Yuki Imamatsu, Yuka Iwata, Ayuka Yokoyama, Yuko Tanaka, Etsuko Tadaka
Empowering Community Health Workers in Japan: Determinants of Non-Communicable Disease Prevention Competency
Healthcare (Basel, Switzerland)
communitylevel interventions may helpful populationfocused hiv prevention members populations risk hiv infection popular members engaged advocate benefits behaviour change peers decreases risk behaviour may possible assessed communitylevel intervention lower risk hiv infection focusing men patronising gay bars eight small us citieswe used randomised communitylevel field design four cities received intervention four control cities participants men city went gay bars men completed surveys sexual behaviour entering bars 3night periods baseline 1year followup control cities hiv educational materials placed bars intervention cities recruited popular homosexual men community trained spread behaviourchange endorsements recommendations peers conversationpopulationlevel risk behaviour decreased significantly intervention cities compared control cities 1year followup exclusion surveys completed transients men exclusive sexual partners citylevel analysis intervention cities found reduction mean frequency unprotected anal intercourse previous 2 months baseline 168 occasions followup 059 p 004 increase mean percentage occasions anal intercourse protected condoms baseline 447 followup 668 p 002 increased numbers condoms taken dispensers interventioncity bars corroborated riskbehaviour selfreportspopular wellliked members community systematically endorse recommend riskreduction behaviour influence sexualrisk practices others social networks natural styles communication conversations brought populationlevel changes risk behaviour