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Mohammadi M, Peyman N, Hossainabadi M, Ghavami V, Tehrani H. Effect of sexual health education on sexual function and satisfaction of menopausal migrant women: an application of the theory of planned behavior. BMC Public Health 2024; 24:1626. [PMID: 38890576 PMCID: PMC11186239 DOI: 10.1186/s12889-024-19162-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES This study investigated the effect of an intervention based on the theory of planned behavior on sexual function and satisfaction of migrant women during menopause in Iran. METHODS This quasi-experimental study was conducted on 88 migrant and menopausal women in Iran. Sampling was performed using the multistage methods in four health care centers. The educational program based on the theory of planned behavior was held in 4 sessions of 90 min for 4 weeks in the intervention group. The final evaluation of the intervention was performed immediately, and the follow-up stage (3 months after the intervention) by completing questionnaires in two groups. The data was analyzed with SPSS 20 software with statistical tests of mean and standard deviation, Manwitney, Frideman, Generalized Estimating Equations. RESULTS The results showed that after the intervention, the mean score of sexual function in the intervention group increased from 16.53 ± 2.68 before to 17.52 ± 2.90 immediately and 17.38 ± 2.81 in follow up stage (p < 0.05). But in the control group, this score was not statistically significant during the study stages (p > 0.05). CONCLUSION The results indicate that the intervention based on the theory of planned behavior is effective in sexual function and satisfaction with the married life of migrant women during menopause. but to change the sexual function, studies with a longer duration and also the use of other educational models are suggested.
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Affiliation(s)
- Maryam Mohammadi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Peyman
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohadese Hossainabadi
- MSC student of Health Education and Health Promotion, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Ghavami
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
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Depression, Abuse, Relationship Power and Condom Use by Pregnant and Postpartum Women with Substance Abuse History. AIDS Behav 2016; 20:292-303. [PMID: 26319131 DOI: 10.1007/s10461-015-1176-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (-0.17, p < 0.05) and relationship power (-0.48, p < 0.001), and greater depression (-0.16, p < 0.05) predicted more condom-use barriers. History of mental health problems predicted condom-use barriers, mediated by recent depression and relationship power (0.15, p < 0.001). These findings suggest depression and diminished relationship power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.
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Gallo AM, Wilkie DJ, Yao Y, Molokie RE, Stahl C, Hershberger PE, Zhao Z, Suarez ML, Johnson B, Angulo R, Carrasco J, Angulo V, Thompson AA. Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years. J Genet Couns 2015; 25:325-36. [PMID: 26310871 DOI: 10.1007/s10897-015-9874-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 08/07/2015] [Indexed: 01/31/2023]
Abstract
Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n = 138) or SCT (n = 96) (age 18-35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p = .004) but not intention (p = .18) or behavior (p = .69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p = .04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.
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Affiliation(s)
- Agatha M Gallo
- Department of Women, Family and Children Health Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Avenue, MC 802, Chicago, IL, 60612-7352, USA.
| | - Diana J Wilkie
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Yingwei Yao
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Robert E Molokie
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Jesse Brown Veterans Administration Medical Center, Chicago, IL, USA
| | - Christiane Stahl
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - Patricia E Hershberger
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Zhongsheng Zhao
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Marie L Suarez
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Bonnye Johnson
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Rigoberto Angulo
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Jesus Carrasco
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Veronica Angulo
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Alexis A Thompson
- Division of Hematology/Oncology/Stem Cell Transplantation, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Northwestern University-Feinberg School of Medicine, Chicago, IL, USA
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Gaioso VP, Villarruel AM, Wilson LA, Azuero A, Childs GD, Davies SL. A Path Analysis of Latino Parental, Teenager and Cultural Variables in Teenagers' Sexual Attitudes, Norms, Self-Efficacy, and Sexual Intentions. Rev Lat Am Enfermagem 2015; 23:500-11. [PMID: 26312635 PMCID: PMC4547074 DOI: 10.1590/0104-1169.0398.2581] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/16/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to test a theoretical model based on the Parent-Based Expansion of the Theory of Planned Behavior examining relation between selected parental, teenager and cultural variables and Latino teenagers' intentions to engage in sexual behavior. METHOD a cross-sectional correlational design based on a secondary data analysis of 130 Latino parent and teenager dyads. RESULTS regression and path analysis procedures were used to test seven hypotheses and the results demonstrated partial support for the model. Parent familism and knowledge about sex were significantly associated with parents' attitudes toward sexual communication with their teenagers. Parent Latino acculturation was negatively associated with parents' self-efficacy toward sexual communication with their teenagers and positevely associated with parents' subjective norms toward sexual communication with their teenagers. Teenager knowledge about sex was significantly associated with higher levels of teenagers' attitudes and subjective norms about sexual communication with parents. Only the predictor of teenagers' attitudes toward having sex in the next 3 months was significantly associated with teenagers' intentions to have sex in the next 3 months. CONCLUSION the results of this study provide important information to guide future research that can inform development of interventions to prevent risky teenager sexual behavior among Latinos.
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Affiliation(s)
- Vanessa Pirani Gaioso
- PhD, Instructor, University of Alabama at Birmingham, School of Nursing,
Birmingham, AL, United States
| | - Antonia Maria Villarruel
- PhD, Full Professor, University of Pennsylvania, School of Nursing,
Philadelphia, PA, United States
| | - Lynda Anne Wilson
- PhD, Full Professor, University of Alabama at Birmingham, School of
Nursing, Birmingham, AL, United States
| | - Andres Azuero
- PhD, Associate Professor, University of Alabama at Birmingham, School of
Nursing, Birmingham, AL, United States
| | - Gwendolyn Denice Childs
- PhD, Assistant Professor, University of Alabama at Birmingham, School of
Nursing, Birmingham, AL, United States
| | - Susan Lane Davies
- PhD, Associate Professor, University of Alabama at Birmingham, School of
Public Health, Birmingham, AL, United States
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Reproductive health choices for young adults with sickle cell disease or trait: randomized controlled trial immediate posttest effects. Nurs Res 2013; 62:352-61. [PMID: 23995469 DOI: 10.1097/nnr.0b013e3182a0316b] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND People with sickle cell disease (SCD) or sickle cell trait (SCT) may not have information about genetic inheritance needed for making informed reproductive health decisions. CHOICES is a Web-based, multimedia educational intervention that provides information about reproductive options and consequences to help those with SCD or SCT identify and implement an informed parenting plan. Efficacy of CHOICES compared with usual care must be evaluated. OBJECTIVE The purpose was to compare immediate posttest effects of CHOICES versus an attention-control usual care intervention (e-Book) on SCD-/SCT-related reproductive health knowledge, intention, and behavior. METHODS In a randomized controlled study, we recruited subjects with SCD/SCT from clinics, community settings, and online networks with data collected at sites convenient to the 234 subjects with SCD (n = 136) or SCT (n = 98). Their ages ranged from 18 to 35 years; 65% were women, and 94% were African American. Subjects completed a measure of sickle cell reproductive knowledge, intention, and behavior before and immediately after the intervention. RESULTS Compared with the e-Book group, the CHOICES group had significantly higher average knowledge scores and probability of reporting a parenting plan to avoid SCD or SCD and SCT when pretest scores were controlled. Effects on intention and planned behavior were not significant. The CHOICES group showed significant change in their intention and planned behavior, whereas the e-Book group did not show significant change in their intention, but their planned behavior differed significantly. DISCUSSION Initial efficacy findings are encouraging but warrant planned booster sessions and outcome follow-ups to determine sustained intervention efficacy on reproductive health knowledge, intention, and actual behavior of persons with SCD/SCT.
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Lam CB, Lefkowitz ES. Risky sexual behaviors in emerging adults: longitudinal changes and within-person variations. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:523-532. [PMID: 22576250 DOI: 10.1007/s10508-012-9959-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 12/05/2011] [Accepted: 12/15/2011] [Indexed: 05/31/2023]
Abstract
This study examined longitudinal changes in condom use inconsistency and sexual encounters involving alcohol use and the within-person associations of these two risky sexual behaviors with other personal and contextual factors. Data were drawn from a sample of college students who completed surveys on four occasions across 3 years and included 317 participants (48 % male; 32 % African American, 28 % Latino American, and 40 % European American) who reported recent penetrative sexual activities on at least one of the occasions. Multilevel models revealed that, although condom use inconsistency increased and then leveled off over time, sexual encounters involving alcohol use showed a linear increase. Moreover, at times when students held more negative attitudes toward condoms than usual, they used condoms less consistently than usual; at times when students felt more anxious about HIV/AIDS than usual, they had more sexual encounters involving alcohol use than usual; and at times when students were involved in a serious relationship, they used condoms less consistently and had fewer sexual encounters involving alcohol use than usual. Findings demonstrate the utility of a developmental perspective in understanding sexual behaviors, the importance of examining the unique correlates of different risky sexual behaviors, and the distinctiveness between within-person versus between-person associations.
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Affiliation(s)
- Chun Bun Lam
- Department of Human Development and Family Studies, The Pennsylvania State University, 211 South Henderson Building, University Park, PA 16802, USA.
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O'Leary A, Jemmott JB, Jemmott LS, Bellamy S, Ngwane Z, Icard L, Gueits L. Moderation and mediation of an effective HIV risk-reduction intervention for South African adolescents. Ann Behav Med 2013; 44:181-91. [PMID: 22618963 DOI: 10.1007/s12160-012-9375-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND "Let Us Protect Our Future" is a sexual risk-reduction intervention for sixth-grade adolescents in South Africa. Tested in a cluster-randomized controlled trial, the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period. PURPOSE The present analyses were conducted to identify moderators of the intervention's efficacy as well as, which theory-based variables mediated the intervention's effects. METHODS Intervention efficacy over the 3-, 6-, and 12-month follow-up was tested using generalized estimating equation models. RESULTS Living with their father in the home, parental strictness, and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse. Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse, derived from Social Cognitive Theory, significantly mediated the intervention's effect on abstinence. CONCLUSIONS This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents.
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Affiliation(s)
- Ann O'Leary
- Prevention Research Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Kao TSA, Guthrie B, Loveland-Cherry C, Caldwell CH. Cross-cultural variations in adolescents' perceived maternal expectancy and sexual initiation. J Transcult Nurs 2012; 23:377-88. [PMID: 22902880 DOI: 10.1177/1043659612452669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This study built on previous findings and compared the effects of maternal influences on adolescents' sexual initiation among four racial and ethnic groups: Asian American Pacific Islanders, African Americans, Hispanic Americans, and Caucasians. DESIGN An exploratory, comparative secondary analysis of longitudinal data from 433 Asian American Pacific Islanders, 1,367 African Americans, 1,241 Hispanic Americans, and 4,567 Caucasian adolescents between the ages of 15 and 17 years at Wave 1 was conducted using structural equation modeling. Bronfenbrenner's Social Ecological Model guided the modeling and analyses. RESULTS Adolescents' sexual initiation was significantly associated with mother-adolescent interactions and adolescents' perceived maternal sexual expectations. Cross-cultural variations are noted and discussed. CONCLUSIONS Nursing interventions designed to delay adolescents' sexual initiation need to focus on familial and cultural variations associated with mother-adolescent interactions.
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Affiliation(s)
- Tsui-Sui Annie Kao
- School of Nursing, University of Michigan, Ann Arbor, MI 48109-5482, USA.
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Huebner DM, Neilands TB, Rebchook GM, Kegeles SM. Sorting through chickens and eggs: a longitudinal examination of the associations between attitudes, norms, and sexual risk behavior. Health Psychol 2011; 30:110-8. [PMID: 21299299 DOI: 10.1037/a0021973] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Health behavior theories posit that health-relevant attitudes, beliefs, and behavioral skills drive subsequent actions people take to protect themselves from health threats. Within the realm of HIV-related sexual risk behavior, much of the research in support of this notion is cross-sectional, rather than longitudinal, particularly in studies of gay and bisexual men. Other psychological theories (e.g., self-perception or cognitive dissonance theories) suggest that the opposite could be true--that health-relevant attitudes and beliefs might change as a function of previous risk or precautionary behavior. Appreciating the complex nature of these associations is essential for modifying theory and developing appropriate interventions. DESIGN Using longitudinal data from gay and bisexual men (n = 1465), we used structural equation modeling to examine three possibilities--that perceived norms and attitudes about sexual risk would be (a) related to unprotected anal intercourse cross-sectionally, (b) related to unprotected anal intercourse at a subsequent time point, and/or (c) predicted from previous instances of unprotected anal intercourse. RESULTS Safe-sex norms and attitudes were related to unprotected anal intercourse cross-sectionally, but did not predict unprotected sex longitudinally. Rather, perceived norms and attitudes changed as a function of previous risk behavior. CONCLUSIONS These results raise the possibility that modified theoretical models might be necessary to adequately describe sexual risk behavior among gay and bisexual men.
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Affiliation(s)
- David M Huebner
- Department of Psychology, University of Utah, 380 South 1530 East, Salt Lake City, UT 84122, USA.
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Burnett SM, Weaver MR, Mody-Pan PN, Thomas LAR, Mar CM. Evaluation of an intervention to increase human immunodeficiency virus testing among youth in Manzini, Swaziland: a randomized control trial. J Adolesc Health 2011; 48:507-13. [PMID: 21501811 DOI: 10.1016/j.jadohealth.2010.08.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 08/23/2010] [Accepted: 08/24/2010] [Indexed: 12/01/2022]
Abstract
There is an urgent need for effective HIV prevention programs for adolescents in Swaziland, given the high prevalence of HIV and lack of HIV-related knowledge and skills among Swazi youth. This study set out to determine whether an HIV education intervention designed in the United States, and adapted for Swaziland, would be effective in changing participants' HIV-related knowledge, attitudes, and protective behaviors including HIV testing. We also explored whether the components of Self-Efficacy Theory are associated with these behaviors. Data were obtained from 135 students who participated in a school-based program. The study found significant differences between the intervention and control groups regarding HIV knowledge, self-efficacy for abstinence, condom use, and getting HIV test results, outcome expectations for knowing one's own HIV status, and the protective behavior of getting an HIV test. This is evidence that school-based HIV education programs can successfully increase HIV testing among in-school youth in Swaziland.
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Affiliation(s)
- Sarah M Burnett
- International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, WA, USA.
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Frew PM, Archibald M, Diallo DD, Hou SI, Horton T, Chan K, Mulligan MJ, del Rio C. An extended model of reasoned action to understand the influence of individual- and network-level factors on African Americans' participation in HIV vaccine research. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2010; 11:207-18. [PMID: 20012200 DOI: 10.1007/s11121-009-0162-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In the United States, the number and proportion of HIV/AIDS cases among black/African Americans continue to highlight the need for new biomedical prevention interventions, including an HIV vaccine, microbicide, or new antiretroviral (ARV) prevention strategies such as pre-exposure prophylaxis (PrEP) to complement existing condom usage, harm reduction methods, and behavioral change strategies to stem the HIV epidemic. Although black/African Americans are disproportionately impacted by HIV/AIDS, their participation in HIV clinical research continues to have unique challenges. We theorize that interaction among multilevel factors creates ideal alignment for minority participation in HIV clinical studies. Thus, we initially set out to test an extended model of reasoned action with 362 participants to understand the interplay of sociopsychological and network-level considerations influencing minority participation in HIV prevention research efforts. In this study, we linked the intrapersonal dimensions of attitudes, beliefs, and normative concerns to community-level components, appraisal of involvement with the clinical research organization, an entity which operates within a networked structure of community partner agencies, and identification with coalition advocacy aims. Various participatory outcomes were explored including involvement in future HIV vaccine community functions, participation in community promotion of HIV vaccine research, and community mobilization. Three-stage least squares estimates indicated similar findings across three models. Significant effects demonstrate the importance of positive attitudes toward HIV vaccine research, favorable health research beliefs, perceived social support for participation, HIV/AIDS issue engagement, and perceived relevance of the clinical research site's mission and values. Identification of these nuanced pathway effects provides implications for tailored community program development.
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Affiliation(s)
- Paula M Frew
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
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Busse P, Fishbein M, Bleakley A, Hennessy M. The Role of Communication with Friends in Sexual Initiation. COMMUNICATION RESEARCH 2010; 37:239-255. [PMID: 20613973 PMCID: PMC2897170 DOI: 10.1177/0093650209356393] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This study identifies a theoretical mechanism through which communication with friends about sex influences sexual initiation in a sample of adolescents. The Integrative Model was used to assess the effect of attitudes, normative pressure and self efficacy on intentions to have sex in a sample of virgin adolescents. Results show that the constructs of the theory partially mediated the effect of communication with friends on subsequent sexual initiation. The effect of communication with friends on sexual initiation was not different for males and females. Overall, the results suggest how conversations with friends about sex influence adolescents' intentions to initiate sexual intercourse, which in turn influence subsequent sexual initiation.
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Wang RH, Cheng CP, Chou FH. Predictors of sexual abstinence behaviour in Taiwanese adolescents: a longitudinal application of the transtheoretical model. J Clin Nurs 2009; 18:1010-7. [DOI: 10.1111/j.1365-2702.2008.02509.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
BACKGROUND The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, educational interventions addressing contraception often have no stated theoretical base. OBJECTIVES Review randomized controlled trials that tested a theoretical approach to inform contraceptive choice; encourage contraceptive use; or promote adherence to, or continuation of, a contraceptive regimen. SEARCH STRATEGY We searched computerized databases for trials that tested a theory-based intervention for improving contraceptive use (MEDLINE, POPLINE, CENTRAL, PsycINFO, EMBASE, ClinicalTrials.gov, and ICTRP). We also wrote to researchers to find other trials. SELECTION CRITERIA Trials tested a theory-based intervention for improving contraceptive use. We excluded trials focused on high-risk groups. Interventions addressed the use of one or more contraceptive methods. The reports provided evidence that the intervention was based on a specific theory or model. The primary outcomes were pregnancy, contraceptive choice, initiating or changing contraceptive use, contraceptive regimen adherence, and contraception continuation. DATA COLLECTION AND ANALYSIS The primary author evaluated abstracts for eligibility. Two authors extracted data from included studies. We calculated the odds ratio for dichotomous outcomes and the mean difference for continuous data. No meta-analysis was conducted due to intervention differences. MAIN RESULTS Of 26 trials, 12 interventions addressed contraception (other than condoms), while 14 focused on condom use for preventing HIV or STIs. In 2 of 10 trials with pregnancy or birth data, a theory-based group showed better results. Four of nine trials with contraceptive use (other than condoms) showed better outcomes in an experimental group. For condom use, a theory-based group had favorable results in 14 of 20 trials, but the number was halved in a subgroup analysis. Social Cognitive Theory was the main theoretical basis for 12 trials, and 10 showed positive results. Of the other 14 trials, favorable results were shown for other social cognition models (N=2), motivational interviewing (N=5), and the AIDS Risk Reduction Model (N=2). No major patterns were detected by type of theory, intervention, or target population. AUTHORS' CONCLUSIONS Family planning researchers and practitioners could apply the relevant theories and effective interventions from HIV and STI prevention. More thorough use of single theories would help inform the field about what works. Better reporting is needed on research design and intervention implementation.
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Affiliation(s)
- Laureen M Lopez
- Behavioral and Biomedical Research, Family Health International, P.O. Box 13950, Research Triangle Park, North Carolina 27709, USA.
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Wang RH, Cheng CP, Chou FH. A causal model of contraceptive intention and its gender comparison among Taiwanese sexually inexperienced adolescents. J Clin Nurs 2008; 17:930-9. [DOI: 10.1111/j.1365-2702.2007.02088.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Wang RH, Wang HH, Cheng CP, Hsu HY, Lin SY. Testing a model of contraception use behavior among sexually active female adolescents in Taiwan. Res Nurs Health 2008; 30:628-40. [PMID: 18022833 DOI: 10.1002/nur.20222] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this cross-sectional study was to test a model of contraception use among sexually active Taiwanese female adolescents, using structural equation modeling. Anonymous questionnaires were distributed to 404 female adolescents who had had sexual intercourse in the previous 3 months. A model was produced in which past contraception use, self-efficacy for contraception use, and decisional balance for using contraception had significant direct effects on current contraception use. Social influences had not only significant direct effects on self-efficacy and on decisional balance, but also a significant indirect effect on current contraception use. These findings provide a reference for the development of contraceptive intervention programs for sexually active female adolescents in Taiwan.
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Affiliation(s)
- Ruey-Hsia Wang
- Kaohsiung Medical University, College of Nursing, No. 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan
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Bralock AR, Koniak-Griffin D. Relationship, power, and other influences on self-protective sexual behaviors of African American female adolescents. Health Care Women Int 2007; 28:247-67. [PMID: 17364984 DOI: 10.1080/07399330601180123] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined risky sexual behaviors, gender, and power issues affecting risk taking, and factors most likely to promote self-protection among female African American adolescents. A cross-sectional design was used for data collection. The sample included 130 adolescents ranging from 14 to 20 years of age, who completed questionnaires. Multiple regression analysis resulted in two models that accounted for 23% and 37% of the variance. Behavioral intention, partner age, pregnancy status, current substance use, and length of sexual relationship were statistically significant predictor variables. Behavioral intentions, in particular, were found to be a strong predictor of condom use among African American youth.
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Affiliation(s)
- Anita R Bralock
- Azusa Pacific University, School of Nursing, Azusa, California, USA.
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