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Commentary by Tourangeau

Over the past decade, there has been growth in research literature related to prevention of sexually transmitted diseases, particularly within high-risk populations such as low-income African American women. One important strategy proposed to prevent incidence and spread of sexually transmitted diseases has been to promote consistent use of condoms during sexual activity (Bird & Harvey, 2000-2001; Cohen et al., 1999; Dancy, Marcantonio, & Norr, 2000; Lauby, Smith, Stark, Person, & Adams, 2000; Robinson et al., 2002; St. Lawrence et al., 1998). The public health challenge continues to be development and implementation of education strategies that successfully result in target populations changing their sexual practice behaviors to include consistent condom use. This article by Dancy and Berbaum is an important contribution to this body of literature. Dancy and Berbaum report on effectiveness of two distinct health education curricula delivered to low-income African American women with the desired outcome of promoting consistent condom use by these women. One curriculum included an HIV-prevention educational opportunity and the other a general health maintenance curriculum. As hypothesized, the HIV-prevention curriculum intervention group of women significantly increased their condom use behaviors more than the general health maintenance curriculum intervention group of women. Using modified logistic regression modeling, Dancy and Berbaum also explore effects of mediating variables such as self-efficacy, HIV-related community behavior, and social norms, that are all hypothesized to predict condom use over time. This article strengthens knowledge of the effectiveness of interventions aimed at promoting consistent condom use with a sample of lowincome African American women. So what might be appropriate next steps? How could knowledge of efficacy and effectiveness of interventions aimed at preventing sexually transmitted disease be further developed and disseminated? What might be useful to encourage further research and use of these findings? The development and articulation of intervention theory such as that proposed by Sidani and Braden (1998) would be useful for researchers, practitioners, decision makers, and policy makers. Intervention theory combines descriptive middle range theory explaining causal processes with prescriptive practice