The HEART Campaign [7] in Zambia was designed in 1999 for youth by youth to inform young people about HIV/AIDS, specifically about ways to protect oneself from HIV/AIDS, and to promote abstinence and condom use. The campaign, implemented by the Zambia Integrated Health Programme, focused on sexually active and abstinent youth aged 13 to 19. It was designed to create a social atmosphere conducive to changing prevailing social norms and individual sexual behavior. The campaign contributed to the national effort of helping young people choose safer sex, thereby reducing the incidence of HIV/AIDS and other STIs.

The design team created five TV spots that included messages ranging from how a girl can say "no" to sex to promoting regular condom use. Producers of radio spots and songs adapted the same messages and concepts to the rural context and translated them into local languages. Other materials such as posters, book stickers, exercise books, messages on buses, and music videos complemented the mass media materials.

How it worked

The design team, which included seven young people, was responsible for strategic planning, campaign development, and implementation. The young people on the design team had a variety of backgrounds, including print, radio, peer education, video, and drama, and were the key decision-makers for critical aspects of the campaign. One young person on the design team was HIV+. This person was important in ensuring accurate and empathetic representation for HIV+ youth during the design and implementation stages.

To achieve broader youth involvement, a Youth Advisory Group (YAG) was formed. The YAG included 35 young people from 11 youth groups and served as an advisory body to the design team to help develop the communication objectives and messages for each audience.

The creative team designing the campaign used extensive pretesting. Messaging concepts were tested for appeal and comprehension through focus group discussions and in-depth interviews. Spot surveys after broadcasts were conducted to test reach and recall. The fieldwork involved over 1,200 rural and urban youth (aged 13 to 19) who were in or out of school.

Evaluation Results

METHODOLOGY: To evaluate the campaign, a quasi-experimental, separate sample pretest and posttest design was used. [8] The pretest survey was conducted from July to November 1999 to establish benchmark indicators for performance evaluation. Data analysis showed that the overall objectives of the campaign were met. For example:

The HEART Campaign reached over 50 percent of the intended audience. Almost three-fourths of urban youth and more than one-third of rural youth saw one or more of the health communication TV spots. Urban and rural young women were as likely as young men to see some or all of the ads.

Approximately 74 percent of male viewers and 68 percent of female viewers reported that the spots prompted them to talk with others about the ads, decide to abstain from sex, or use a condom.

Among women who are sexually experienced, 82 percent of campaign viewers compared to 64 percent of non-viewers reported feeling confident in their ability to say "no" to unwanted sex.

Viewers who saw one of the TV spots, Mutale & Ing 'utu, became more knowledgeable about HIV/AIDS than non-viewers. Nearly 86 percent of viewers compared to 72 percent of non-viewers recognised that a person who looks healthy can be HIV+.

Viewers of the campaign were more likely to report condom use than non-viewers, even when sex, age, residence, and education were held constant. Older, better-educated respondents were more likely than others to use condoms, and women were more likely to report condom use than men.

Fully 74 percent of male viewers and 68 percent of female viewers reported taking at least one action as a result of seeing the campaign. Young men reported an average of about 2.0 actions taken, and young women reported taking 1.5 actions on average. The action most commonly reported by respondents was talking with others-friends, partners, spouses, or parents - about the ads. The decisions to use a condom or abstain from sex were reported frequently by viewers as a direct result of campaign exposure (see Table 2).

These findings correspond to Phase One of the HEART Campaign. They do not reflect the effects of Phase Two, which began in the fall of 2000, or Phase Three, which started in the fall of 2001.

Notes:

1 Too few cases to report results

* Differences within cell significant at p.<.05

** Differences within cell significant at p<.01

Source: Zambia Youth Impact Survey, 2001

8 Cook, T.D. and Campbell, D.T. (1979). Quasi-experimentation: Design and analysis issues for field settings. Boston: Houghton Mifflin Co.

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