In the current study, researchers evaluated the effects of a six-month social marketing campaign on awareness of, attitudes toward, and use of female and male condoms for females ages 15-25.

A cross-sectional survey of 3,407 females in 12 western U.S. neighborhoods was conducted prior to the campaign using a time-space sampling methodology. Participants were surveyed about female and male condom awareness, attitudes, and use.

Six of the 12 study locations were randomly selected to receive the POWER social marketing campaign designed to impact condom knowledge, attitudes, and use. The campaign was followed by another cross-sectional survey of 3,003 women in all 12 study neighborhoods on condom knowledge, attitudes, use and awareness of POWER materials.

To determine the efficacy of POWER, pre- and post-campaign surveys were compared. In addition, post hoc analyses on post-campaign data were conducted to assess whether exposure to POWER was related to higher levels of positive condom attitudes and norms and condom use.

No differences between neighborhoods with and without the POWER campaign were found with regard to the study's primary outcomes. To diagnose reasons for this null effect, the researchers examined outcomes post hoc examining the influence of POWER exposure. Post hoc analyses showed some evidence that exposure to POWER was associated with condom use. In the context of the nested trial, this raised concerns of the limitations of post test only evaluations.

"Establishing the efficacy of a social marketing campaign is challenging," the researchers concluded. "This group randomized trial showed a null effect. Social marketing campaigns may need to have more media channels and saturation before they can show behavioral effects. Using a nested design with randomization at the community level and probability sampling introduces rigor not commonly seen in evaluations of social marketing campaigns."

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