A variety of primary prevention strategies are used in HIV prevention programs in Africa. However, these are often developed through intuition and the theoretical basis for many interventions is limited to the knowledge /attitude model. This Article illustrates how research findings from a base-line survey are combined with Paulo Freire's social change theory and the Ecological Model for Health Promotion to develop a participatory intervention for HIV/AIDS prevention in farm workers in Zimbabwe. The article addresses the need to focus attention on the process of change at the interpersonal level, organizational and policy levels of the community. Dialogue is central to the range of strategies proposed for the intervention. The effect will be measured through process and outcome evaluation.
Get full access to this article
View all access options for this article.
References
1.
FinchamS., Community Health Promotion Programs, Social Science Medicine, 35: 3, pp. 239–249, 1992.
2.
KokG., Health Education and Research for AIDS Prevention, Hygie-Vol X, pp. 32–39, 1991/1992.
3.
AmaroH., Love, Sex and Power. Considering Women's Realities in HIV Prevention, American Psychologist, 50: 6, pp. 437–447, 1995.
4.
WallersteinN. and Sanchez-MerkiV., Freirian Praxis in Health Education: Research Results from an Adolescent Prevention, Health Education Research, Theory and Practice, 9: 1, pp. 105–118, 1994.
5.
BeckerM. H., The Health Belief Model and Sick Role Behaviour, Health Education Monographs, 2, pp. 409–419, 1974.
6.
RogersR. W.DecknerC. W., and MewbornC. R., An Expectancy-Value Theory Approach to the Long Term Modification of Smoking Behaviour. Journal of Clinical Psychology, 34, pp. 562–566, 1978.
7.
WallersteinN. and BernsteinE., Empowerment Education: Freire's Ideas Adapted to Health Education, Health Education Quarterly, 15, pp. 379–394, 1988.
8.
GlanzK. F.LewisM., and RimmerB. K. (eds.), Health Behaviour and Health Education, Theory and Practice, Jossy-Bass Publishers, San Francisco, 1990.
9.
WallersteinN. and BernsteinE., Introduction to Community Empowerment, Participatory Education and Health. Health Education Quarterly, 21: 2, pp. 141–148, Summer 1994.
10.
HopeATimmelS., and HodziC., Training for Transformation: A Handbook for Community Workers, 3 Volumes, Mambo Press, Gweru, Zimbabwe, 1984.
11.
FreireP., Pedagogy of the Oppressed, Seabury Press, New York, 1972.
12.
FreireP., Education for Critical Consciousness, Seabury Press/Continuum Press, New York, 1983.
13.
MinklerM. and CoxK., Creating Critical Consciousness in Health: Applications of Freire's philosophy and Methods to the Health Care Setting, International Journal of Health Services, pp. 311–322, 1980.
14.
AuerbachE. R. and WallersteinN., ESL for Action Problem Posing at Work, Teaching Guide, Addison Wesley, Reading, Massachusetts, 1987.
15.
WerchC. E. and DiClimenteJ., A Multi-Component Stage Model for Matching Drug Prevention Strategies and Messages to Yough Stage of Use, Health Education Research Theory and Practice, 9: 1, pp. 37–46, 1994.
16.
McElroyK. R.BibeauD., A Steckler, and K. Glanz. An Ecological Perspective on Health Promotion Program, Health Education Quarterly, 15: 4, pp. 351–377, 1988.
17.
FaragH., Report on Zimbabwe Television News, (ZTV), January 23, 1995.
18.
LoewensonR., Sunday Mail Newspaper, Harare, Zimbabwe, June 18, 1995.
19.
De MayJ.HIV sentinel Surveillance in Mashonaland West Province: HIV Sero-Prevalence Survey in the Commercial Farming Area of Zvimba District, March—July, A Final Report, PMD Mashonaland West Province, 1992.
20.
LaverS. M., A Pre-Invention Survey to Determine Understanding of HIV/AIDS in Farm Worker Communities of Zimbabwe, in press, 1995.
21.
CSO, Census Report Central Statistical Office, Government Printers, Harare, Zimbabwe, 1992.
22.
WilliamsG. and RayS., Workplace against AIDS, Workplace-Based AIDS Initiatives in Zimbabwe, Strategies for Hope Series No. 8, Action Aid, AMREF, Kenya, 1993.
23.
BrachtN., Introduction, in Health Promotion at the Community Level, BrachtN (ed.), Sage, Newbury Park, California, pp. 19–25, 1990.
24.
LaverS., AIDS Education is More than Telling People What Not To Do. Tropical Doctor, 23, pp. 156–160, 1993.
25.
WernerD. and BowerB., Helping Health Workers Learn, The Hesperian Foundation, Palo Alto, California, 1982.
26.
RogersR. W., Changing Health-Related Attitudes and Behaviour: The Role of Preventive Health Psychology, in Interfaces in Psychology, McGlynR.MaddoxJ.StoltenburyC., and HarveyR. J. (eds.), Texas Tech University Press, Lubbock, Texas, 1984.
27.
BeckerM. and JosephJ., AIDS and Behavioral Change to Avoid Risk, A Review, American Journal of Public Health, 78, pp. 384–410, 1988.
28.
BranduraA., Social Foundations of Thought and Action: A Social Cognitive Theory, Prentice-Hall, Englewood Cliffs, New Jersey, 1977.
29.
FisbbeinM. and AjzenI., Beliefs, Attitudes, Intention and Behaviour: An Introduction to Theory and Research, Addison-Wesley, Reading, Massachusetts, 1975.
30.
FishbeinM. and AjzenI., Understanding Attitudes and Predicting Social Behaviour, Prentice Hall, Englewood Cliffs, New Jersey, 1980.
31.
BrachtN. and KingsburyL., Community Organisation Principles in Health Promotion: A Five Stage Model, in Health Promotion at the Community Level, BrachtN. (ed.), Sage, Newbury Park, California, pp. 66–88, 1990.
32.
MinklerM., Group Intervention Models of Health Behaviour Change, in Health Behaviour and Health Education, Theory and Research, GlanzK.LewisF. M., and RimerB. K. (eds.), Jossey-Bass Health Series, San Francisco, pp. 253–287, 1990.
33.
RossM., Community Organisation: Theory and Principles, Harper and Row, New York, 1955.
34.
RogersE. and ShoemakerF., Communication of Innovations (2nd Edition), Free Press, New York, 1971.
35.
RogersE., Diffusion of Innovations, Free Press, New York, 1983.
36.
HavelockR., Planning for Innovation through Dissemination and Utilisation of Knowledge, Institute for Social Research, Ann Arbor, Michigan, 1971.
37.
OrlandiM. A., The Diffusion and Adoption of Worksite Health Promotion Innovations: An Analysis of Barriers, Preventive Medicine, 15, pp. 522–536, 1986.
38.
OrlandiM. A., Promoting Health and Preventing Disease in Health Care Settings, Preventing Medicine, 16, pp. 99–130, 1987.
39.
GraeffJ. A.ElderJ. P., and BoothMills E., Communication for Health and Behaviour Change, A Developing Country Perspective, Jossey-Bass Publishers, San Francisco, 1983.
40.
LaverS., Picture Codes in AIDS Education, World Health Forum, 15, pp. 39–41, 1994.
