Engaging Families in the Choice of Social Marketing Strategies for Male Circumcision Services in Johannesburg, South Africa

Abstract

Male circumcision (MC) prevents HIV acquisition in males, leading to calls for extensive implementation in sub-Saharan Africa. The widespread adoption of male circumcision will require social marketing targeted at various families and family members. The objective of this article is to demonstrate the utility of conjoint analysis in the choice of social marketing strategies tailored to different populations to promote male circumcision in Johannesburg, South Africa. Seven social marketing strategies for MC were identified through open-ended interviews ( n = 25). Preferences were assessed using conjoint analysis, implemented in a cross-sectional survey of randomly selected households. An oversampling strategy ensured balance between Blacks (34%), Coloreds (mixed-race; 32%), and Whites (34%). Respondents randomly received a block of 4 conjoint analysis tasks comparing 2 mutually exclusive and exhaustive subsets of the 7 strategies. Preferences were then evaluated using logistic regression stratified by ethnicity and family member. Whereas all strategies were attractive, television marketing, endorsement by church/school leaders, and a countrywide program were most preferred ( p < .0001). Stratified analyses identified heterogeneity, e.g., only Coloreds valued radio ( p < .0001) and a lasting presence in the community ( p < .0001). Within families, mothers and sons were most concordant for Blacks ( p < .05) and Coloreds ( p < .01), but fathers were most concordant with sons among Whites ( p <.05). Conjoint analysis provides valuable insight into preferences and can be used in the development of social marketing, especially when aimed at promoting behavioral change.

Designing Family-Centered Male Circumcision Services

“…Furthermore, our previous research on social marketing for MC services indicated that all races had a preference for a national approach that saw all South Africans receive a similar service. [15] Based on these results, we deemed that it would be politically incorrect to tailor MC services based on race, and hence this was not the focus of our study (although some key differences in attitudes by race are summarized).…”

“…[15] Despite the need for scale-up, there has been little written on the actual design of MC services and the preferences of decision makers for MC. We sought to identify design characteristics of MC services in Johannesburg, South Africa, and to estimate preferences for the identified characteristics.…”

Eliciting Preferences for HIV Prevention Technologies: A Systematic Review

“…Further, we re-classified some studies that were published as CA. Upon examination of their methods, we labeled them as DCE for this review, given their use of choice tasks comparing two or more profiles [27,[37][38][39][40]. "True" CA studies involved rating or ranking of profiles individually, rather than in head-to-head comparisons.…”

“…Of the 28 studies that employed DCE, several base statistical models were reported, including conditional logit (4, 14%) [27][28][29][30], multinomial logit (5, 18%) [31][32][33][34][35][36], ordinary least-squares regression (2, 7%) [37,38], and logistic regression (1) [39]. Three (11%) reported relative impor-tance scores [32,40,41].…”

Prioritizing strategies for comprehensive liver cancer control in Asia: a conjoint analysis

“…Stated-preference methods, such as conjoint analysis [45,46] and best-worst scaling (BWS) [47], offer a potentially superior alternative to simple rating and ranking methods as they ensure people have to make tradeoffs [43]. Furthermore, as these methods can utilize random utility theory (RUT), they are more consistent with economic [48] and psychological [49] theories of choice.…”