An Expansion and Modification of the Information, Motivation, and Behavioral Skills Model: Implications from a Study with African American Girls and Their Mothers

Applying the information-motivation-behavioral skills model to explain adolescents' fruits and vegetables consumption

Inadequate fruits and vegetables consumption in adolescence increases adolescents' current and future chronic disease risk and is predictive of inadequate consumption in adulthood. Given that adolescents' engagement in dietary behaviors is complicated by intrapersonal, interpersonal, and environmental factors, a health behavior model of change incorporating all of these factors is most appropriate to inform research and intervention efforts. Yet, common preventive health behavior models used to explain adolescents' dietary behaviors do not adequately account for these factors. The current study explored the utility of a comprehensive, predictive model, that is the Information-Motivation-Behavioral Skills (IMB) model, for explaining adolescents' fruits and vegetables consumption in a cross-sectional national sample. Study hypotheses included (1) health information and motivation for fruits and vegetables would directly be related to fruits and vegetables consumption; and (2) the relationship between fruits and vegetables consumption and health information and motivation would be mediated by behavioral skills for consumption. Data from the adolescent diet-related surveys of the Family Life, Activity, Sun, Health, and Eating (FLASHE) study (N = 1646) were used. Structural equation modeling was used to test study hypotheses. Fruits and vegetables-related information and motivation were positively related to adolescents' fruits and vegetables consumption. For information and personal motivation (specifically fruits and vegetables preferences), the relationship with fruits and vegetables consumption was partially mediated through behavioral skills. These preliminary findings support the utility of the IMB model to explain adolescents' fruits and vegetables consumption.

Puberty Experiences of Low-Income Girls in the United States: A Systematic Review of Qualitative Literature From 2000 to 2014

PURPOSE

Puberty is a critical period of development that lays the foundation for future sexual and reproductive health. It is essential to learn about the puberty experiences of low-income girls in the United States given their increased vulnerability to negative sexual and reproductive health outcomes. To understand the present-day puberty experiences of this population, we conducted a qualitative systematic review.

METHODS

We systematically searched the peer-reviewed literature published between 2000 and 2014 on the puberty experiences of low-income girls in the United States. Reviewers screened titles, abstracts, and the full texts of articles. Using standardized templates, reviewers assessed the methodologic quality and extracted data. Data were synthesized using thematic analysis. Confidence in each finding was assessed using Confidence in the Evidence from Reviews of Qualitative research.

RESULTS

Twenty qualitative articles were included. They described the experiences of mostly African-American, Caucasian, and Hispanic girls living primarily in urban areas of Northeastern United States. Five overarching themes emerged: content of girls' puberty experiences, quality of girls' puberty experiences, messages girls receive about puberty, other factors that shape girls' puberty experiences, and relationships that shape girls' experiences of puberty.

CONCLUSIONS

The limited existing evidence suggests that low-income girls in the United States are unprepared for puberty and have largely negative experiences of this transition.

Sexual communication intervention for African American mothers & daughters

BACKGROUND

African American girls ages 13-19 comprised nearly 3 out of 4 new cases of HIV in 2009. The goal of this study was to deliver a theoretically-driven intervention to test the feasibility for recruitment and retention of mother-daughter dyads.

METHODS

Twenty mother-daughter dyads were recruited from a community health center between February-April 2014. Comparisons were made between pre- and post-intervention scores using percent change.

RESULTS

Twelve dyads (60%) completed the intervention. There were no demographic differences between completers and noncompleters. Notable post-intervention percent increases in scores were observed in the domains: Sexual knowledge (15%), confidence to talk (23.2%); and openness of sexual communication (26.4%).

CONCLUSION

Our small-sized study showed promise in the intervention. Increasing sexual communication between African American mothers and daughters is likely to be sustainable over time and across relationships, and thus have a greater impact on HIV-prevention behaviors later in life.

Modeling predictors of risky drug use behavior among male street laborers in urban Vietnam

BACKGROUND

The application of theoretical frameworks for modeling predictors of drug risk among male street laborers remains limited. The objective of this study was to test a modified version of the IMB (Information-Motivation-Behavioral Skills Model), which includes psychosocial stress, and compare this modified version with the original IMB model in terms of goodness-of-fit to predict risky drug use behavior among this population.

METHODS

In a cross-sectional study, social mapping technique was conducted to recruit 450 male street laborers from 135 street venues across 13 districts of Hanoi city, Vietnam, for face-to-face interviews. Structural equation modeling (SEM) was used to analyze data from interviews.

RESULTS

Overall measures of fit via SEM indicated that the original IMB model provided a better fit to the data than the modified version. Although the former model was able to predict a lesser variance than the latter (55% vs. 62%), it was of better fit. The findings suggest that men who are better informed and motivated for HIV prevention are more likely to report higher behavioral skills, which, in turn, are less likely to be engaged in risky drug use behavior.

CONCLUSIONS

This was the first application of the modified IMB model for drug use in men who were unskilled, unregistered laborers in urban settings. An AIDS prevention program for these men should not only distribute information and enhance motivations for HIV prevention, but consider interventions that could improve self-efficacy for preventing HIV infection. Future public health research and action may also consider broader factors such as structural social capital and social policy to alter the conditions that drive risky drug use among these men.

Cross-cultural variations in adolescents' perceived maternal expectancy and sexual initiation

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.

Understanding sexual abstinence in urban adolescent girls

OBJECTIVES

To gain insight into the context of sexual abstinence and identify potential determinants of abstinence in this population.

DESIGN

Four focus groups.

PARTICIPANTS AND SETTING

Twenty-four, predominantly African American (88%) girls aged 14 to 19 years were recruited from urban health centers and youth development programs in Rochester, New York, between September and December 2006.

DATA ANALYSIS

Content analysis was used to analyze the four verbatim transcripts. Using analytic induction, groups were compared and contrasted at the micro (within-group) and macro (between-group) levels to identify themes.

RESULTS

Four themes were identified that provided insight into how and why these girls remain abstinent despite being in sexually active social climates. They focused on the following: self-respect (I'm worth it), impact of mothers (Mama says ... think before you let it go), influence of boys and other peers (Boys will be boys), and potential negative consequences of sex (Hold on, there's a catch).

CONCLUSIONS

Developing interventions to maintain abstinence, delay onset of sexual activity, and promote protected first and subsequent sexual contact in abstinent girls are key to decreasing future sexual risk. These findings suggest opportunities to develop HIV prevention strategies tailored to the needs of abstinent girls.