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      The Saleema initiative in Sudan to abandon female genital mutilation: Outcomes and dose response effects

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          Abstract

          Purpose

          The overall goal of the Saleema Initiative in Sudan is to promote long-term abandonment of female genital mutilation and cutting (FGM) through a contribution to changing social norms, attitudes, and intentions related to the practice. The initiative aims to create positive cultural associations with a girl remaining uncut, a new social norm. Saleema hypothesizes that branding the alternative to FGM (abandonment) will promote social norms change. In 2014, the lead author designed a monitoring and evaluation framework for Saleema in partnership with UNICEF, the National Council for Child Welfare (NCCW), and local organizations.

          Methods

          The Saleema evaluation aimed to evaluate the effectiveness of the campaign in reducing pro-FGM social norms. A quasi-experimental design controlled for dosage of campaign messages delivered across the 18 states in Sudan to measure a dose-response effect. We operationalized social norms through a 4-item scale validated in previous research.

          Results

          This paper reports on quantitative evaluation findings based on data gathered in from 2015–2017 and focuses on the dose-response relationship between Saleema exposure and changes in FGM social norms. We found that self-reported exposure was associated with reduced pro-FGM social norms (coeff. = -0.329, p < .001). Additionally, higher doses of Saleema, measured through an exogenous measure of campaign event exposure from an independent monitoring system was associated with reduced pro-FGM social norms (coeff. = -0.146, p < .001).

          Conclusions

          Saleema was effective in reducing pro-FGM social norms. It is a promising strategy and findings contribute to the growing literature on social norms approaches to behavior change.

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          Most cited references 19

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          How T.V. Advertising Works: A Meta-Analysis of 389 Real World Split Cable T.V. Advertising Experiments

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            Descriptive Social Norms as Underappreciated Sources of Social Control

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              Evidence of a dose-response relationship between "truth" antismoking ads and youth smoking prevalence.

              In early 2000, the American Legacy Foundation launched the national "truth" campaign, the first national antismoking campaign to discourage tobacco use among youths. We studied the impact of the campaign on national smoking rates among US youths (students in grades 8, 10, and 12). We used data from the Monitoring the Future survey in a pre/post quasi-experimental design to relate trends in youth smoking prevalence to varied doses of the "truth" campaign in a national sample of approximately 50000 students in grades 8, 10, and 12, surveyed each spring from 1997 through 2002. Findings indicate that the campaign accounted for a significant portion of the recent decline in youth smoking prevalence. We found that smoking prevalence among all students declined from 25.3% to 18.0% between 1999 and 2002 and that the campaign accounted for approximately 22% of this decline. This study showed that the campaign was associated with substantial declines in youth smoking and has accelerated recent declines in youth smoking prevalence.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draft
                Role: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Formal analysis
                Role: InvestigationRole: Project administration
                Role: InvestigationRole: Project administration
                Role: ConceptualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                12 March 2019
                2019
                : 14
                : 3
                Affiliations
                [1 ] Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America
                [2 ] Child Protection Unit, UNICEF, Khartoum, Sudan
                [3 ] Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, United States of America
                [4 ] Gender and Rights Advocacy Center, Ahfad University for Women, Khartoum, Sudan
                [5 ] Independent Research, Khartoum, Sudan
                Mälardalen University, SWEDEN
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Article
                PONE-D-18-28549
                10.1371/journal.pone.0213380
                6413931
                30861029
                © 2019 Evans et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 0, Tables: 4, Pages: 14
                Product
                Funding
                Funded by: UNICEF (US)
                Award ID: 43191913
                Award Recipient :
                This study was funded by UNICEF. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Social Sciences
                Sociology
                Sexual and Gender Issues
                Female Genital Mutilation
                People and Places
                Geographical Locations
                Africa
                Sudan
                Social Sciences
                Sociology
                Social Research
                Social Sciences
                Sociology
                Human Families
                Social Sciences
                Sociology
                Communications
                Marketing
                Advertising
                Social Sciences
                Sociology
                Communications
                Marketing
                Social Sciences
                Sociology
                Culture
                Medicine and Health Sciences
                Public and Occupational Health
                Behavioral and Social Aspects of Health
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

                Uncategorized

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