sexualhealthupdate06

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Sexual Health Update

20 June 2005
Issue Six

Kia ora tatou katoa, Talofa lava, Malo e lelei, Kia orana, Fakaalofa lahi atu, Ni sa bula, Taloha ni and greetings. I'm very pleased to be able to bring you another issue of the No Rubba, No Hubba Hubba newsletter, made possible because of an extension to the campaign.

The Ministry of Health is funding the campaign until the end of June - you may have seen the Hubba TV commercials, which have been on air again since 22 May. The commercials are being reinforced with radio, cinema, adshel (bus stop) and internet advertising, as well as the continued presence of the Hubba website - www.hubba.co.nz.

Last month we received the formal campaign evaluation report. The results showed that there had been a fantastic response to Hubba from young people, with half saying that it had increased the likelihood that they would use condoms. The commercials themselves had high recall - 97 percent of those surveyed had seen them, and 65 percent had talked to a friend about the campaign.

It has been a privilege to be involved in the development and running of the Hubba campaign, and in particular to have been able to work so closely with the sexual health sector. There are a number of learnings that can be taken from the campaign, and applied to any future campaigns. These messages are pretty simple, but I believe they are the key to a campaign that really makes a difference. They include:

involvement of the sector gives ownership and maximises campaign reach. No one knows your audience as well as those who work with them every day - harness their knowledge and experience
stick to first principles and don't water down your message. There were many suggestions as to the messages we should be putting in the television commercial. If we had included them all we would have had a commercial hour not a TVC
do what your research indicates you should. It is so tempting to think you know what you are talking about. Resist!
have one really clear simple message. The research is very clear on this point. The campaigns that are the most effective are the ones with one clear message
gather support from reputable groups and individuals especially if your topic is controversial. This makes it much easier to address misinformation and criticism
have your target audience involved at all stages of development and at all levels of decisionmaking. I cannot emphasis this point enough. It not only shows that you respect the people that the campaign is for, but it makes it much more likely that it will be effective.

I would also like to thank the campaign team at Graham Strategic for their great work and fantastic commitment to Hubba.

So where to from here? The Ministry of Health needs to undertake further work to inform decisions about future sexual health programmes. Whatever decision is made, I think the whole sector deserves a huge pat on the back for tackling a difficult issue that was always going to upset some people, working together, sticking to our key message - always use a condom - and promoting this message strongly, consistently and unashamedly.

Sally Hughes
Project Manager, Sexual Health Campaign
Ministry of Health

In this issue:

Evaluation results positive
Anecdotal feedback
Events
Resources
Hubba website has 2.8 million hits
Young people more concerned with pregnancy
Youth sexual health web links

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Evaluation results positive

The No Rubba, No Hubba Hubba campaign was evaluated by TNS Research. The research objectives for both the pre- and post-campaign quantitative research were to benchmark and monitor the attitudes and behaviours of 15 to 19 year olds, including:

their awareness of STI and condom advertising
attitudes towards condoms
level of sexual activity and use of condoms
perceptions of what can and cannot protect against STIs.

The surveys were carried out online because phone surveys that ask questions about sex, particularly of teenagers, face strong barriers in terms of getting to teenagers and then getting them to talk frankly. Reaching Māori, Pacific and lower socio-economic teenagers is particularly difficult.

A sample of 301 15 to 19 year olds were randomly surveyed pre-campaign, and 313 15 to 19 year olds were randomly surveyed post campaign.

At a glance:

49 percent of respondents indicated the campaign had 'definitely' or 'probably' increased their likelihood of using condoms in the future. The percentage was the same (49%) for Māori but higher for Pacific people (63%)
the proportion of respondents who said they would still have sex if no condom was available decreased significantly between the pre- and post-campaign (36%, down from 46%)
there has not been a change in proportion of youth who agree having a condom is still necessary when having sex with someone they are going out with or know well
there has been a significant reduction in the proportion of Māori respondents who said they would still have sex if no condom was available (43%, down from 59%).

In more detail:

awareness of advertising about STIs, condoms and condom use increased dramatically pre- and post-campaign. Awareness of STI advertising rose from 25 percent to 73 percent, awareness of condom advertising rose from 52 percent to 77 percent and awareness of condom use rose from 28 percent to 80 percent
the No Rubba, No Hubba Hubba television advertisement had a high unprompted recall (74%). The prompted awareness of the heterosexual version was almost at absolute levels (97%), while there was a lower awareness (although still high at 84%) of the homosexual version of the advertisement
key messages (unprompted) taken from the advertisement were: to always use condoms (54%), no condoms no sex (28%), have safe sex (14%), and condoms offer the best protection (10%)
prompted, over half the respondents agreed that both versions of the advertisements reminded them they needed to use a condom every time they had sex, they had talked with their friends about the advertisements, they thought the animation was 'wicked' and they could say no to sex if a condom was not available
pre- and post-campaign perceptions of condoms generally did not change with the exception that more respondents (91%, up from 81%) were likely to agree that condoms are the best form of protection against STIs
during the concept testing, 'moment barriers' to using a condom were identified. While these dropped pre- to post-campaign (46% to 36%), there is still a large proportion of teenagers who do not see the benefit of wearing a condom every time. Teenagers were just as likely post-campaign to not use a condom with someone they know well or are going out with
half the quantitative research respondents indicated that the campaign had 'definitely' or 'probably' increased the likelihood of using condoms in the future every time they had sex. Key stakeholders believed the campaign had increased awareness, but may not change behaviour
the quantitative research confirmed aspects of the concept testing, including that the advertisement was found to be memorable and that the key message to wear condoms was generally well received. Stakeholders agreed with this latter point
the key stakeholder interviews and the secondary analysis suggest that the No Rubba, No Hubba Hubba language has entered into our culture. Quantitative research showed that three quarters of teenagers referred unprompted to the campaign name
presence in the print media, both regionally and nationally, supported the campaign. While there was a mixed response, the positive articles utilised credible spokespeople as opposed to the negative, which typically were letters to the editor. The secondary analysis suggested that regardless of the type of feedback, the issue was being discussed
while the concept testing revealed that the television campaign had the strongest cutthrough of the concepts tested, the quantitative research showed that the appeal was mixed. Approximately one-third liked the campaign, one-third were neutral and a third disliked the campaign. Males were less likely to like the campaign
behavour change at this level can not be accurately assessed on current information, nor should it be expected of a short campaign.

A PowerPoint presentation of the findings has been developed, and is available (until the end of June) by email or on CD from Sally Hughes, phone 09 580 9076 or email Sally_Hughes@moh.govt.nz.

Anecdotal feedback

Formal evaluations are all very well, but anecdotal feedback is much more fun! Here are some of the stories we have been told about the Hubba campaign:

jingle being sung at parties
condom pouches being 'worn' in town
posters being stolen from bus shelters
condoms being referred to as 'hubbas'.

In addition the amount of media coverage received indicates the community interest in the campaign. The campaign slogan or images popping up in places that haven't been paid for, for example the Shortland Street discussion forum, is evidence that people are talking about the campaign.

Our favourite story came from a provider in the South Island who was walking along the Avon River and spotted two boys fishing. They were singing the Hubba song together, giggling, and saying 'cool eh!'.

Events

	Phat Pak crew members hanging out at the Hubba tent waiting for the 10,000 plus crowd at the Auckland Edgefest. (Phat Pak is a youth mentoring support programme - the crews from Tokoroa and Hamilton offered huge assistance at Edgefest in Auckland and Hamilton).

	Waka ama - rangatahi crew from Mareikura strutting the Hubba message at the Waka Ama nationals 2005 (proudly supported by Wendy Baker).

	Phat Pak crew mixing and mingling with the crowd at Edgefest. The tees were a prized possession.

Resources

Additional Hubba tees and new trucker caps have been developed for the June period, and a limited number are still available. For more information, contact Trevor on 04 384 1907, or email trevor@grahamstrategic.co.nz. To date the tees have been extremely popular and have been a great vehicle for extending the reach of the message.

Some campaign resources will continue to be available once the media advertising finishes at the end of June. Several resources have been developed to support the campaign messages, and are available free of charge from the Ministry of Health. They are:

Talking with your teenager/rangatahi about safer sex - A5 booklet for parents/caregivers (English and te reo Māori)
You and your teenager - A5 booklet for Pacific parents/care givers (Samoan, Tongan, Cook Island Māori and Niuean languages as well as English)
No Rubba, No Hubba Hubba - A6 booklet for teens about safer sex
No Rubba, No Hubba Hubba - A3 campaign poster.

You can order free copies of these resources from the Ministry of Health's storage and distribution centre by:

emailing moh@wickliffe.co.nz
telephoning 04 496 2277
writing to Ministry of Health Publications, c/- Wickliffe Press, PO Box 932, Dunedin.

Please provide a physical address, contact details and a phone number.

Hubba website has 2.8 million hits

The Hubba website will stay online until the end of the year. It continues to be extremely popular; to date 2.8 million hits have been received. If you have a spare moment, check it out - www.hubba.co.nz.

The Hubba site gives visitors the opportunity to try out various decisions and situations in a safe environment. They pick a character from the television commercial and then choose a partner for that character. The 'chemistry' between the couple is measured and shown on the risk-o-meter. They can alter their risk levels by drinking alcohol, in which case the needle goes further into the red or by buying condoms, which moves the needle in the other direction. The player determines their actions but the partner makes their own decisions. The consequences are shown for the various decisions. If safer sex is opted for everything is fine. But if condoms aren't used then things do not turn out so well. In that situation information is provided on STIs and treatments. The challenge clearly illustrates the risks associated with unprotected sex but does so in a way that is not blaming or judgmental but factual.

Young people more concerned with pregnancy

A cross-sectional survey on sexual behaviour has found that young people are more concerned about preventing pregnancy than about contracting an STI. The research was conducted before the start of the Hubba campaign by the Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago. The survey, carried out on a random sample of year 12 and 13 students, showed that many continued to exhibit a sense of invulnerability to STIs, and their overriding concern was to prevent unwanted pregnancies.

Of the 1136 students who participated in the study, half were sexually active, and fewer than half used condoms on every occasion of sexual intercourse. Only 23 percent of participants said they felt vulnerable to acquiring an STI, with a quarter reporting not using condoms because they did not think that either they or their partner had an infection.

Hubba project manager Sally Hughes said that the survey findings were similar to the findings of research carried out to inform the development of the Hubba campaign.

"We also found that young people - and particularly females - were more likely to use condoms because of a fear of pregnancy. They tended to underestimate their risk of contracting an STI."

She said that the study findings underlined the need for on-going youth-targeted education about STIs, such as campaigns like No Rubba, No Hubba Hubba.

The study concluded that the key to achieving more consistent condom use for STI prevention for young people may be through finding ways to get them to accept that they are vulnerable to STIs. For more detail, see Abel G., Brunton C. (2005). Young people's use of condoms and their perceived vulnerability to sexually transmitted infections. Australian and New Zealand Journal of Public Health 29:254-260.

Youth sexual health web links

Below are some useful links for those working in youth sexual health or wishing to support comprehensive sexuality education:

Advocates for Youth: www.advocatesforyouth.org/rrr/mythsfacts.htm
Coalition for positive sexuality: www.positive.org
Sexuality Education and Information Council of the US: www.siecus.com
Kaiser Family Foundation: www.kff.org/youthhivstds/sexeducation.cfm.

Sexual Health Update can be accessed on the Ministry of Health website www.moh.govt.nz/publications/newsletters

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Sexual Health Update June 2005 (PDF, 569 kB)

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Related information

Issue 1 of Sexual Health Update

Issue 2 of Sexual Health Update

Issue 3 of Sexual Health Update

Issue 4 of Sexual Health Update

Issue 5 of Sexual Health Update

Other Ministry of Health newsletters

New Youth Sexual Health Campaign Pulls No Punches 22 November 2004
A new television commercial has a strong message for teens, No Rubba, No Hubba Hubba. The commercial is part of the Ministry of Health's campaign to reduce high rates of sexually transmitted infections (STIs) in teenagers. The campaign was launched at Parliament today by the Minister of Health, Hon Annette King.

New sexual health campaign will encourage condom use 26 August 2004
The Ministry of Health is developing a sexual health campaign aimed at encouraging sexually active young people to protect themselves when having sex. With New Zealand's rapidly growing rates of sexually transmitted infections (STIs), the campaign provides an exciting opportunity to promote safer sex messages and condom use.

Sexual health homepage