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Title: Evidence-based identification of key beliefs explaining infant male circumcision motivation among expectant parents in zimbabwe : targets for behavior change messaging
Authors: Montaño, DE
Tshimanga, M
Hamilton, DT
Gorn, G 
Kasprzyk, D
Keywords: Behavior change communication
Behavioral theory
Evidence based demand creation
Implementation science
Infant circumcision
Integrated behavioral model
Voluntary medical male circumcision (VMMC)
Issue Date: 2018
Publisher: Springer
Source: AIDS and behavior, 2018, v. 22, no. 2, p. 479-496 How to cite?
Journal: AIDS and behavior 
Abstract: Slow adult male circumcision uptake is one factor leading some to recommend increased priority for infant male circumcision (IMC) in sub-Saharan African countries. This research, guided by the integrated behavioral model (IBM), was carried out to identify key beliefs that best explain Zimbabwean parents’ motivation to have their infant sons circumcised. A quantitative survey, designed from qualitative elicitation study results, was administered to independent representative samples of 800 expectant mothers and 795 expectant fathers in two urban and two rural areas in Zimbabwe. Multiple regression analyses found IMC motivation among fathers was explained by instrumental attitude, descriptive norm and self-efficacyMergeCell while motivation among mothers was explained by instrumental attitude, injunctive norm, descriptive norm, self-efficacy, and perceived control. Regression analyses of beliefs underlying IBM constructs found some overlap but many differences in key beliefs explaining IMC motivation among mothers and fathers. We found differences in key beliefs among urban and rural parents. Urban fathers’ IMC motivation was explained best by behavioral beliefs, while rural fathers’ motivation was explained by both behavioral and efficacy beliefs. Urban mothers’ IMC motivation was explained primarily by behavioral and normative beliefs, while rural mothers’ motivation was explained mostly by behavioral beliefs. The key beliefs we identified should serve as targets for developing messages to improve demand and maximize parent uptake as IMC programs are rolled out. These targets need to be different among urban and rural expectant mothers and fathers.
ISSN: 1090-7165
EISSN: 1090-7165
DOI: 10.1007/s10461-017-1796-4
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