What are mass media interventions made of? Exploring the active content of interventions designed to increase HIV testing in gay men within a systematic review

Abstract

Purpose Mass media HIV testing interventions are effective in increasing testing, but there has been no examination of their theory or behaviour change technique (BCT) content. Within a heterogeneous body of studies with weak evaluative designs and differing outcomes, we attempted to gain useful knowledge to shape future interventions. Methods Within a systematic review, following repeated requests to the authors of included studies for intervention materials, the Theory Coding Scheme, the Theoretical Domains Framework (TDF), and Behaviour Change Technique Taxonomy (BCTT) were used to extract data relating to active intervention content. Results Of 19 studies, five reported an explicit theoretical basis to their intervention. TDF analysis highlighted the key domains employed within the majority of interventions: ‘knowledge’, ‘social roles and identities’, and ‘beliefs about consequences’. BCT analysis showed three BCT groupings commonly reported within interventions: ‘Comparison of outcomes’, ‘Natural consequences’, and ‘Shaping knowledge’. Three individual BCTs formed the backbone of most interventions and can be considered ‘standard’ content: ‘Instructions on how to perform behaviour’; ‘Credible source’; and ‘Information about health consequences’. Conclusions This is the first study to examine and detail active intervention content in this field. It suggests future interventions should improve knowledge about testing, and use well‐branded and trusted sources that endorse testing. Future interventions should also provide clear information about the health benefits of testing. Our analysis also suggests that to improve levels of effectiveness characterizing the current field, it may be useful to elicit commitment, and action plans, relating to how to implement testing intentions. Statement of contribution What is already known on this subject? Interventions are urgently needed to increase HIV testing among men who have sex with men (MSM) and enable increased access to effective treatment for HIV infection. There is some evidence of the effectiveness of mass media interventions in increasing HIV testing among MSM. Nothing is known about the active components of existing mass media interventions targeting HIV testing. What does this study add? It describes the available literature concerning evaluated mass media interventions to increase HIV testing. It shows few interventions report any explicit theoretical basis although many interventions share common components, including coherently connected causal mechanisms and behaviour change techniques to moderate them. As a minimum, future interventions should improve knowledge about testing; use well‐branded and trusted sources that endorse testing; and provide clear information about the health benefits of testing. Our analysis also tentatively suggests it may be useful to elicit commitment and planning of how to implement testing intentions.

Mass media and communication interventions to increase HIV testing among gay and other men who have sex with men: Social marketing and visual design component analysis

“…The current paper is part of a series of papers presenting findings from a systematic review exploring evidence related to mass media and communication interventions to increase HIV testing among GBMSM. More detailed analysis relating to intervention effectiveness (McDaid et al, 2019), the active content of interventions (Flowers et al, 2019) and affect used within interventions (Langdridge et al, 2020) can be found elsewhere. The current analyses employed rigorous data extraction tools to attempt to identify the common social marketing principles and visual design elements associated with effectiveness across a range of HIV testing campaigns.…”

“…The current paper is part of a series of papers presenting findings from a systematic review exploring evidence related to mass media and communication interventions to increase HIV testing among GBMSM. More detailed analysis relating to intervention effectiveness ( McDaid et al, 2019 ), the active content of interventions ( Flowers et al, 2019 ) and affect used within interventions ( Langdridge et al, 2020 ) can be found elsewhere.…”

“…The current study was part of a systematic review of mass media and communication interventions for HIV testing with GBMSM conducted globally. Here we describe the social marketing and visual component analysis, conducted alongside a review of effectiveness and behaviour change component analysis, reported elsewhere ( Flowers et al, 2019 ; McDaid et al, 2019 ). The following paper aims to describe the social marketing and visual design components commonly found in HIV testing campaigns and furthermore to determine what social marketing and visual design components are linked to effectiveness (evidence of clear behaviour change in the desired direction, i.e.…”

Association Between Public Knowledge About COVID-19, Trust in Information Sources, and Adherence to Social Distancing: Cross-Sectional Survey

“…Previous research has shown that trust in sources is an essential component associated with both individual understanding of information and willingness to act on it [ 12 ]. Additionally, research in China has shown that people vary in their risk perception of COVID-19 depending on whether they received information from mass media or social media [ 13 ].…”

A qualitative examination of affect and ideology within mass media interventions to increase HIV testing with gay men garnered from a systematic review

“…The broader systematic review from which the data for this study have been garnered has sought to utilize a pluralistic approach to better understand intervention content and its relationship to effectiveness. To date, we have examined effectiveness per se (McDaid et al , 2019), behaviour change techniques and theoretical domains (Flowers et al , 2016), and the social marketing, mode of delivery, and use of imagery focusing upon the social position of the viewer and context of viewing (Riddell et al , under review). In contrast to these analyses, the focus in the present study is on an analysis of the cultural determinants of visual materials, as visual materials provide one of the primary means for the encoding of affect within mass media oriented health communications (Langdridge, Davis, et al , 2019; Noar, Francis, et al ., 2016).…”