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      Enhancing condom use experiences among young men to improve correct and consistent condom use: feasibility of a home-based intervention strategy (HIS-UK)

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          Abstract

          Background

          Condoms remain the main protection against sexually transmitted infections (STIs) when used correctly and consistently. Yet, there are many reported barriers to their use such as negative attitudes, reduced sexual pleasure, fit-and-feel problems and erection difficulties. The UK home-based intervention strategy (HIS-UK) is a behaviour change condom promotion intervention for use among young men (aged 16–25 years) designed to increase condom use by enhancing enjoyment of condom-protected intercourse. The objective of this feasibility study was to test HIS-UK for viability, operability and acceptability. Along with an assessment of the recruitment strategy and adherence to the intervention protocol, the study tested the reliability and suitability of a series of behavioural and condom use outcome measures to assess condom use attitudes, motivations, self-efficacy, use experience, errors and problems and fit and feel.

          Methods

          The HIS-UK intervention and associated assessment instruments were tested for feasibility using a single-arm, repeated measures design with baseline measurement and two follow-up measurements over 3 months. A 3-month target of 50 young men completing the baseline questionnaire was set. Twenty process and acceptability evaluation interviews with participants and health promotion professionals were conducted post trial.

          Results

          Of the 61 young men who registered for the study, 57 completed the baseline questionnaire and 33 met with the study researcher to receive the HIS-UK condom kit. Twenty-one young men remained for the duration of the study (64% retention). The Cronbach’s alpha scores for the condom use outcome measures were 0.84 attitudes, 0.78 self-efficacy, 0.83 use experience, 0.69 errors and problems and 0.75 fit and feel. Participant and health professional feedback indicated strong acceptability of the intervention.

          Conclusions

          The feasibility study demonstrated that our recruitment strategy was appropriate and the target sample size was achieved. Adherence was favourable when compared to other similar studies. The condom use measures tested proved to be fit-for-purpose with good internal consistency. Some further development and subsequent piloting of HIS-UK is required prior to a full randomised controlled trial, including the feasibility of collecting STI biomarkers, and assessment of participant acceptance of randomisation.

          Trial registration

          Research registry, RR2315, 27th March 2017 (retrospectively registered).

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          Most cited references20

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          A systematic review of the effect of retention methods in population-based cohort studies

          Background Longitudinal studies are of aetiological and public health relevance but can be undermined by attrition. The aim of this paper was to identify effective retention strategies to increase participation in population-based cohort studies. Methods Systematic review of the literature to identify prospective population-based cohort studies with health outcomes in which retention strategies had been evaluated. Results Twenty-eight studies published up to January 2011 were included. Eleven of which were randomized controlled trials of retention strategies (RCT). Fifty-seven percent of the studies were postal, 21% in-person, 14% telephone and 7% had mixed data collection methods. A total of 45 different retention strategies were used, categorised as 1) incentives, 2) reminder methods, repeat visits or repeat questionnaires, alternative modes of data collection or 3) other methods. Incentives were associated with an increase in retention rates, which improved with greater incentive value. Whether cash was the most effective incentive was not clear from studies that compared cash and gifts of similar value. The average increase in retention rate was 12% for reminder letters, 5% for reminder calls and 12% for repeat questionnaires. Ten studies used alternative data collection methods, mainly as a last resort. All postal studies offered telephone interviews to non-responders, which increased retention rates by 3%. Studies that used face-to-face interviews increased their retention rates by 24% by offering alternative locations and modes of data collection. Conclusions Incentives boosted retention rates in prospective cohort studies. Other methods appeared to have a beneficial effect but there was a general lack of a systematic approach to their evaluation.
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            Development and validation of a condom self-efficacy scale for college students.

            This study proposed to develop and validate a scale for the college population that measures self-efficacy in using condoms. The Condom Use Self-Efficacy Scale (CUSES) was derived from several sources and consisted of 28 items describing an individual's feelings of confidence about being able to purchase condoms, put them on and take them off, and negotiate their use with a new sexual partner. This scale was administered to a sample of 768 college students. It was found to possess adequate reliability (Cronbach's alpha = .91; test-retest correlation = .81) and correlated well with the Attitude Toward the Condom Scale (r = .51) and the Contraceptive Self-Efficacy Scale for women (r = .55). Our scale also correlated with a measure of intention to use condoms (r = .40) but was unrelated to a measure of social desirability. Students who differed on measures of previous condom use as well as on sexual intercourse experience also showed significant differences on this scale in the expected direction, indicating evidence of this scale's discriminant validity. The potential uses of this scale in a college population are discussed, along with the issues underlying condom usage self-efficacy.
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              What sample sizes for reliability and validity studies in neurology?

              Rating scales are increasingly used in neurologic research and trials. A key question relating to their use across the range of neurologic diseases, both common and rare, is what sample sizes provide meaningful estimates of reliability and validity. Here, we address two questions: (1) to what extent does sample size influence the stability of reliability and validity estimates; and (2) to what extent does sample size influence the inferences made from reliability and validity testing? We examined data from two studies. In Study 1, we retrospectively reduced the total sample randomly and nonrandomly by decrements of approximately 50 % to generate sub-samples from n = 713-20. In Study 2, we prospectively generated sub-samples from n = 20-320, by entry time into study. In all samples we estimated reliability (internal consistency, item total correlations, test-retest) and validity (within scale correlations, convergent and discriminant construct validity). Reliability estimates were stable in magnitude and interpretation in all sub-samples of both studies. Validity estimates were stable in samples of n ≥ 80, for 75 % of scales in samples of n = 40, and for 50 % of scales in samples of n = 20. In this study, sample sizes of a minimum of 20 for reliability and 80 for validity provided estimates highly representative of the main study samples. These findings should be considered provisional and more work is needed to determine if these estimates are generalisable, consistent, and useful.
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                Author and article information

                Contributors
                n.stone@soton.ac.uk
                c.a.graham@soton.ac.uk
                s.anstee@soton.ac.uk
                hsx536@coventry.ac.uk
                hsx414@coventry.ac.uk
                roger.ingham@soton.ac.uk
                Journal
                Pilot Feasibility Stud
                Pilot Feasibility Stud
                Pilot and Feasibility Studies
                BioMed Central (London )
                2055-5784
                7 March 2018
                7 March 2018
                2018
                : 4
                : 63
                Affiliations
                [1 ]ISNI 0000 0004 1936 9297, GRID grid.5491.9, Centre for Sexual Health Research, Department of Psychology, , University of Southampton, ; Southampton, UK
                [2 ]ISNI 0000000106754565, GRID grid.8096.7, Centre for Advances in Behavioural Science, , Coventry University, ; Coventry, UK
                Author information
                http://orcid.org/0000-0003-0995-8699
                Article
                257
                10.1186/s40814-018-0257-9
                5842531
                885dfed2-ee01-4dd0-a762-4460455faecb
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 November 2017
                : 22 February 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100009187, Medical Research Foundation;
                Award ID: MR/M026191/1
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                condom,condom use,fit and feel,intervention,sexual health,sexually transmitted infections,behaviour change,health promotion,young men,feasibility

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