A Direct Mailing to Teenage Males About Condom Use: Its Impact On Knowledge, Attitudes and Sexual Behavior.

Summary

In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males 16-17 years of age. An experimental design was used to measure the impact of the mailing on teenagers' knowledge, attitudes and behavior. Approximately five weeks after the mailing, 985 members of this group and 1,033 members of the control group (who received no mailing) were interviewed by telephone. About seven months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about three-fourths of the teenagers in the experimental group had received the materials, and about two-thirds had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy and contracepti ves. On the other hand, there were no differences between males in the experimental and control groups in attitudes toward STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to first intercourse, suggesting a possibly important early intervention.

Introduction

In this country, efforts to combat unintended pregnancy and the spread of STDs have focused primarily upon sex education in the schools and upon the provision of services through family planning clinics and STD clinics. Thus far, organizations concerned with teenage pregnancy and STDs have placed very little emphasis on the marketing of contraceptives. There has in fact been surprisingly little research on marketing initiatives in this area: promising direct-mail experiments in Chicago in 1962, (1) an advertising experiment in four American cities in 1971, (2) a direct mailing to welfare mothers in 1972, (3) a direct mailing to teenagers in 1974 (4) and a promising test of radio messages to promote vasectomies in 1977. (5) Little other such research is reported in the literature.

During the last decade, a number of organizations have tried related (but different) types of efforts, such as media campaigns. Nonprofit organizations such as the Center for Population Options and the Children's Defense Fund and governmental agencies such as the City of New York, the Ounce of Prevention in Illinois and the federal Office of Family Planning have developed poster campaigns for communities or public service announcements for radio or television. Initially, most of these campaigns focused upon the need to prevent teenage pregnancy and upon sexual responsibility; more recently, some have focused upon the prevention of AIDS. Few or none have been devoted to specific methods of birth control, such as condoms, and none have involved direct mail.

A variety of local initiatives have sought to promote condom use. For example, during "Condom Week," a number of communities have held "condom parties," condom limerick contests and other events intended to popularize the method. Increasing concern about AIDS has spurred efforts to distribute condoms free of charge (e.g., "Three for Free" in Maryland (6) and "Condom Sense" in Atlanta (7)). However, these initiatives, while laudable, are still limited in scope; they are not mass-marketing approaches, and their impact upon knowledge and behavior has not been carefully evaluated.

Finally, private manufacturers and distributors of contraceptives have done limited contraceptive advertising in magazines and on television. However, these efforts have been in the private sector, they do not appear to have been directed toward teenagers and they have not been designed or evaluated for social impact.