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

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.

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.

Metrics

  • 3,567
    views
  • 239
    downloads
  • 25
    citations

Views, downloads and citations are aggregated across all versions of this paper published by eLife.

Download links

A two-part list of links to download the article, or parts of the article, in various formats.

Downloads (link to download the article as PDF)

Open citations (links to open the citations from this article in various online reference manager services)

Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)

  1. Sema K Sgaier
  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
(2017)
A case study for a psychographic-behavioral segmentation approach for targeted demand generation in voluntary medical male circumcision
eLife 6:e25923.
https://doi.org/10.7554/eLife.25923

Share this article

https://doi.org/10.7554/eLife.25923

Further reading

    1. Epidemiology and Global Health
    2. Microbiology and Infectious Disease
    Gillian AM Tarr, Linda Chui ... Tim A McAllister
    Research Article

    Several areas of the world suffer a notably high incidence of Shiga toxin-producing Escherichia coli. To assess the impact of persistent cross-species transmission systems on the epidemiology of E. coli O157:H7 in Alberta, Canada, we sequenced and assembled E. coli O157:H7 isolates originating from collocated cattle and human populations, 2007–2015. We constructed a timed phylogeny using BEAST2 using a structured coalescent model. We then extended the tree with human isolates through 2019 to assess the long-term disease impact of locally persistent lineages. During 2007–2015, we estimated that 88.5% of human lineages arose from cattle lineages. We identified 11 persistent lineages local to Alberta, which were associated with 38.0% (95% CI 29.3%, 47.3%) of human isolates. During the later period, six locally persistent lineages continued to be associated with human illness, including 74.7% (95% CI 68.3%, 80.3%) of reported cases in 2018 and 2019. Our study identified multiple locally evolving lineages transmitted between cattle and humans persistently associated with E. coli O157:H7 illnesses for up to 13 y. Locally persistent lineages may be a principal cause of the high incidence of E. coli O157:H7 in locations such as Alberta and provide opportunities for focused control efforts.

    1. Epidemiology and Global Health
    Riccardo Spott, Mathias W Pletz ... Christian Brandt
    Research Article

    Given the rapid cross-country spread of SARS-CoV-2 and the resulting difficulty in tracking lineage spread, we investigated the potential of combining mobile service data and fine-granular metadata (such as postal codes and genomic data) to advance integrated genomic surveillance of the pandemic in the federal state of Thuringia, Germany. We sequenced over 6500 SARS-CoV-2 Alpha genomes (B.1.1.7) across 7 months within Thuringia while collecting patients’ isolation dates and postal codes. Our dataset is complemented by over 66,000 publicly available German Alpha genomes and mobile service data for Thuringia. We identified the existence and spread of nine persistent mutation variants within the Alpha lineage, seven of which formed separate phylogenetic clusters with different spreading patterns in Thuringia. The remaining two are subclusters. Mobile service data can indicate these clusters’ spread and highlight a potential sampling bias, especially of low-prevalence variants. Thereby, mobile service data can be used either retrospectively to assess surveillance coverage and efficiency from already collected data or to actively guide part of a surveillance sampling process to districts where these variants are expected to emerge. The latter concept was successfully implemented as a proof-of-concept for a mobility-guided sampling strategy in response to the surveillance of Omicron sublineage BQ.1.1. The combination of mobile service data and SARS-CoV-2 surveillance by genome sequencing is a valuable tool for more targeted and responsive surveillance.