Is Facebook Effective in Preventing HIV/STDs in Scholarized Adolescents? A Cluster Rct

Research Article

Austin J HIV/AIDS Res. 2015; 2(2): 1016.

Is Facebook Effective in Preventing HIV/STDs in Scholarized Adolescents? A Cluster Rct

R Moretti¹*, M Cremaschini¹, G Brembilla¹, F Fenili¹, MN Gambirasio², M Valoti¹, M Bardus³, L Suzanne Suggs³ and G Barbaglio4

¹Lombardy Region, Local Health Authority of Bergamo, Health Promotion Service

²Policlinico S.Pietro, Unit of Internal Medicine. Ponte San Pietro Bergamo

³University of Italian Switzerland, Faculty of Communication Sciences

4Lombardy Region, Local Health Authority of Bergamo, Health Director

*Corresponding author: Roberto Moretti, Lombardy Region, Local Health Authority of Bergamo, Italy

Received: October 20, 2015; Accepted: October 26, 2015; Published: November 16, 2015

Abstract

Background: In Italy less than 60% of adolescents have a comprehensive knowledge on HIV/AIDS. Generally, there is an overestimation of the subjectively perceived knowledge on items related to AIDS that may have considerable implications on risk taking.

Purpose: The aim of this study was to evaluate a Facebook program on HIV and STDs prevention targeting a group of students attending high schools.

Design: The study implemented a “cluster randomized trial” design with two groups of classrooms: one received an educational intervention on Facebook and the second (control group) received no intervention.

Setting Participants: The sample included 405 students of aged 17.16 classrooms (265 students) participated in the intervention group and 8 classrooms (n=145) in the control group.

Intervention: The intervention lasted one month. Both intervention and control groups completed an anonymous questionnaire before and after the intervention.

Main Outcome Measures: A global index of knowledge on HIV/STD Prevention was measured in both intervention and control group.

Results: An increased level of knowledge was reported in both intervention and control groups. But the increase was significantly higher in the intervention cluster +7.1% than in the control one 1.8% (difference +5.3 two tailed p=0,0006).

Risk-Behaviors did not significantly change after the intervention, probably due to the short time-lag between intervention and evaluation.

Among the intervention group, at individual level, knowledge increased proportionally with the level of participation: + 6.2 among “low participants” and +9.3 among “intensive” participants.

Conclusion: Facebook intervention on the prevention of HIV / STDs for adolescents seems to be effective in improving the level of knowledge, feasible and has got a good appreciation by participants.

Key Points:

What is already known?

1. Risk knowledge on HIV is very poor in European adolescents.

2. Social Networks are widely used but their effectiveness in health promotion for HIV / STD prevention is unknown.

What this paper adds

1. Use of a structured Facebook educational program is effective in improving student’s knowledge on HIV prevention.

2. Social Network health promotion is promising and feasible by a public health institution.

Keywords: HIV/AIDS; Social networks; Health promotion; Effectiveness; Adolescents

Introduction

According to the UNAIDS global Report 2011, less than 60% of adolescents in Europe have a comprehensive knowledge on HIV/ AIDS. Generally, there is an overestimation of the subjectively perceived knowledge on items related to AIDS that may have considerable implications on risk behaviors of adolescents. Although, even if sex education programs have a modest impact on behaviors, such effects could be important at a population level if the programs were largely scaled up [1]. Web 2.0 and social networking could be useful tools to scale up and reach large segments of the population. Using social media for promoting health behaviors among young people could be an important opportunity if educational programs are responding to specific needs, program contents are interesting and their presentation is attractive. Public Health organizations working in health promotion could exploit the interaction and the exponential growth of contacts (viral spread) typical of social networks [2] to enhance correct lifestyles among young generations.

Worldwide, the penetration of Web 2.0 applications, and especially social networking sites, has been growing. Among social networking sites, Facebook is the most widely diffused with 552 million daily active users and 955 million monthly active users at the end of June 2012. In our country, there are about 22 million Facebook users, representing the 73.1% of the online population (Social bakers, 2012), and 13% of people aged 13-17. Facebook is the preferred social network of Italian teenagers. In the age group of 12-18, Facebook is used by 85.6% of the population and about 30.8% have more than 500 Facebook friends. 68.8% of teenagers use Facebook every day: 32.2% for 1-2 hours, 14.4% from 2-5 hours and 3.9% more than 5 hours a day.

Thus, a health intervention based on Facebook could certainly offer high reach, but it could also be cost-effective, as the utilization of built-in features allows time and money savings in the management of the intervention. For example, Facebook provides a set of interactive tools (surveys, polls, events, videos, links, tags, educational games, chatting with specialists, case studies, etc.) to enhance and articulate interventions customized and tailored to individual’s needs. Moreover, students can interact and play an active role by posting contents and providing feedback. Furthermore, the co-creation of content through the involvement of the target audience in various activities could leverage the workload of health professionals and create an environment that better meets the needs of the population.

While the potential of Facebook and other Web 2.0 and social networking sites can be effective for promoting health particularly HIV/STD prevention, the data supporting this hypothesis are not yet clear although a recent cluster randomized trial on social mediadelivered sexual health intervention [3] showed to be effective in improving the use of condoms:. Some studies show that blogging and watching online videos are associated with better outcomes in class performance and education [4-6]. Few studies discuss the need of skill development and training for health personnel involved in the development and implementation of these programs [7-10].

The aim of this study was to evaluate a HIV/AIDS and STD prevention program delivered on Facebook. The program targeted a group of teenaged students attending high schools and “professionaltechnical The aim of this study was to evaluate a HIV/AIDS and STD prevention program delivered on Facebook. The program targeted a group of teenaged students attending high schools and “professionaltechnical” schools (i.e., a practical and work oriented secondary school in the Italian system) in the province of Bergamo. We were interested in both summative and process outcomes, of both participants of the program as well as public health officials who developed and implemented the program.

The study aimed to answer the following research questions

1) Can a public health program addressed to adolescents on Facebook be effective in enhancing comprehensive and correct knowledge on HIV/AIDS and STD as well as HIV and STD risk behaviors?

2) Would users of an HIV/AIDS and STD prevention program delivered on Facebook like receiving and participating in such a program using this channel?

3) Could such a program could be feasible for a Public Health institution?

Methods

Design

To evaluate the effectiveness of the Facebook intervention at increasing knowledge on HIV/AIDS/STDs as a determinant of risky sexual behaviors, the study implemented a “cluster randomized trial” design with two groups of classrooms: one received an educational intervention on Facebook and the second (control group) received no intervention. Cluster randomization was performed at classroom level, so that the risk of bias due to potential information exchanges among participants from same classroom was reduced. 30 classes were identified, 16 classes were randomly assigned in the intervention group and 12 in the control group, (4 classes in the control group dropped after randomization and did not fulfill the initial questionnaire). The final analysis was performed in 16 intervention classes and 8 control classes.

Randomization of classes was performed with Epi (Table 1) program, by generating random numbers list. The intervention was not blind; searchers knew the classes’ allocation.

Citation: Moretti R, Cremaschini M, Brembilla G, Fenili F, Gambirasio MN, Valoti M, et al. Is Facebook Effective in Preventing HIV/STDs in Scholarized Adolescents? A Cluster Rct. Austin J HIV/AIDS Res. 2015; 2(2): 1016. ISSN : 2380-0755