1. Epidemiology and Global Health
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A case study for a psychographic-behavioral segmentation approach for targeted demand generation in voluntary medical male circumcision

  1. Sema K Sgaier  Is a corresponding author
  2. Maria Eletskaya
  3. Elisabeth Engl
  4. Owen Mugurungi
  5. Bushimbwa Tambatamba
  6. Gertrude Ncube
  7. Sinokuthemba Xaba
  8. Alice Nanga
  9. Svetlana Gogolina
  10. Patrick Odawo
  11. Sehlulekile Gumede-Moyo
  12. Steve Kretschmer
  1. Surgo Foundation, United States
  2. Cello Health Insight, United Kingdom
  3. Surgo Foundation, United Kingdom
  4. Ministry of Health and Child Care, Zimbabwe
  5. Ministry of Community Development, Mother and Child Health, Zambia
  6. Ipsos Healthcare, United Kingdom
  7. Ahimsa Group LLC, Kenya
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Cite this article as: eLife 2017;6:e25923 doi: 10.7554/eLife.25923

Abstract

Public health programs are starting to recognize the need to move beyond a one-size-fits-all approach in demand generation, and instead tailor interventions to the heterogeneity underlying human decision making. Currently, however, there is a lack of methods to enable such targeting. We describe a novel hybrid behavioral-psychographic segmentation approach to segment stakeholders on potential barriers to a target behavior. We then apply the method in a case study of demand generation for voluntary medical male circumcision (VMMC) among 15-29-year-old males in Zambia and Zimbabwe. Canonical correlations and hierarchical clustering techniques were applied on representative samples of men in each country who were differentiated by their underlying reasons for their propensity to get circumcised. We characterized six distinct segments of men in Zimbabwe, and seven segments in Zambia, according to their needs, perceptions, attitudes and behaviors towards VMMC, thus highlighting distinct reasons for a failure to engage in the desired behavior.

Article and author information

Author details

  1. Sema K Sgaier

    Surgo Foundation, Seattle, United States
    For correspondence
    semasgaier@surgo-foundation.org
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-8311-2686
  2. Maria Eletskaya

    Cello Health Insight, London, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  3. Elisabeth Engl

    Surgo Foundation, London, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  4. Owen Mugurungi

    Ministry of Health and Child Care, Harare, Zimbabwe
    Competing interests
    The authors declare that no competing interests exist.
  5. Bushimbwa Tambatamba

    Ministry of Community Development, Mother and Child Health, Lusaka, Zambia
    Competing interests
    The authors declare that no competing interests exist.
  6. Gertrude Ncube

    Ministry of Health and Child Care, Harare, Zimbabwe
    Competing interests
    The authors declare that no competing interests exist.
  7. Sinokuthemba Xaba

    Ministry of Health and Child Care, Harare, Zimbabwe
    Competing interests
    The authors declare that no competing interests exist.
  8. Alice Nanga

    Ipsos Healthcare, London, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  9. Svetlana Gogolina

    Ipsos Healthcare, London, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  10. Patrick Odawo

    Ahimsa Group LLC, Nairobi, Kenya
    Competing interests
    The authors declare that no competing interests exist.
  11. Sehlulekile Gumede-Moyo

    Ipsos Healthcare, London, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  12. Steve Kretschmer

    Surgo Foundation, Seattle, United States
    Competing interests
    The authors declare that no competing interests exist.

Funding

Bill and Melinda Gates Foundation (Contract #24210)

  • Steve Kretschmer

The funders were involved in the study design, but had no role in data collection and interpretation, or the decision to submit the work for publication.

Ethics

Human subjects: In Zambia, ethical approval was received by ERES CONVERGE IRB, Ref. No. 2014-Aug-008In Zimbabwe, ethical approval was received by MRCZ, Ref. No. MRCZ/A/1884Consent to publish was received by all authors and the governments of Zambia and Zimbabwe.Written consent was obtained by all respondents. For those respondents below the age of 18 years (minors), both parental consent and consent from the interviewee were received. Consent forms were signed by both parent/guardian and minor in these cases. No respondents were under the age of 13 years.

Reviewing Editor

  1. Quarraisha Abdool Karim, University of KwaZulu Natal, South Africa

Publication history

  1. Received: February 14, 2017
  2. Accepted: September 4, 2017
  3. Accepted Manuscript published: September 13, 2017 (version 1)
  4. Version of Record published: October 4, 2017 (version 2)

Copyright

© 2017, Sgaier et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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Further reading

    1. Epidemiology and Global Health
    2. Immunology and Inflammation
    Yansheng Li et al.
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    Influenza pandemics pose public health threats annually for lacking vaccine that provides cross-protection against novel and emerging influenza viruses. Combining conserved antigens that induce cross-protective antibody responses with epitopes that activate cross-protective T cell responses might be an attractive strategy for developing a universal vaccine. In this study, we constructed a recombinant protein named NMHC that consists of influenza viral conserved epitopes and a superantigen fragment. NMHC promoted the maturation of bone marrow-derived dendritic cells and induced CD4+ T cells to differentiate into Th1, Th2, and Th17 subtypes. Mice vaccinated with NMHC produced high levels of immunoglobulins that cross-bound to HA fragments from six influenza virus subtypes with high antibody titers. Anti-NMHC serum showed potent hemagglutinin inhibition effects to highly divergent group 1 (H1 subtype) and group 2 (H3 subtype) influenza virus strains. Furthermore, purified anti-NMHC antibodies bound to multiple HAs with high affinities. NMHC vaccination effectively protected mice from infection and lung damage when exposed to two subtypes of H1N1 influenza virus. Moreover, NMHC vaccination elicited CD4+ and CD8+ T cell responses that cleared the virus from infected tissues and prevented virus spread. In conclusion, this study provides proof of concept that NMHC vaccination triggers B and T cell immune responses against multiple influenza virus infections. Therefore, NMHC might be a candidate universal broad-spectrum vaccine for the prevention and treatment of multiple influenza viruses.

    1. Epidemiology and Global Health
    2. Microbiology and Infectious Disease
    Mark Ferris et al.
    Research Advance Updated

    Background:

    Respiratory protective equipment recommended in the UK for healthcare workers (HCWs) caring for patients with COVID-19 comprises a fluid-resistant surgical mask (FRSM), except in the context of aerosol generating procedures (AGPs). We previously demonstrated frequent pauci- and asymptomatic severe acute respiratory syndrome coronavirus 2 infection HCWs during the first wave of the COVID-19 pandemic in the UK, using a comprehensive PCR-based HCW screening programme (Rivett et al., 2020; Jones et al., 2020).

    Methods:

    Here, we use observational data and mathematical modelling to analyse infection rates amongst HCWs working on ‘red’ (coronavirus disease 2019, COVID-19) and ‘green’ (non-COVID-19) wards during the second wave of the pandemic, before and after the substitution of filtering face piece 3 (FFP3) respirators for FRSMs.

    Results:

    Whilst using FRSMs, HCWs working on red wards faced an approximately 31-fold (and at least fivefold) increased risk of direct, ward-based infection. Conversely, after changing to FFP3 respirators, this risk was significantly reduced (52–100% protection).

    Conclusions:

    FFP3 respirators may therefore provide more effective protection than FRSMs for HCWs caring for patients with COVID-19, whether or not AGPs are undertaken.

    Funding:

    Wellcome Trust, Medical Research Council, Addenbrooke’s Charitable Trust, NIHR Cambridge Biomedical Research Centre, NHS Blood and Transfusion, UKRI.