Identification of Key Beliefs Explaining Male Circumcision Motivation Among Adolescent Boys in Zimbabwe: Targets for Behavior Change Communication
This study examined specific factors that explain adolescent boys’ level of motivation to undergo male circumcision (MC) in Zimbabwe. It applied the Integrated Behavioral Model (IBM) as the theoretic framework. The IBM focuses on six constructs. Three constructs are determinants of intention, specifically attitude, social influence, and personal agency. Each of these constructs includes two further components: experiential attitude (one’s emotional or affective response to the idea of performing the behavior) and instrumental attitude (beliefs about positive or negative consequences or attributes of the behavior). The study included a questionnaire development phase and a cross-sectional survey to quantitatively measure the issues identified in the qualitative phase to explain circumcision intention. The survey was administered to 802 13–17-year-old adolescent boys in two urban and two rural areas. The findings suggested that communication interventions to increase MC uptake among adolescent boys may be most effective if they target all six IBM constructs/components. Messaging focused on reducing HIV risk would not be effective in increasing adolescents’ intention to get circumcised. The study demonstrated the application of theory-driven research as a systematic approach for identifying beliefs to address through behavior change messaging, the authors said. They suggested that incorporating findings into communication campaigns is likely to improve demand for MC.