Research Activities, January 2014
Social marketing campaign may not improve adherence to antiretroviral therapy
A variety of educational efforts are used to improve medication adherence among individuals with HIV infection. Despite these efforts, adherence to antiretroviral therapy is difficult and remains suboptimal for a number of patients. Social marketing interventions are now being used to change behavior by appealing to cultural sensibilities, group identity, and social norms.
A new study measured the results of a 5-month, clinic-wide, social marketing campaign designed to improve medication adherence in this group. The intervention did not increase adherence levels over the short term. However, those individuals who were more engaged in the campaign did experience some increases in adherence.
First, 31 clinic patients were asked to participate in focus groups, where they worked on possible slogans, materials, and ideas for the social marketing campaign. The input resulted in a campaign that was peer-to-peer in its approach, had positive messages, and used multimedia elements at the clinic. The campaign was called "Live the Solution: Take Your Pills Every Day." Mentors were videotaped sharing their stories about how they became successful with adherence, and the video was played on the televisions in the clinics' waiting rooms about 3 times a day. Other elements included posters, pens, mugs, and slogan lapel buttons for staff to wear.
To evaluate the impact of the intervention, 141 participants self-reported their medication adherence over a 4-week period, and responded to pre- and post-campaign surveys. Most participants had positive impressions of the campaign, including the video and posters. The majority (86 percent) said the intervention made it "easy" to take pills every day. However, self-reported adherence did not improve. Adherence actually declined more for patients with more than 3 visits to the clinic compared to those with less than 3 visits. No significant differences in adherence were noted based on exposure to individual campaign elements. Participants who correctly identified the campaign's slogan and who were more engaged, however, had some small non-significant increases in adherence.
Future social marketing campaigns aimed at adherence may need to include take-home components and broader interventions to make them successful. The study was supported in part by AHRQ (HS16093).
See "Effect of a clinic-wide social marketing campaign to improve adherence to antiretroviral therapy for HIV infection," by Thomas P. Giordano, M.D., M.P.H., Sonia Rodriguez, B.S., Hong Zhang, Ph.D., and others in AIDS Behavior 17, pp. 104-112, 2013.