Effects of transfer-oriented curriculum on multiple behaviors in the Netherlands

Many school health promotion curricula address a single health behavior, without paying attention to potential learning effects in associated behavioral domains. We developed an innovative curriculum about smoking and safe sex that also focused on promoting students' transfer of knowledge, skills and attitudes to other domains. In a quasi-experimental study involving 1107 students (Grades 7 and 8) in the Netherlands, the curriculum was compared with regular lessons about smoking and safe sex. The central research questions were to what extent the transfer-oriented curriculum: (i) had effects on psychosocial determinants and behaviors in the domains of smoking and safe sex, (ii) had effects on determinants and behaviors in three domains about which no lessons were taught (consumption of alcohol, fruit and breakfast). Multi-level analyses showed that the answer to both questions is positive. The results indicate that a transfer approach may have surplus value over the classic domain-specific approach and warrant further elaboration in the future

Determinants of Human Papillomavirus Vaccination Intention Among Female Sex Workers in Amsterdam, the Netherlands

Introduction Female sex workers (FSWs) are at risk for human papillomavirus (HPV)-induced diseases but are currently not targeted by the HPV vaccination program in the Netherlands. We explored determinants of their intention to get vaccinated against HPV in case vaccination would be offered to them. Methods In 2016, FSWs 18 years and older having a sexually transmitted infection consultation with the Prostitution & Health Center (P&G292) in Amsterdam, either at the clinic or at their working location, were invited to complete a questionnaire assessing sociopsychological determinants of HPV vaccination intention (scale ranging from -3 to +3). Determinants of HPV vaccination intention were assessed with univariable and multivariable linear regression. In addition, we explored the effect of out-of-pocket payment on intention. Results Between May and September 2016, 294 FSWs participated. The median age was 29 years (interquartile range, 25-37 years). Human papillomavirus vaccination intention was high (mean, 2.0; 95% confidence interval [CI], 1.8-2.2). In multivariable analysis, attitude ( = 0.6; 95% CI, 0.5-0.7), descriptive norm ( = 0.2; 95% CI, 0.1-0.3), self-efficacy ( = 0.2; 95% CI, 0.1-0.3), beliefs ( = 0.1; 95% CI, 0.0-0.2), and subjective norm ( = 0.1; 95% CI, 0.0-0.2) seemed to be the strongest predictors of HPV vaccination intention (R-2 = 0.54). Human papillomavirus vaccination intention decreased significantly to a mean of 0.2 when vaccination would require out-of-pocket payment of Euro350. Conclusions The HPV vaccination intention among FSWs seems relatively high and is most strongly constituted in attitudinal, normative, and self-efficacy beliefs. Out-of-pocket payment will probably have a negative impact on their HPV vaccination acceptabilit