design
O’Donnell LN, San Doval A, Duran R, and O’Donnell C. (1995). Video-based sexually transmitted disease patient education: Its impact on condom acquisition. American Journal of Public Health, 85(6), 817-822.

The Intervention

A Package Developed from Science
Replicating Effective Programs (REP) is a CDC-initiated project that supports the translation of evidence-based HIV/AIDS prevention interventions into everyday practice, by working with the original researchers in developing a user-friendly package of materials designed for prevention providers. VOICES/VOCES is one of the REP interventions. The VOICES/VOCES intervention package is the product of extensive collaboration among researchers, health department officials, and representatives from community-based HIV, STD, and family planning service organizations. The package was refined through pilot testing in community-based clinics, with non-research staff at these sites helping to identify key strategies for implementation. VOICES/VOCES is meant to supplement, rather than supplant, existing services.

Core Elements
Core elements are intervention components that must be maintained without alteration to ensure program effectiveness.

The core elements of VOICES/VOCES include:

  1. Viewing culturally specific videos portraying condom negotiation
  2. Convening small group skill-building sessions to work on overcoming barriers to condom use
  3. Educating program participants about different types of condoms and their features
  4. Distributing samples of condoms identified by participants as best meeting their needs

Package Contents

  • Preview Guide of materials for agency administrators
  • Bilingual (English/Spanish) planning and implementation manual for program staff
  • Bilingual (English/Spanish) condom feature poster board displaying a variety of commercially available condoms and descriptions of their unique features
  • Two videos developed specifically for the VOICES/VOCES intervention: Porque Sí targeting Latino men and women, and Love Exchange, targeting African Americans

Timeline for Availability
The intervention package is available in Spanish and bilingual (English, Spanish) versions. Packages are available from CDC along with training on program implementation and technical assistance.

For More Information on the VOICES/VOCES Package
To find out more about future trainings, please visit Effective Interventions.