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Norr KF, Banda CK, Chang C, Krishna S, Kumbani LC, Liu L, McCreary LL, Patil CL. Condom use increased after a peer group intervention implemented by community volunteers in Malawi. BMC Public Health 2024; 24:1483. [PMID: 38831266 PMCID: PMC11145788 DOI: 10.1186/s12889-024-18991-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 05/29/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND HIV prevention remains a global priority, especially in sub-Saharan Africa. Our research team previously developed an evidence-based peer group program for HIV prevention called Mzake ndi Mzake (Friend to Friend). A community-engaged collaboration adapted the program for community ownership and implementation. Here we report whether this HIV prevention program, implemented by community volunteers, increased condom use among sexually active individuals in rural Malawi. METHODS Three communities sequentially rolled out the program. Effectiveness was evaluated using a stepped wedge design. Repeated surveys 11-13 months apart were conducted between 2016 and 2019. At Time 1, no community had offered the intervention. At Time 2, the first community had offered the intervention and two had not (control group). At Time 3, two communities had offered the intervention and one had not (control group). We used two condom use indicators; condom use frequency in the last 2 months (N = 771) and condom use at last sex (N = 880). The analytical sample included all sexually active persons answering that question at one or more time points. Mixed-effects cumulative logit and Generalized Estimating Equation (GEE) models were used to model the two condom indicators over time, controlling for demographic factors, UNAIDS HIV knowledge, safer sex self-efficacy and partner communication. RESULTS This peer group intervention implemented by trained community volunteers increased both condom use indicators at Times 2 and 3. In the final adjusted models with non-significant factors removed, condom use in the last two months increased for the intervention group vs. control group [Time 2: Adjusted Odds Ratio (AOR) = 1.59 (1.15, 2.21); Time 3: AOR 2.01 (1.23, 3.30)]. Similarly, condom use at last sex increased for the intervention group vs. control group [Time 2: AOR = 1.48 (1.08, 2.03); Time 3: AOR 1.81 (1.13, 2.90)]. Other significant predictors of greater condom use were also described. Although the intervention increased UNAIDS HIV knowledge, knowledge did not predict condom use. CONCLUSIONS In this community-engaged implementation study, an evidence-based peer group program for HIV prevention increased condom use when delivered by trained community volunteers. Community ownership and program delivery by trained volunteers offer an innovative and cost-effective strategy to address ongoing HIV prevention needs without overburdening healthcare systems in sub-Saharan Africa. TRIAL REGISTRATION Clinical Trials.gov NCT02765659 Registered May 6, 2016.
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Affiliation(s)
- Kathleen F Norr
- College of Nursing, University of Illinois Chicago, 845 S Damen Ave, Chicago, IL, 60612, USA.
| | - Chimwemwe K Banda
- Malawi Liverpool Wellcome Clinical Research Program, P.O Box 30096, Chichiri, Blantyre 3, Malawi
| | - Cecilia Chang
- School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA
| | - Shruthi Krishna
- School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA
| | - Lily C Kumbani
- Kamuzu University of Health Sciences, P/Bag 360, Chichiri, Blantyre 3, Malawi
| | - Li Liu
- School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA
| | - Linda L McCreary
- College of Nursing, University of Illinois Chicago, 845 S Damen Ave, Chicago, IL, 60612, USA
| | - Crystal L Patil
- School of Nursing, University of Michigan, 400 N. Ingalls St, Ann Arbor, MI, 48109, USA
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Majeed R, Hamilton K, Watts GF, Hagger MS. Social cognition correlates of self-management behaviors in patients with familial hypercholesterolemia (FH): A meta-analytic review. Soc Sci Med 2024; 351:116968. [PMID: 38759387 DOI: 10.1016/j.socscimed.2024.116968] [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: 11/10/2023] [Revised: 02/25/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE Familial Hypercholesterolemia (FH) is an inherited disorder leading to increased risk of premature atherosclerotic cardiovascular disease. This risk can be ameliorated through adherence to pharmacological treatment and salient lifestyle behaviors (e.g., physical activity participation, healthy eating). Identifying theory-based, modifiable determinants of these behaviors may inform behavioral interventions promoting participation in FH self-management behaviors. We aimed to identify the belief-based social cognition constructs uniquely associated with intentions to perform, and actual participation in, FH self-management behaviors in the extant research. METHOD A systematic database search identified studies (k = 9, N = 1394) reporting relations between social cognition theory constructs and intention toward, or actual participation in, self-management behaviors in FH patients. As no studies examining prospectively-measured behaviors were identified, we tested relations among social cognition constructs, intentions, and past FH-self-management behavior using random effects multi-level meta-analysis and meta-analytic structural equation modelling. RESULTS We found non-zero averaged correlations among the key social cognition constructs (attitudes, norms, risk perceptions, self-efficacy), intentions, and past behavior. A meta-analytic structural equation model indicated non-zero averaged direct effects of attitudes, norms, self-efficacy, and past behavior on FH self-management behavioral intentions. There were also non-zero averaged indirect effects of past behavior on intentions mediated by the social cognition constructs. CONCLUSION Findings provide evidence to support the proposed model and highlight the importance of personal, normative, and capacity related beliefs and past experience as unique correlates of intentions to perform FH self-management behaviors. The model may signal potential constructs that could be targeted in behavioral interventions to promote participation in FH self-management behaviors.
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Affiliation(s)
- Rabia Majeed
- Department of Psychological Sciences, University of California, Merced, United States
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Mt. Gravatt, Australia; Health Sciences Research Institute, University of California, Merced, United States; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Gerald F Watts
- School of Medicine, University of Western Australia, Perth, Australia; Cardiometabolic Service, Department of Cardiology, Royal Perth Hospital, Perth, Australia
| | - Martin S Hagger
- Department of Psychological Sciences, University of California, Merced, United States; School of Applied Psychology, Griffith University, Mt. Gravatt, Australia; Health Sciences Research Institute, University of California, Merced, United States; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Rodrigues DL, Carvalho AC, Prada M, Garrido MV, Balzarini RN, de Visser RO, Lopes D. Condom Use Beliefs Differ According to Regulatory Focus: A Mixed-Methods Study in Portugal and Spain. JOURNAL OF SEX RESEARCH 2024; 61:709-726. [PMID: 36877803 DOI: 10.1080/00224499.2023.2181305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Reports worldwide have been showing increasing rates of sexually transmitted infections (STIs) and condomless sex in recent years. Research has identified several individual and situational variables that can determine the decision to use condoms or forgo their use. We argue that such a decision can also be shaped by motives related to pleasure and safety (i.e., regulatory focus in sexuality). Using open ended questions, we asked 742 Portuguese and Spanish adults to indicate situations and reasons that could inform the decision making process with casual partners and the functions/attributes related to condoms. Using thematic analyses, we coded the drivers of condomless sex and condom use into themes and subthemes, and computed their frequencies. Using quantitative measures, we also asked participants to indicate their condom use expectancies and perceived barriers. Comparing participants according to regulatory focus revealed some differences. Pleasure promotion participants were more likely to consider that condom use decision making is driven by unexpectedness, pleasure, and intimacy pursuit, attached more pleasure reduction functions to condoms, expected more negative outcomes in condom use, and endorsed more sensation and partner barriers in condom use. In contrast, disease prevention participants were more likely to consider that condom use decision making is driven by adequate sexual education, responsibility, and behavioral control, and attached more health protective functions to condoms. These differences can inform the development of tailored intervention and awareness campaigns aimed at helping people to use condoms more consistently with casual partners and to avoid behaviors that put them at risk of STI transmission.
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Affiliation(s)
- David L Rodrigues
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Lisboa, Portugal
| | | | - Marília Prada
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Lisboa, Portugal
| | | | - Rhonda N Balzarini
- Department of Psychology, Texas State University, San Marcos, TX, USA
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Richard O de Visser
- Department of Primary Care & Public Health, Brighton and Sussex Medical School, Falmer, UK
| | - Diniz Lopes
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Lisboa, Portugal
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Cortina AH, Scanlan J, Paneque RJ, Vasquez Osses MA. Cross-Cultural Adaptation and Psychometric Evaluation of Condom Use Self-Efficacy Scale in Chilean College Students. J Nurs Meas 2023; 31:360-369. [PMID: 37558259 DOI: 10.1891/jnm-2021-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Background and Purpose: Limited culturally relevant condom self-efficacy measures have been adapted for use with Chilean college students. This study aims to culturally adapt and measure the psychometric properties of the Condom Use Self-Efficacy Scale (CUSES) by use in college students in Chile. Methods: This cross-sectional study was carried out in six stages: (a) authorization from original authors, (b) translation, (c) back translation, (d) analysis of equivalences, (e) content analysis, and (f) exploratory factor analysis and reliability assessment. Results: Of the 460 college students who completed the Chilean CUSES (Ch-CUSES), 73.9% were women and 99% were single with a mean age of 20.5. Total scale Cronbach's alpha was 0.845, and factor analysis demonstrated six dimensions with 59.1% of the total variance. The factor loading scores of 21 items ranged between 0.515 and 0.921. Conclusions: Ch-CUSES shows good psychometric properties for assessing self-efficacy for condom use in Chilean college students.
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Affiliation(s)
- Abdul Hernández Cortina
- Universidad Autónoma de Chile, Providencia, Región Metropolitana, Chile
- Universidad Finis Terrae, Providencia, Región Metropolitana, Chile
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Norr KF, Banda CK, Chang C, Krishna S, Kumbani LC, Liu L, McCreary LL, Patil CL. Condom use increased after a peer group intervention implemented by community volunteers in Malawi. RESEARCH SQUARE 2023:rs.3.rs-3120974. [PMID: 37461672 PMCID: PMC10350185 DOI: 10.21203/rs.3.rs-3120974/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Background HIV prevention remains a global priority, especially in sub-Saharan Africa. Our research team previously developed an evidence-based peer group program for HIV prevention called Mzake ndi Mzake (Friend to Friend). A community-engaged collaboration adapted the program for community ownership and implementation. Here we report whether this HIV prevention program, implemented by community volunteers, increased condom use among sexually active individuals in rural Malawi. Methods Three communities sequentially rolled out the program. Effectiveness was evaluated using repeated surveys. At Time 1, no community had offered the intervention. At Time 2, the first community had offered the intervention and two had not (control group). At Time 3, two communities had offered the intervention and one had not (control group). We used two condom use indicators; condom use frequency in the last 2 months (N = 776) and condom use at last sex (N = 880). For each indicator, the sample included all sexually active persons answering that question at one or more time points. Regression analyses were used to model the two condom indicators over time, controlling for demographic factors, UNAIDS HIV knowledge, safer sex self-efficacy and partner communication. Results This peer group intervention implemented by trained community volunteers increased both condom use indicators at Times 2 and 3. In the final regression models. Other predictors of greater condom use for at least one condom use indicator included younger age group (13-19), male gender, not married/cohabiting, high involvement in religiously affiliated activities, higher safer sex self-efficacy, and greater partner communication. Although the intervention increased UNAIDS HIV knowledge, knowledge did not predict condom use. Conclusions This community engaged implementation study found that an evidence-based peer group program for HIV prevention increased condom use when delivered by trained community volunteers. Leveraging community strengths and human capital resources facilitated implementation of this effective HIV prevention program in rural Malawi. Community ownership and program delivery by trained local volunteers offers an innovative and cost-effective strategy to address ongoing HIV prevention needs without overburdening heathcare systems in sub. Trial registration Clinical Trials.gov NCT02765659 Registered May 6, 2016.
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Affiliation(s)
| | | | - Cecilia Chang
- School of Public Health, University of Illinois Chicago
| | | | | | - Li Liu
- School of Public Health, University of Illinois Chicago
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Elshiekh HF, Hoving C, de Vries H. Psychosocial determinants of consistent condom use among university students in Sudan: findings from a study using the Integrated Change Model. BMC Public Health 2023; 23:578. [PMID: 36978037 PMCID: PMC10045195 DOI: 10.1186/s12889-023-15466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Unprotected sex is common among university students in Sudan, thus increasing risks for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV). As little is known about the psychosocial determinants of consistent condom use among this population, this study was designed to identify them. The Integrated Change Model (ICM) was applied in a cross-sectional design to identify in 218 students (aged 18-25 years) from Khartoum which items distinguish condom users from non-condom users. Condom users differed significantly from non-condom users in having more HIV and condom use-related knowledge, higher perception of susceptibility to HIV, reporting more exposure to condom use cues, having a less negative attitude towards condom use (attitude cons), experiencing social support and norms favouring condom use and having higher condom use self-efficacy. Binary logistic regression showed that peer norms favouring condom use in addition to HIV-related knowledge, condom use cues, negative attitude and self-efficacy were the factors uniquely associated with consistent condom use among university students in Sudan. Interventions seeking to promote consistent condom use among sexually active students could benefit from increasing knowledge about HIV transmission and prevention, raising HIV-risk perception, using condom use cues, addressing perceived condom disadvantages and enhancing students` self-efficacy to avoid unprotected sex. Moreover, such interventions should raise students` perceptions of their peers` beliefs and behaviours favouring condom use and seek health care professionals` and religious scholars` support for condom use.
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Affiliation(s)
- Husameddin Farouk Elshiekh
- CAPHRI School for Public Health and Primary Care, Department of Health Promotion, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands.
| | - Ciska Hoving
- CAPHRI School for Public Health and Primary Care, Department of Health Promotion, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands
| | - Hein de Vries
- CAPHRI School for Public Health and Primary Care, Department of Health Promotion, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands
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Hagger MS, Smith SR, Keech JJ, Moyers SA, Hamilton K. Predicting physical distancing over time during COVID-19: testing an integrated model. Psychol Health 2022; 37:1436-1456. [PMID: 34435916 DOI: 10.1080/08870446.2021.1968397] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Objective: We applied an integrated social cognition model to predict physical distancing behavior, a key COVID-19 preventive behavior, over a four-month period. Design: A three-wave longitudinal survey design. Methods: Australian and US residents (N = 601) completed self-report measures of social cognition constructs (attitude, subjective norm, moral norm, perceived behavioral control [PBC]), intention, habit, and physical distancing behavior on an initial occasion (T1) and on two further occasions one week (T2) and four months (T3) later. Results: A structural equation model revealed that subjective norm, moral norm, and PBC, were consistent predictors of physical distancing intention on all three occasions. Intention and habit at T1 and T2 predicted physical distancing behavior at T2 and T3, respectively. Intention at T2 mediated effects of subjective norm, moral norm, and PBC at T2 on physical distancing behavior at T3, and habit at T1 and T2 mediated effects of behavior at T1 and T2 on follow-up behavior at T2 and T3, respectively. Conclusion: Normative (subjective and moral norms) and capacity (PBC) constructs were consistent predictors of physical distancing intention, and intention and habit were consistent predictors of physical distancing behavior. Interventions promoting physical distancing should target change in normative and personal capacity beliefs, and habit.Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2021.1968397 .
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Affiliation(s)
- Martin S Hagger
- Social and Health Psychology Behavioral Research for Prevention and Promotion (SHARPP) Lab, Department of Psychological Sciences and Health Sciences Research Institute, University of California Merced, Merced, California, USA.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland.,Health and Psychology Innovations (HaPI) Research Lab, School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Stephanie R Smith
- Health and Psychology Innovations (HaPI) Research Lab, School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Jacob J Keech
- Health and Psychology Innovations (HaPI) Research Lab, School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.,School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Susette A Moyers
- Social and Health Psychology Behavioral Research for Prevention and Promotion (SHARPP) Lab, Department of Psychological Sciences and Health Sciences Research Institute, University of California Merced, Merced, California, USA
| | - Kyra Hamilton
- Health and Psychology Innovations (HaPI) Research Lab, School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Social cognition theories and behavior change in COVID-19: A conceptual review. Behav Res Ther 2022; 154:104095. [PMID: 35605335 PMCID: PMC9005242 DOI: 10.1016/j.brat.2022.104095] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/31/2022] [Accepted: 04/08/2022] [Indexed: 01/31/2023]
Abstract
The COVID-19 pandemic has had unprecedented health, economic, and social consequences worldwide. Although contact reductions and wearing face coverings have reduced infection rates, and vaccines have reduced illness severity, emergence of new variants of the coronavirus that causes COVID-19, and the shift from pandemic to endemic patterns of infection, highlights the importance of ongoing preventive behavior adherence to manage future outbreaks. Research applying social cognition theories may assist in explaining variance in these behaviors and inform the development of efficacious behavior change interventions to promote adherence. In the present article, we summarize research applying these theories to identify modifiable determinants of COVID-19 preventive behaviors and the mechanisms involved, and their utility in informing interventions. We identify limitations of these applications (e.g., overreliance on correlational data, lack of long-term behavioral follow-up), and suggest how they can be addressed. We demonstrate the virtue of augmenting theories with additional constructs (e.g., moral norms, anticipated regret) and processes (e.g., multiple action phases, automatic processes) to provide comprehensive, parsimonious behavioral explanations. We also outline how the theories contribute to testing mechanisms of action of behavioral interventions. Finally, we recommend future studies applying these theories to inform and test interventions to promote COVID-19 preventive behavior adherence.
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Ballester-Arnal R, Giménez-García C, Ruiz-Palomino E, Castro-Calvo J, Gil-Llario MD. A Trend Analysis of Condom use in Spanish Young People over the Two Past Decades, 1999-2020. AIDS Behav 2022; 26:2299-2313. [PMID: 35038068 PMCID: PMC8762636 DOI: 10.1007/s10461-021-03573-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2021] [Indexed: 11/18/2022]
Abstract
HIV exposure is one of the greatest sexual risks in young people, and condom use is the best protective measure. Despite the preventive efforts, trend in condom use is still unclear. This study examines the trend of condom use by gender in Spanish young people, in different sexual practices (vaginal, oral and anal), relationships (regular and casual) and having sex after drugs consumption during the two past decades (from 1999 to 2020). For this, 14,472 people who ranged from 17 to 40 years old (63.5% women) filled the AIDS Prevention Questionnaire in each year. In general, low condom use remains stable and even gets worse regardless of the type of sexual practice, relationship and the substance consumption. Regarding gender, this trend is worse in women who have been less likely to report condom use than men have. Moreover, older people have reported a minor frequency of condom use than the youngest people have done, except for anal sex. Therefore, it is necessary to analyze why, despite preventive efforts, condom use seems to decrease over time.
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de Wit JBF, Adam PCG, den Daas C, Jonas K. Sexually transmitted infection prevention behaviours: health impact, prevalence, correlates, and interventions. Psychol Health 2022; 38:675-700. [PMID: 35748408 DOI: 10.1080/08870446.2022.2090560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Sexually transmitted infections (STIs) remain a major public health threat, disproportionately affecting young people, and men who have sex with men. In this narrative review of the current state of behavioural science research on STI prevention, we consider the definition, health impacts, correlates and determinants, and interventions to promote STI prevention behaviour. Research on STI prevention behaviour has extended from a focus on abstinence, partner reduction and condom use, to also include novel preventive behaviours, notably treatment-as-prevention, pre-exposure prophylaxis (i.e., the preventive use of medicines by uninfected people), and vaccination for some STIs. Social-cognitive factors specified by, for instance the theory of planned behaviour, are critical proximal determinants of STI prevention behaviours, and related interventions can effectively promote STI prevention behaviours. Social-ecological perspectives highlight that individual-level determinants are embedded in more distal environmental influences, with social stigma especially affecting STI prevention behaviours and requiring effective intervention. Further to providing a major domain of application, STI prevention also poses critical challenges and opportunities for health psychology theory and research. We identify a need for health behaviour theory that addresses the processes linking multiple levels of influence on behaviour and provides practical guidance for multi-level behaviour change interventions adapted to specific contexts.
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Affiliation(s)
- John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Philippe C. G. Adam
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
- Institute for Prevention and Social Research, Bangkok, Thailand
| | - Chantal den Daas
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
| | - Kai Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
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Hegdahl HK, Musonda P, Svanemyr J, Zulu JM, Grønvik T, Jacobs C, Sandøy IF. Effects of economic support, comprehensive sexuality education and community dialogue on sexual behaviour: Findings from a cluster-RCT among adolescent girls in rural Zambia. Soc Sci Med 2022; 306:115125. [PMID: 35724585 DOI: 10.1016/j.socscimed.2022.115125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/14/2022] [Accepted: 06/09/2022] [Indexed: 10/18/2022]
Abstract
Adolescent girls in Sub-Saharan Africa are at high risk of poor sexual and reproductive health outcomes. We present findings from a cluster-randomised trial in rural Zambia on the effects of economic support, comprehensive sexuality education (CSE) and community dialogue on sexual activity, contraceptive use and beliefs among adolescent girls. We recruited 157 schools in 2016, and all girls in grade 7 were invited to participate. Schools were randomised to either economic support, combined economic support, CSE and community dialogue, or control. Economic support consisted of unconditional cash transfers to girls and their guardians, and payment of school fees for girls continuing to grades eight and nine. CSE and community dialogue meetings focused on practices around girls' fertility, marriage and education. The interventions lasted two years from 2016 to 2018, with follow-up for another two years. The effects on outcomes were measured in 2018 and 2019 and compared using generalised estimating equations. We found that economic support lowered sexual activity (risk ratio (RR) 0.70; 95% C.I. 0.54 to 0.91), with a small added benefit of CSE and community dialogue. Economic support and the additional CSE and community dialogue were effective in lowering unprotected sexual activity (RR 0.53 for combined support vs. control; 95% C.I. 0.37 to 0.75). There was no evidence of intervention effects on contraceptive use among those ever sexually active, but the addition of CSE and community dialogue improved contraceptive use among those recently sexually active (RR 1.26; 95% C.I. 1.06 to 1.50) and knowledge regarding contraceptives (RR 1.18; 95% C.I. 1.01 to 1.38) compared to economic support alone. Perceived community support regarding contraceptives was lower in both intervention arms compared to the control. These findings indicate that economic support in combination with CSE and community dialogue can improve the sexual and reproductive health of adolescent girls.
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Affiliation(s)
- Hanne Keyser Hegdahl
- Centre for International Health, University of Bergen, Årstadveien 21 (Overlege Danielsens Hus), 5006, Bergen, Norway; Centre for Intervention Science in Maternal and Child Health, University of Bergen, P.O. Box 7804, NO-5020, Bergen, Norway.
| | - Patrick Musonda
- School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Joar Svanemyr
- Chr. Michelsen Institute, P.O. Box 6033, N-5892, Bergen, Norway
| | - Joseph Mumba Zulu
- School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Taran Grønvik
- Centre for International Health, University of Bergen, Årstadveien 21 (Overlege Danielsens Hus), 5006, Bergen, Norway; Centre for Intervention Science in Maternal and Child Health, University of Bergen, P.O. Box 7804, NO-5020, Bergen, Norway
| | - Choolwe Jacobs
- School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Ingvild Fossgard Sandøy
- Centre for International Health, University of Bergen, Årstadveien 21 (Overlege Danielsens Hus), 5006, Bergen, Norway; Centre for Intervention Science in Maternal and Child Health, University of Bergen, P.O. Box 7804, NO-5020, Bergen, Norway
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Sharma A, Mwamba C, Ng'andu M, Kamanga V, Zoonadi Mendamenda M, Azgad Y, Jabbie Z, Chipungu J, Pry JM. Pilot implementation of a user-driven, web-based application designed to improve sexual health knowledge and communication among young Zambians: a mixed method study (Preprint). J Med Internet Res 2022; 24:e37600. [PMID: 35797099 PMCID: PMC9305403 DOI: 10.2196/37600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/14/2022] [Accepted: 05/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Digital health interventions show promise in improving the uptake of HIV services among adolescents and young people aged 15 to 24 years in sub-Saharan Africa. Objective This study aimed to pilot-test a theory-based, empirically grounded web-based application designed to increase condom-related knowledge, sexual and reproductive health (SRH) communication, and healthier choices among young Zambians. Methods We conducted a pre-post quasi-experimental evaluation of the user-driven Be in the Know Zambia (BITKZ) web application using web-based surveys and in-depth interviews (IDIs) on the phone. We enrolled participants using social media advertisements. Our final analysis set comprised 46.04% (749/1627) of participants in the intervention group (which received the BITKZ link) and 53.96% (878/1627) of participants in the comparison group (no intervention). We collected survey data at study enrollment (baseline) and 5 weeks after the first enrollment in each group. Approximately 85% (637/749) of BITKZ users completed a user survey, of whom 9.3% (59/637) participated in IDIs. We calculated the time interfacing with BITKZ using the application log files. We conducted descriptive analyses to describe baseline characteristics and the user experience. At the endline, we assessed association using a t test and adjusted logistic regression for binary outcomes and ordinal regression for ordered outcomes, conditioning on age, sex, marital status, and employment status. We used adjusted average treatment effects (aATE) to assess the effects of BITKZ intervention. We conducted rapid matrix analyses of IDI transcripts in Microsoft Excel, sorting the data by theme, gender, and experience rating. Results Users rated BITKZ highly (excellent: 352/609, 57.8%; good: 218/609, 35.8%). At the endline, the intervention group had a higher level of knowledge related to condoms (adjusted odds ratio [aOR]: 1.35, 95% CI 1.06-1.69) and on wearing condoms correctly (aOR: 1.23, 95% CI 1.02-1.49). Those who had full-time employment had increased odds of knowing how to wear condoms correctly (aOR: 1.67, 95% CI 1.06-2.63) compared with those who reported being unemployed, as did men when compared with women (aOR: 1.92, 95% CI 1.59-2.31). Those in the intervention group were more likely to score higher for intention to test for sexually transmitted infections (STIs; aATE 0.21; P=.01) and HIV (aATE 0.32; P=.05), as well as for resisting peer pressure (aATE 2.64; P=.02). IDIs corroborated increased knowledge on correct condom use among men and female condoms among women, awareness of STIs and testing, and resistance to peer pressure. Interviewees provided examples of more open SRH communication with partners and peers and of considering, adopting, and influencing others to adopt healthier behaviors. Conclusions Despite the high baseline awareness of SRH among Zambian adolescents and young people with internet access, BITKZ provided modest gains in condom-related knowledge, resistance to peer pressure, and intention to test for STIs and HIV.
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Affiliation(s)
- Anjali Sharma
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Chanda Mwamba
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Mwila Ng'andu
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Vikwato Kamanga
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | | | | - Zainab Jabbie
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Jenala Chipungu
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Jake M Pry
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Public Health Sciences, University of California, Davis, CA, United States
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Hagger MS, Hamilton K. Predicting COVID-19 booster vaccine intentions. Appl Psychol Health Well Being 2022; 14:819-841. [PMID: 35193171 PMCID: PMC9111247 DOI: 10.1111/aphw.12349] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/08/2022] [Indexed: 01/21/2023]
Abstract
Achieving broad immunity through vaccination is a cornerstone strategy for long‐term management of COVID‐19 infections, particularly the prevention of serious cases and hospitalizations. Evidence that vaccine‐induced immunity wanes over time points to the need for COVID‐19 booster vaccines, and maximum compliance is required to maintain population‐level immunity. Little is known of the correlates of intentions to receive booster vaccines among previously vaccinated individuals. The present study applied an integrated model to examine effects of beliefs from multiple social cognition theories alongside sets of generalized, stable beliefs on individuals' booster vaccine intentions. US residents (N = 479) recruited from an online survey panel completed measures of social cognition constructs (attitude, subjective norms, perceived behavioral control, and risk perceptions), generalized beliefs (vaccine hesitancy, political orientation, and free will beliefs), and COVID‐19 vaccine intentions. Social cognition constructs were related to booster vaccine intentions, with attitude and subjective norms exhibiting the largest effects. Effects of vaccine hesitancy, political orientation, and free will beliefs on intentions were mediated by the social cognition constructs, and only vaccine hesitancy had a small residual effect on intentions. Findings provide preliminary evidence that contributes to an evidence base of potential targets for intervention messages aimed at promoting booster vaccine intentions.
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Affiliation(s)
- Martin S Hagger
- Department of Psychological Sciences, University of California, Merced, California, USA.,Health Sciences Research Institute, University of California, Merced, California, USA.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Kyra Hamilton
- Health Sciences Research Institute, University of California, Merced, California, USA.,School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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14
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Bolarinwa OA, Ajayi KV, Sah RK. Association between knowledge of Human Immunodeficiency Virus transmission and consistent condom use among sexually active men in Nigeria: An analysis of 2018 Nigeria Demographic Health Survey. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000223. [PMID: 36962299 PMCID: PMC10021623 DOI: 10.1371/journal.pgph.0000223] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/01/2022] [Indexed: 11/18/2022]
Abstract
An estimated 1.7 million people were living with HIV in Nigeria in 2020, with over 86,000 people newly infected. Although the global rates of HIV have remained consistent over time, Nigeria has the second-highest number of people living with HIV and contributes to 9% of the global burden of HIV/AIDS. This is due to several structural and individual-level factors that limit knowledge of HIV and condom utilization. In this context, this study examines the association between knowledge about HIV transmission and consistent condom use among sexually active men in Nigeria. The data utilised in this study was sourced from the latest Nigeria Demographic and Health Survey conducted in 2018. The sample included a total of 9,346 men between the ages of 15-59 years who were sexually active at the time of data collection. Frequency distribution, univariate and multivariable analyses were performed at 95% confidence interval and p-value less than 0.05 to determine the association between the key independent variables and covariates. The results showed that 85.03% of sexually active men who had no knowledge of HIV engaged in inconsistent condom use. The key independent variable showed that sexually active men who had knowledge of HIV had higher odds [AOR = 1.37; 95%(CI = 1.10-1.72)] of consistent condom use compared to those without knowledge of HIV. However, sexually active men who were previously married [AOR = 0.38; 95%(CI = 0.24-0.61)], and those residing in the South Eastern region of Nigeria [AOR = 0.62; 95%(CI = 0.44-0.96)] had lower odds of consistent condom use. This study established the association between HIV knowledge and consistent condom use among sexually active males in Nigeria even after controlling for confounders. Educational level, wealth index, and ethnicity are also associated with condom use. This calls for the consideration of social determinants of health, localised and cultural health promotion and targeted public health strategies at all governmental levels to combat the HIV/AIDS epidemic in Nigeria.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Department of Global Public Health, School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, United Kingdom
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Obaxlove Consult, Lagos, Nigeria
| | - Kobi V Ajayi
- Education, Direction, Empowerment, & Nurturing (EDEN) Foundation, Abuja, Nigeria
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States of America
- Laboratory for Community Health Evaluation and Systems Science (CHESS), Texas A&M University, College Station, TX, United States of America
| | - Rajeeb Kumar Sah
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, United Kingdom
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15
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Hagger MS. Developing an open science 'mindset'. Health Psychol Behav Med 2021; 10:1-21. [PMID: 34993003 PMCID: PMC8725925 DOI: 10.1080/21642850.2021.2012474] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/24/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Identification of widespread biases present in reported research findings in many scientific disciplines, including psychology, such as failures to replicate and the likely extensive application of questionable research practices, has raised serious concerns over the reliability and trustworthiness of scientific research. This has led to the development of, and advocacy for, 'open science' practices, including data, materials, analysis, and output sharing, pre-registration of study predictions and analysis plans, and increased access to published research findings. Implementation of such practices has been enthusiastic in some quarters, but literacy in, and adoption of, these practices has lagged behind among many researchers in the scientific community. ADVANCES In the current article I propose that researchers adopt an open science 'mindset', a comprehensive approach to open science predicated on researchers' operating under the basic assumption that, wherever possible, open science practices will be a central component of all steps of their research projects. The primary, defining feature of the mindset is a commitment to open science principles in all research projects from inception to dissemination. Other features of the mindset include the assumption that all components of research projects (e.g. pre-registered hypotheses, protocols, materials, analysis plans, data, and output) will be accessible broadly; pro-active selection of open fora to disseminate research components and findings; open and transparent dissemination of reports of the research findings in advance of, and after, formal publication; and active promotion of open science practices through education, modeling, and advocacy. CONCLUSION The open science mindset is a 'farm to fork' approach to open science aimed at promoting comprehensive quality in application of open science, and widening participation in open science practices so that they become the norm in research in health psychology and behavioral medicine going forward.
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Affiliation(s)
- Martin S. Hagger
- Department of Psychological Sciences and Health Sciences Research Institute, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- School of Applied Psychology, Griffith University, Mt. Gravatt, Australia
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16
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Giménez-García C, Ballester-Arnal R, Ruiz-Palomino E, Nebot-García JE, Gil-Llario MD. Trends in HIV sexual prevention: Attitudinal beliefs and behavioral intention in Spanish young people over the past two decades (1999-2020). SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 31:100677. [PMID: 34775354 DOI: 10.1016/j.srhc.2021.100677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/28/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Despite preventive efforts, HIV exposure is still a concern for public health. The current prevalence is related to unsafe sex, which is based on socio-cognitive variables. Therefore, information about these variables is required to verify whether the past preventive strategies have been effective and improve the future ones. However, there is not updated information to adjust future preventive interventions. For this reason, this study analyzes trends by gender in Spanish young people over the past two decades in perceived susceptibility to HIV, severity perceived to HIV, condom confidence and the intention of condom use, from 1999 to 2020. For this purpose, 11,665 Spanish young people (from 17 to 40 years old) completed the AIDS Prevention Questionnaire in each year. Following our results, in general, the socio-cognitive variables have revealed an unsatisfactory trend: a low perceived susceptibility to HIV and a behavioral intention that have remained stable or even declined slightly over the past years. Particularly, men are more likely to report a riskier level in socio-cognitive variables although, in the latest evaluations, women would decrease condom use intention largely than men. In general, regarding age, young adult would report better levels of condom confidence, but early youth would get higher results in perceived severity, as well as better scores in the latest evaluations of condom use intention. Considering these results, policies should make an effort in HIV prevention programs, and emphasize the attention to attitudinal beliefs and behavioral intention to improve their effectiveness.
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Affiliation(s)
- Cristina Giménez-García
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain
| | - Rafael Ballester-Arnal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain.
| | - Estefanía Ruiz-Palomino
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castellón, Spain
| | | | - María Dolores Gil-Llario
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Valencia, Spain
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17
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Perceived norms, personal agency, and postpartum family planning intentions among first-time mothers age 15-24 years in Kinshasa: A cross-sectional analysis. PLoS One 2021; 16:e0254085. [PMID: 34242267 PMCID: PMC8270160 DOI: 10.1371/journal.pone.0254085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/18/2021] [Indexed: 11/19/2022] Open
Abstract
Unintended pregnancy is an important global health problem and frequently occurs during the immediate postpartum period. However, few studies have examined postpartum family planning (PPFP) intentions among adolescent girls and young women. This study assessed whether perceived norms and personal agency predicted PPFP intentions among first-time mothers age 15–24 in Kinshasa, the Democratic Republic of Congo. Data were derived from the 2018 Momentum Project baseline survey. Analysis was based on 2,418 nulliparous pregnant women age 15–24 who were approximately six months pregnant with their first child in six health zones of Kinshasa. Overall PPFP intentions were low and ten to thirteen percent of women stated they were very likely to discuss PPFP next month with (a) their husband/male partner and (b) a health worker, and to (c) obtain and (d) use a contraceptive method during the first six weeks following childbirth. The results of multivariable linear regression models indicated that the PPFP intention index was predicted by description norms, perceptions of the larger community’s approval of PPFP, normative expectations, perceived behavioral control, self-efficacy, and autonomy. Rejection of family planning myths and misconceptions was also a significant predictor. Interaction terms suggested that the association of normative expectations with PPFP intentions varied across ethnic groups and that the positive association of injunctive norms with PPFP intentions was significantly increased when the larger community was perceived to disapprove of PPFP use. Normative expectations and PPFP-related self-efficacy accounted for two-thirds of the variance in PPFP intentions. The results suggested that understanding different normative influences may be important to motivate women to use contraception in the immediate postpartum period. In addition to addressing institutional, individual, and social determinants of PPFP, programs should consider integrating norm-based and empowerment strategies.
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18
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Aventin Á, Gordon S, Laurenzi C, Rabie S, Tomlinson M, Lohan M, Stewart J, Thurston A, Lohfeld L, Melendez-Torres GJ, Makhetha M, Chideya Y, Skeen S. Adolescent condom use in Southern Africa: narrative systematic review and conceptual model of multilevel barriers and facilitators. BMC Public Health 2021; 21:1228. [PMID: 34172027 PMCID: PMC8234649 DOI: 10.1186/s12889-021-11306-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Adolescent HIV and pregnancy rates in Southern Africa are amongst the highest in the world. Despite decades of sexual and reproductive health (SRH) programming targeting adolescents, recent trends suggest there is a continued need for interventions targeting condom use for this age group. METHODS This review synthesises evidence from qualitative studies that describe the determinants of condom use among adolescents in Southern Africa. We conducted systematic searches in four databases. Data were extracted, appraised for quality and analysed using a 'best-fit' framework synthesis approach. RESULTS We coded deductively findings from 23 original studies using an a priori framework and subsequently conducted thematic analysis. Synthesised findings produced six key themes relating to: 1) pervasive unequal gender norms and restrictive masculinities favouring male sexual decision-making and stigmatising condom use in committed relationships; 2) other social norms reflecting negative constructions of adolescent sexuality and non-traditional family planning; 3) economic and political barriers including poverty and a lack of policy support for condom use; 4) service-level barriers including a lack of youth-friendly SRH services and comprehensive sex education in schools; 5) interpersonal barriers and facilitators including unequal power dynamics in sexual partnerships, peer influences and encouraging condoning condom use, and inadequate communication about SRH from parents/caregivers; and 6) negative attitudes and beliefs about condoms and condom use among adolescents. A conceptual model was generated to describe determinants of condom use, illustrating individual-, interpersonal- and structural-level barriers and facilitating factors. CONCLUSION SRH programming targeting barriers and facilitators of condom use at multiple levels is recommended in Southern Africa. We present a multilevel integrated model of barriers and facilitators to guide adolescent SRH decision-making, programme planning and evaluation. Given the existence of multilevel barriers and facilitators, interventions should, likewise, take a multilevel approach that incorporates locally relevant understanding of the individual-, interpersonal- and structural-level barriers and facilitators to condom use among adolescents in the region.
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Affiliation(s)
- Áine Aventin
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Sarah Gordon
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Christina Laurenzi
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Stephan Rabie
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, Cape Town, South Africa
| | - Mark Tomlinson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Maria Lohan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Jackie Stewart
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Allen Thurston
- School of Education, Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, Northern Ireland
| | - Lynne Lohfeld
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | | | - Moroesi Makhetha
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
- World Vision, Maseru, Lesotho
| | - Yeukai Chideya
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
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Kaushal N, Bérubé B, Hagger MS, Bherer L. Investigating the role of self-control beliefs in predicting exercise behaviour: A longitudinal study. Br J Health Psychol 2021; 26:1155-1175. [PMID: 33870633 DOI: 10.1111/bjhp.12525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/23/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Engaging in exercise behaviour regularly requires a repeated investment of resources to reap the health benefits. An individual's self-control resources, when performing a behaviour can be perceived as being recharged or depleted. The investigation on how self-control beliefs resources predict exercise behaviour is very limited in the literature. The purpose of this study was to understand how self-control beliefs predict exercise behaviour across time in a physical activity model. METHODS Participants (N = 161) were a sample of adults recruited across twelve gyms and recreation centres in a large city. Participants completed surveys across five months. Data were analysed using a multilevel structural equation model with participants (level 2) nested within time (level 1). RESULTS Behaviour was found to be a function of intention, habit, and planning. Specifically, planning moderated the intention-behaviour relationship, where those who scored higher on planning engaged in more exercise. Self-control beliefs functioned as a proximal predictor of autonomous motivation and predicted habit, and intention when accounting for total effects. CONCLUSIONS Self-control beliefs played a pivotal role in supporting recognized exercise determinants. Exercise-focussed interventions that help participants strengthen their beliefs as recharging and reduce depletion beliefs could be beneficial for promoting regular exercise.
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Affiliation(s)
- Navin Kaushal
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, Indiana, USA
| | - Béatrice Bérubé
- Department of Medicine, University of Montréal, Québec, Canada.,Research Center, Montréal Heart Institute, Québec, Canada.,Centre de Recherche de l'Institut, Universitaire de Gériatrie de Montréal, Québec, Canada
| | - Martin S Hagger
- Department of Psychological Sciences, University of California, Merced, California, USA.,Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Louis Bherer
- Department of Medicine, University of Montréal, Québec, Canada.,Research Center, Montréal Heart Institute, Québec, Canada.,Centre de Recherche de l'Institut, Universitaire de Gériatrie de Montréal, Québec, Canada
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20
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Hagger MS, Orbell S. The common sense model of illness self-regulation: a conceptual review and proposed extended model. Health Psychol Rev 2021; 16:347-377. [DOI: 10.1080/17437199.2021.1878050] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Martin S. Hagger
- Department of Psychological Sciences, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sheina Orbell
- Department of Psychology, University of Essex, Colchester, UK
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21
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22
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Xu F, Bu K, Chen F, Jin S, Zhang H, Zhang D, Sun C, Wang N, Han M, Wang L. Structural equation modeling test of the pre-intentional phase of the health action process approach (HAPA) model on condom use intention among senior high school students in Tianjin, China. Medicine (Baltimore) 2020; 99:e22776. [PMID: 33126316 PMCID: PMC7598788 DOI: 10.1097/md.0000000000022776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Based on the Theory of Health Action Process Approach (HAPA) Model, this study aimed to investigate factors associated with condom use intention in Chinese adolescents.In 2017, we conducted a cross-sectional study using stratified cluster, convenience sampling method to assess condom use intention among senior high school students in Tianjin, China. One thousand eighty two senior high school students were anonymously surveyed through self-administered questionnaires. Structural equation modelling was used to assess the pre-intentional phase of HAPA model.Among the participants, 41.5% (449/1082) were male, 54.1% (585/1082) were female, 4.4% (48/1082) were gender-deficient. The average age was 16.7 years. The final pre-intentional phase of HAPA model was acceptable (CFI = 0.95; GFI = 0.94; RMSEA = 0.06). Action self-efficacy (r = 0.60) had a strong direct effect on condom use intention.The pre-intentional phase of HAPA model is valid to assess condom use intention among Chinese senior high school students. The pre-intention phase of the HAPA model could be applied to guide AIDS health educations of students, and further research is needed to evaluate the effect.
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Affiliation(s)
- Fang Xu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
- Department of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Kai Bu
- School of Health Humanities, Peking University
| | - Fangfang Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | | | - Hanxi Zhang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Dong Zhang
- Dongli Center for Disease Control and Prevention, Tianjin
| | - Caixia Sun
- Qinghai Of Health Sciences, Qinghai, Beijing, China
| | - Ning Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Mengjie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
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Ahinkorah BO, Budu E, Seidu AA, Hagan JE, Agbaglo E, Hormenu T, Schack T, Yaya S. Consistent condom use among men who pay for sex in sub-Saharan Africa: Empirical evidence from Demographic and Health Surveys. PLoS One 2020; 15:e0236552. [PMID: 32776965 PMCID: PMC7416936 DOI: 10.1371/journal.pone.0236552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Paying for sex has often been associated with risky sexual behavior among heterosexual men, and men who pay for sex are considered as a bridging population for sexually transmitted infections. Consistent condom use during paid sex is essential for reducing sexually transmitted infections, including HIV/AIDS. In this study, we assessed the prevalence and predictors of consistent condom use among men who pay for sex in sub-Saharan Africa. MATERIALS AND METHODS We pooled data from 29 sub-Saharan African countries' Demographic and Health Surveys. A total of 3,353 men in sub-Saharan Africa who had paid for sex in the last 12 months preceding the surveys and had complete information on all the variables of interest were used in this study. The outcome variable for the study was consistent condom use for every paid sex in the last 12 months. Both bivariate and multivariable logistic regression analyses were carried out. Results were presented as adjusted odds ratios with their corresponding 95% confidence intervals. Statistical significance was declared at p< 0.05. RESULTS Overall, the prevalence of consistent condom use during paid sex in sub-Saharan Africa was 83.96% (CI = 80.35-87.56), ranging from 48.70% in Benin to 98% in Burkina Faso. Men aged 35-44 [AOR, 1.39 CI = 1.04-1.49], men in the richest wealth quintile [AOR, 1.96 CI = 1.30-3.00], men with secondary level of education [AOR, 1.69 CI = 1.17-2.44], and men in Burkina Faso [AOR = 67.59, CI = 8.72-523.9] had higher odds of consistent condom use during paid sex, compared to men aged 15-19, those in the poorest wealth quintile, those with no formal education, and men in Benin respectively. Conversely, Muslim men had lower odds [AOR = 0.71, CI = 0.53-0.95] of using condom consistently during paid sex, compared to Christian men. CONCLUSION Empirical evidence from this study suggests that consistent condom use during paid sex encompasses complex social and demographic characteristics. The study also revealed that demographic characteristics such as age, wealth quintile, education, and religion were independently related to consistent condom use for paid sex among men. With sub-Saharan Africa having the highest sexual and reproductive health burden in the world, continuous application of evidence-based interventions (e.g., educational and entrepreneurial training) that account for behavioural and social vulnerabilities are required.
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Affiliation(s)
- Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research (ACPPHR), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Thomas Hormenu
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, The University of Oxford, Oxford, United Kingdom
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24
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Levy E, Warner LM, Fleig L, Kaufman MR, Deschepper R, Gidron Y. The effects of psychological inoculation on condom use tendencies and barriers; a randomized controlled trial. Psychol Health 2020; 36:575-592. [PMID: 32498613 DOI: 10.1080/08870446.2020.1775832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Condom use prevents the contraction of the HIV. Research shows limited effects of education on increasing condom use. Psychological inoculation (PI) has been found to be more effective in this domain, however, its mechanism is unknown. This study examined effects of PI versus education on condom use barriers and tendencies, and its relations with cognitive dissonance, using a fully automatized online system. DESIGN The study was a randomized controlled trial (RCT) and included 149 students from a German University randomly assigned to PI or a control condition. MAIN OUTCOME MEASURES An indirect condom use test (I-CUTE), a condom use barriers questionnaire, self-reported condom use, and cognitive dissonance estimations were all assessed at baseline and one-month post-intervention. RESULTS PI significantly increased I-CUTE scores when participants had sexual relations. Control participants increased in self-reported condom use and on I-CUTE scores in people without sexual relations. No changes in barriers were seen in either group. The cognitive dissonance tended to be higher in PI participants as compared to control participants. CONCLUSIONS PI increases I-CUTE scores compared to controls (based on effect sizes), and significantly in those with sexual relations. The role of relationship status and the mechanisms of PI should be further examined.
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Affiliation(s)
- Einav Levy
- Faculty of Medicine and Pharmacy, Free University of Brussels (VUB), Brussels, Belgium.,The Israeli School of Humanitarian Action, Tel Aviv, Israel
| | - Lisa M Warner
- Department of Psychology, Health Psychology, Faculty of Natural Sciences, MSB Medical School Berlin, Berlin, Germany
| | - Lena Fleig
- Department of Psychology, Health Psychology, Faculty of Natural Sciences, MSB Medical School Berlin, Berlin, Germany
| | - Michelle R Kaufman
- Department of Health, Behavior & Society, Blomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Reginald Deschepper
- Faculty of Medicine and Pharmacy, Free University of Brussels (VUB), Brussels, Belgium
| | - Yori Gidron
- The Israeli School of Humanitarian Action, Tel Aviv, Israel.,Department of Nursing, Haifa University, Haifa, Israel
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25
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Schaefer R, Thomas R, Maswera R, Kadzura N, Nyamukapa C, Gregson S. Relationships between changes in HIV risk perception and condom use in East Zimbabwe 2003-2013: population-based longitudinal analyses. BMC Public Health 2020; 20:756. [PMID: 32448365 PMCID: PMC7245904 DOI: 10.1186/s12889-020-08815-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 04/30/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Perceiving a personal risk for HIV infection is considered important for engaging in HIV prevention behaviour and often targeted in HIV prevention interventions. However, there is limited evidence for assumed causal relationships between risk perception and prevention behaviour and the degree to which change in behaviour is attributable to change in risk perception is poorly understood. This study examines longitudinal relationships between changes in HIV risk perception and in condom use and the public health importance of changing risk perception. METHODS Data on sexually active, HIV-negative adults (15-54 years) were taken from four surveys of a general-population open-cohort study in Manicaland, Zimbabwe (2003-2013). Increasing condom use between surveys was modelled in generalised estimating equations dependent on change in risk perception between surveys. Accounting for changes in other socio-demographic and behavioural factors, regression models examined the bi-directional relationship between risk perception and condom use, testing whether increasing risk perception is associated with increasing condom use and whether increasing condom use is associated with decreasing risk perception. Population attributable fractions (PAFs) were estimated. RESULTS One thousand, nine hundred eighty-eight males and 3715 females participated in ≥2 surveys, contributing 8426 surveys pairs. Increasing risk perception between two surveys was associated with higher odds of increasing condom use (males: adjusted odds ratio [aOR] = 1.39, 95% confidence interval [CI] = 0.85-2.28, PAF = 3.39%; females: aOR = 1.41 [1.06-1.88], PAF = 6.59%), adjusting for changes in other socio-demographic and behavioural factors. Those who decreased risk perception were also more likely to increase condom use (males: aOR = 1.76 [1.12-2.78]; females: aOR = 1.23 [0.93-1.62]) compared to those without change in risk perception. CONCLUSIONS Results on associations between changing risk perception and increasing condom use support hypothesised effects of risk perception on condom use and effects of condom use on risk perception (down-adjusting risk perception after adopting condom use). However, low proportions of change in condom use were attributable to changing risk perception, underlining the range of factors influencing HIV prevention behaviour and the need for comprehensive approaches to HIV prevention.
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Affiliation(s)
- Robin Schaefer
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
| | - Ranjeeta Thomas
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Noah Kadzura
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Constance Nyamukapa
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Simon Gregson
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
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26
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Hagger MS, Moyers S, McAnally K, McKinley LE. Known knowns and known unknowns on behavior change interventions and mechanisms of action. Health Psychol Rev 2020; 14:199-212. [DOI: 10.1080/17437199.2020.1719184] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Martin S. Hagger
- Psychological Sciences, University of California, Merced, CA, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Susette Moyers
- Psychological Sciences, University of California, Merced, CA, USA
| | - Kaylyn McAnally
- Psychological Sciences, University of California, Merced, CA, USA
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Abstract
Human values are at the heart of our lives. We all hold a set of values that influence our actions. The protection of the natural environment is no exception to this rule. That is why the study of human values is key to reaching the imperative of sustainability. In this conceptual paper, we aim to (1) integrate the key theories and models explaining the influence of human values on behavior and to (2) identify factors that might have previously been overlooked. Drawing from a range of disciplines, this article proposes an integrated model mapping the influence of human values on behavior. It also puts forward the concept of consequences as an emerging factor that could play an important role in this relationship. Recommendations are to extend the research to an empirical investigation of the model and to develop the definition of the concept of consequences and the role they play in the influence of values on consumer behavior.
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28
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Zhang CQ, Wong MCY, Zhang R, Hamilton K, Hagger MS. Adolescent sugar-sweetened beverage consumption: An extended Health Action Process Approach. Appetite 2019; 141:104332. [DOI: 10.1016/j.appet.2019.104332] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 06/22/2019] [Accepted: 06/25/2019] [Indexed: 11/28/2022]
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29
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Schaefer R, Thomas R, Nyamukapa C, Maswera R, Kadzura N, Gregson S. Accuracy of HIV Risk Perception in East Zimbabwe 2003-2013. AIDS Behav 2019; 23:2199-2209. [PMID: 30569314 PMCID: PMC6647479 DOI: 10.1007/s10461-018-2374-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Risk perception for HIV infection is an important determinant for engaging in HIV prevention behaviour. We investigate the degree to which HIV risk perception is accurate, i.e. corresponds to actual HIV infection risks, in a general-population open-cohort study in Zimbabwe (2003-2013) including 7201 individuals over 31,326 person-years. Risk perception for future infection (no/yes) at the beginning of periods between two surveys was associated with increased risk of HIV infection (Cox regression hazard ratio = 1.38 [1.07-1.79], adjusting for socio-demographic characteristics, sexual behaviour, and partner behaviour). The association was stronger among older people (25+ years). This suggests that HIV risk perception can be accurate but the higher HIV incidence (1.27 per 100 person-years) illustrates that individuals may face barriers to HIV prevention behaviour even when they perceive their risks. Gaps in risk perception are underlined by the high incidence among those not perceiving a risk (0.96%), low risk perception even among those reporting potentially risky sexual behaviour, and, particularly, lack of accuracy of risk perception among young people. Innovative interventions are needed to improve accuracy of risk perception but barriers to HIV prevention behaviours need to be addressed too, which may relate to the partner, community, or structural factors.
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Affiliation(s)
- Robin Schaefer
- Department of Infectious Disease Epidemiology, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Ranjeeta Thomas
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Constance Nyamukapa
- Department of Infectious Disease Epidemiology, Imperial College London, Norfolk Place, London, W2 1PG, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | - Noah Kadzura
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Simon Gregson
- Department of Infectious Disease Epidemiology, Imperial College London, Norfolk Place, London, W2 1PG, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
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30
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Hagger MS, Hankonen N, Kangro EM, Lintunen T, Pagaduan J, Polet J, Ries F, Hamilton K. Trait Self-Control, Social Cognition Constructs, and Intentions: Correlational Evidence for Mediation and Moderation Effects in Diverse Health Behaviours. Appl Psychol Health Well Being 2019; 11:407-437. [PMID: 30724028 DOI: 10.1111/aphw.12153] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND We examined effects of trait self-control, constructs from social cognition theories, and intentions on health behaviours. Trait self-control was expected to predict health behaviour indirectly through theory constructs and intentions. Trait self-control was also predicted to moderate the intention-behaviour relationship. METHODS Proposed effects were tested in six datasets for ten health-related behaviours from studies adopting prospective designs. Participants (N = 3,249) completed measures of constructs from social cognition theories and self-control at an initial time point and self-reported their behaviour at follow-up. RESULTS Results revealed indirect effects of self-control on behaviour through social cognition constructs and intentions for eight behaviours: eating fruit and vegetables, avoiding fast food, dietary restrictions, binge drinking, physical activity, walking, out-of-school physical activity, and pre-drinking. Self-control moderated the intention-behaviour relationship in four behaviours: dietary restriction, and alcohol-related behaviours. CONCLUSIONS Mediation effects suggest that individuals with high self-control are more likely to hold beliefs and intentions to participate in future health behaviour, and more likely to act. Moderation effects indicate that individuals with high self-control are more likely to enact healthy intentions and inhibit unhealthy intentions, but findings were restricted to few behaviours. Training self-control and managing contingencies that derail goal-directed action may be effective intervention strategies.
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Affiliation(s)
- Martin S Hagger
- Curtin University, Australia.,University of Jyväskylä, Finland.,Griffith University, QLD, Australia
| | - Nelli Hankonen
- University of Helsinki, Finland.,National Institute for Health and Welfare, Finland
| | | | | | | | | | | | - Kyra Hamilton
- Curtin University, Australia.,Griffith University, QLD, Australia.,Menzies Health Institute, QLD, Australia
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31
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Protogerou C, Hagger MS. A Case For a Study Quality Appraisal in Survey Studies in Psychology. Front Psychol 2019; 9:2788. [PMID: 30733700 PMCID: PMC6353849 DOI: 10.3389/fpsyg.2018.02788] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/31/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cleo Protogerou
- Department of Psychology, University of Cape Town, Cape Town, South Africa.,Health Psychology and Behavioral Medicine Research Group, School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Martin S Hagger
- Health Psychology and Behavioral Medicine Research Group, School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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32
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Hagger MS, Polet J, Lintunen T. The reasoned action approach applied to health behavior: Role of past behavior and tests of some key moderators using meta-analytic structural equation modeling. Soc Sci Med 2018; 213:85-94. [DOI: 10.1016/j.socscimed.2018.07.038] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 07/01/2018] [Accepted: 07/20/2018] [Indexed: 01/30/2023]
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33
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Hagger MS, Gucciardi DF, Chatzisarantis NLD. On Nomological Validity and Auxiliary Assumptions: The Importance of Simultaneously Testing Effects in Social Cognitive Theories Applied to Health Behavior and Some Guidelines. Front Psychol 2017; 8:1933. [PMID: 29163307 PMCID: PMC5675876 DOI: 10.3389/fpsyg.2017.01933] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/19/2017] [Indexed: 11/14/2022] Open
Abstract
Tests of social cognitive theories provide informative data on the factors that relate to health behavior, and the processes and mechanisms involved. In the present article, we contend that tests of social cognitive theories should adhere to the principles of nomological validity, defined as the degree to which predictions in a formal theoretical network are confirmed. We highlight the importance of nomological validity tests to ensure theory predictions can be disconfirmed through observation. We argue that researchers should be explicit on the conditions that lead to theory disconfirmation, and identify any auxiliary assumptions on which theory effects may be conditional. We contend that few researchers formally test the nomological validity of theories, or outline conditions that lead to model rejection and the auxiliary assumptions that may explain findings that run counter to hypotheses, raising potential for ‘falsification evasion.’ We present a brief analysis of studies (k = 122) testing four key social cognitive theories in health behavior to illustrate deficiencies in reporting theory tests and evaluations of nomological validity. Our analysis revealed that few articles report explicit statements suggesting that their findings support or reject the hypotheses of the theories tested, even when findings point to rejection. We illustrate the importance of explicit a priori specification of fundamental theory hypotheses and associated auxiliary assumptions, and identification of the conditions which would lead to rejection of theory predictions. We also demonstrate the value of confirmatory analytic techniques, meta-analytic structural equation modeling, and Bayesian analyses in providing robust converging evidence for nomological validity. We provide a set of guidelines for researchers on how to adopt and apply the nomological validity approach to testing health behavior models.
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Affiliation(s)
- Martin S Hagger
- Health Psychology and Behavioural Medicine Research Group, School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Daniel F Gucciardi
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Nikos L D Chatzisarantis
- Health Psychology and Behavioural Medicine Research Group, School of Psychology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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