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Methodology This meta-analysis will test the fit of a theoretically determined network of relationships among the constructs from the integrated model of model of condom use with data from theoretical research on young people in sub-Saharan Africa. The model will be specified a priori on previous integrated frameworks of the social-cognitive factors associated with health behavior. These frameworks provide a generalized overview of the psychological factors, specifically, attitudes, norms, self representations, control perceptions, and dispositions to act, as well as their pattern of effects on health behavior (McMillan & Conner, 2007). Data will be sourced through a literature search on multiple electronic databases supplemented by manual searches of references of included studies and previous systematic reviews and meta-analyses. To be included, studies will have (1) employed a measure of intended or actual condom use as an outcome variable; (2) provided at least one bivariate statistical association of a theoretical variable with condom use evaluated in a cross-sectional, prospective, or intervention-type design; (3) sampled young people from SSA nations in educational (i.e., elementary, high-school, college and university students) or non-educational settings (e.g., households, at-risk); and (4) been full-text peer-reviewed published articles and other unpublished manuscripts (e.g., theses), written in any language. Following the recommendations of the African Youth Charter (African Union, 2006) young people up to age 35 will be eligible for inclusion. Methodological Quality (MQ) will be assessed by the EBL Critical Appraisal Checklist (Glynn, 2006), a valid tool that determines the credibility, applicability and appropriateness of studies of all designs. The statistical analyses will include a random effects model correcting effect sizes among social cognitive and behavioral variables for sampling and measurement error with tests for heterogeneity. The metric will be the zero-order Pearson correlation coefficient, and the matrix of these with behavior and other variables will be subjected to meta-analytic path analysis (Cheung, 2014). This is a powerful tool for testing the proposed theoretical model specified a priori derived from data across multiple tests and corrected for multiple artifacts of bias. Our meta-analysis will further systematically test key moderators drawn from extant research to establish the key factors that interact with ILT variables in predicting condom use. Specifically, we will examine whether obtained effect sizes will vary as a function of population parameters (e.g., gender, age) and contextual parameters (e.g., at-risk environments; evidence of gender-based power imbalances; socio-economic conditions). In addition, we will also test the extent to which study design parameters, especially those related to methodological quality, influence the patterns of effects in research on the psychological factors associated with condom use (Johnson, Low, & MacDonald, 2015). These analyses will add value to the model tests by evaluating the extent to which MQ will alter conclusions on a quantitative cumulation of findings across the literature on condom use in this population.
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