What is the Extent of Theory in Computer-Based Sexual Health Promotion Interventions?

• Main Author: Christine Cassidy
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2015-10-01
• Series: Frontiers in Public Health
• Subjects: Computer Simulation; Sexually Transmitted Diseases; sexual health; Secondary analysis; Theory Coding Scheme
• Online Access: http://journal.frontiersin.org/Journal/10.3389/conf.FPUBH.2016.01.00106/full

Background: Sexual health is a critical component of health and well-being that remains a public health challenge, with many sexual health interventions having mixed success at preventing sexually transmitted infections (STIs) and HIV/AIDS (1). One strategy in ensuring greater success of sexual health interventions is to use behavior change theory as a guide for the development and implementation of interventions. Behaviour change theory allows for greater understanding of the intrinsic and extrinsic factors that influence an individual’s motivations for change (2). Some studies have shown that interventions are more likely to succeed when theory is used in the development and implementation process (3–7). However, many researchers continue to use theory as a loose framework without explicitly applying or testing it (8). Currently, it is unknown how behaviour change theory is used in computer-based sexual health interventions. Aim: To investigate a systematic review on computer-based sexual health promotion interventions to determine the extent that behaviour change theory is used to inform, develop, and test the interventions. Methods: We conducted an in-depth secondary analysis of a Cochrane review on computer-based interventions for sexual health promotion (1) to determine the extent that behaviour change theory was used to inform, develop, and test the interventions. The extent and type of theory use was assessed using the Theory Coding Scheme (TCS) − a reliable method for assessing the extent to which behavioural interventions are theory-based (8). Two independent coders conducted the analysis. Data were extracted and grouped according to the six categories outlined by the Theory Coding Scheme. Results: The findings suggest that over half of the primary studies (n=9) mention theory in the background to the study. Fewer studies (n=6) used the theory or predictors of behaviour to design the intervention or to select intervention recipients. While some studies discussed the results in relation to theory (n=4), no studies provided support or refutation of the theory or attempted to refine the existing theory. Conclusion: This secondary analysis demonstrates an in-depth method for examining the extent to which behavioural interventions are theory-based. The coding of theory in these studies suggests that behaviour change theory is not used extensively in the development or testing of computer-based sexual health interventions. The studies that used theory yielded more significant results. Moving forward, further efforts are needed to develop explicit links between the theory, mechanisms or action, and study outcomes.