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Wu YP, Stump TK, Hay JL, Buller DB, Jensen JD, Grossman D, Shen J, Haaland BA, Jones J, Tercyak KP. Protocol for a cluster-randomized trial of a school-based skin cancer preventive intervention for adolescents. Contemp Clin Trials 2024; 140:107494. [PMID: 38458557 PMCID: PMC11065585 DOI: 10.1016/j.cct.2024.107494] [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: 09/19/2023] [Revised: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Adolescents infrequently use sun protection and engage in intentional tanning more frequently compared to other age groups, leading to increased ultraviolet radiation (UVR) exposure that heightens skin cancer risk across the lifespan. High schools are therefore an ideal setting for offering skin cancer preventive interventions. Yet, there are limited UVR protection interventions for high school students, especially those that are personalized, tested using randomized designs, and include long-term outcome assessment to determine the durability of intervention effects. METHOD The Sun-safe Habits Intervention and Education (SHINE) cluster-randomized trial will test a novel, personalized intervention that targets high school adolescents' sun protection and tanning behaviors, and tracks their outcomes for up to one year following intervention. Enrolled high schools will be randomized to receive either the personalized SHINE intervention, which includes facial UVR photographs and sun protection action planning, or standard education using publicly available materials. Students in both conditions will receive information about skin cancer, sun protection, and skin self-examination. Outcome variables will include students' sun protection and tanning behaviors and sunburn occurrence. Potential moderators (e.g., race/ethnicity) and mediators (e.g., self-efficacy) will also be assessed and tested. CONCLUSIONS This trial examines the efficacy of a personalized intervention targeting sun protection and tanning of high school students. The project will lead to new scientific understanding of the theoretical mechanisms underlying outcomes and moderators of the intervention effects, which will inform future intervention tailoring to meet the needs of vulnerable subgroups.
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Affiliation(s)
- Yelena P Wu
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Tammy K Stump
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
| | - David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 220, Golden, CO 80401, USA.
| | - Jakob D Jensen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Communication, University of Utah, Salt Lake City, UT, USA.
| | - Douglas Grossman
- Department of Dermatology, University of Utah, 30 N. Mario Capecchi Dr., Salt Lake City, UT 84112, USA; Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
| | - Jincheng Shen
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Benjamin A Haaland
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
| | - Jacey Jones
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112, USA.
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Widman L, Maheux AJ, Craig E, Evans-Paulson R, Choukas-Bradley S. Sexual Communication between Adolescent Partners: A Scoping Review and Directions for Future Research. JOURNAL OF SEX RESEARCH 2022; 59:984-999. [PMID: 35917190 DOI: 10.1080/00224499.2022.2099787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual communication between adolescent partners is an important component of sexual health and wellbeing. Over 40 years of research on adolescent sexual communication has yielded rich information, yet there remain gaps in our understanding of the communication process. The purpose of this scoping review was to synthesize the body of research on adolescent sexual communication to identify how communication has been conceptualized, how researchers have measured communication, and what theoretical frameworks have been applied across the literature. We identified 198 assessments of sexual communication across 119 quantitative studies. This work included 127,489 adolescents (Mage = 15.97) from 15 countries (81.5% U.S.-based). Most studies relied on self-reports (93.4%) and surveyed only one member of a couple (97.5%). The definition of sexual communication was highly varied across the literature: in half of assessments (52.0%) sexual communication was operationalized as a behavior-the verbal or nonverbal exchange of messages about sex-whereas the remaining half of assessments captured social-cognitive aspects of communication (e.g., communication self-efficacy, fear/anxiety). There was also a tendency for investigators to create their own idiosyncratic instruments: half of studies (48.9%) used instruments created by the research team with limited or no discussion of reliability/validity. Regarding the topic of communication, a third of assessments (33.8%) focused exclusively on condom communication and another quarter (24.0%) focused on other safer-sex issues (e.g., STDs, abstinence). Notably absent were studies focused on communication surrounding consent or sexual pleasure. Also absent was a guiding conceptual model or theory that could unify this body of work. Overall, results highlight gaps and inconsistencies in how partner sexual communication has been conceptualized, measured, and theorized about in previous work. We provide several recommendations for future theory-building efforts as well as rigorous, multimethod empirical investigations of adolescent sexual communication that would further our understanding of this important aspect of adolescent sexual wellbeing.
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Affiliation(s)
- Laura Widman
- Department of Psychology, North Carolina State University
| | - Anne J Maheux
- Department of Psychological and Brain Sciences, University of Delaware
| | - Elizabeth Craig
- Department of Communication, North Carolina State University
| | | | - Sophia Choukas-Bradley
- Department of Psychological and Brain Sciences, University of Delaware
- Department of Psychology, University of Pittsburgh
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Tani F, Ponti L, Ghinassi S, Smorti M. A gambling primary prevention program for students through teacher training: an evidence-based study. INTERNATIONAL GAMBLING STUDIES 2021. [DOI: 10.1080/14459795.2020.1861056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Franca Tani
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Lucia Ponti
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy
| | - Simon Ghinassi
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy
| | - Martina Smorti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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Shafii T, Benson SK, Morrison DM, Hughes JP, Golden MR, Holmes KK. Results from e-KISS: electronic-KIOSK Intervention for Safer Sex: A pilot randomized controlled trial of an interactive computer-based intervention for sexual health in adolescents and young adults. PLoS One 2019; 14:e0209064. [PMID: 30673710 PMCID: PMC6343886 DOI: 10.1371/journal.pone.0209064] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 11/27/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Interactive computer-based interventions (ICBI) are potentially scalable tools for use in real-world settings to promote sexual health and prevent sexually transmitted infections (STIs) and unintended pregnancies. We developed and assessed the feasibility and acceptability of an ICBI for promoting adolescent and young adult sexual health, and the effectiveness of the intervention in reducing unprotected sex, STIs, and unintended pregnancy. METHODS This pilot randomized controlled trial enrolled STI Clinic patients, in Seattle, Washington, who were 14-24 years old and reported unprotected vaginal sex during the last 2 months. Both the control and intervention group used a computerized survey to enter their sexual health and only the intervention group received the ICBI. The ICBI included personalized sexual health feedback from a physician avatar; instructive video modules advocating sexual health; and identification of one behavior to change. At 3-month follow-up, participants reported on interim sexual and pregnancy histories and underwent repeat STI testing. We assessed intervention impact on unprotected vaginal sex, number of sexual partners, incident STIs, and unintended pregnancy. RESULTS Of 272 participants, 242 (89%) completed the study, of whom 65% were female. While these findings did not reach statistical significance, at 3-month follow-up, the intervention group reported a 33% lower rate of unprotected vaginal sex (no condom use) [IRR = 0.67, 95% CI: 0.44-1.02]; 29% fewer sex partners [IRR = 0.71, 95% CI: 0.50-1.03]; and 48% fewer STIs [IRR = 0.52, 95% CI: 0.25-1.08] when compared to the control group. Similarly, as compared to the control group, intervention females reported a lower rate of unprotected vaginal sex (no birth control) [IRR = 0.80, 95% CI: 0.47-1.35] and half as many unintended pregnancies (n = 5) versus control females (n = 10) [IRR = 0.51, 95% CI: 0.17-1.58]. In exploratory analyses, intervention females reported fewer partners [IRR = 0.71, 95% CI: 0.50-1.00] and a significantly lower rate of vaginal sex without condoms [IRR = 0.50, 95% CI: 0.30-0.85]. CONCLUSION The intervention was acceptable to both males and females, and at 3-month follow-up, there were non-significant reductions in risk behavior for all outcomes. Among females, exploratory analysis showed a significant reduction in vaginal sex without condoms.
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Affiliation(s)
- Taraneh Shafii
- Department of Pediatrics, Division of Adolescent Medicine, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Samantha K. Benson
- Harborview Medical Center, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Diane M. Morrison
- School of Social Work, University of Washington, Seattle, WA, United States of America
| | - James P. Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Matthew R. Golden
- Department of Medicine, University of Washington School of Medicine, Public Health Seattle & King County HIV/STD Program, Seattle, WA, United States of America
| | - King K. Holmes
- Departments of Global Health and Medicine, University of Washington Schools of Medicine and Public Health; and Center for AIDS & STD, Seattle, WA, United States of America
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Pazol K, Zapata LB, Dehlendorf C, Malcolm NM, Rosmarin RB, Frederiksen BN. Impact of Contraceptive Education on Knowledge and Decision Making: An Updated Systematic Review. Am J Prev Med 2018; 55:703-715. [PMID: 30342633 PMCID: PMC10521032 DOI: 10.1016/j.amepre.2018.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/02/2018] [Accepted: 07/16/2018] [Indexed: 01/01/2023]
Abstract
CONTEXT Educational interventions can help individuals increase their knowledge of available contraceptive methods, enabling them to make informed decisions and use contraception correctly. This review updates a previous review of contraceptive education. EVIDENCE ACQUISITION Multiple databases were searched for articles published March 2011-November 2016. Primary outcomes were knowledge, participation in and satisfaction/comfort with decision making, attitudes toward contraception, and selection of more effective methods. Secondary outcomes included contraceptive behaviors and pregnancy. Excluded articles described interventions that had no comparison group, could not be conducted feasibly in a clinic setting, or were conducted outside the U.S. or similar country. EVIDENCE SYNTHESIS A total of 24,953 articles were identified. Combined with the original review, 37 articles met inclusion criteria and described 31 studies implementing a range of educational approaches (interactive tools, written materials, audio/videotapes, and text messages), with and without healthcare provider feedback, for a total of 36 independent interventions. Of the 31 interventions for which knowledge was assessed, 28 had a positive effect. Fewer were assessed for their effect on attitudes toward contraception, selection of more effective methods, contraceptive behaviors, or pregnancy-although increased knowledge was found to mediate additional outcomes (positive attitudes toward contraception and contraceptive continuation). CONCLUSIONS This systematic review is consistent with evidence from the broader healthcare field in suggesting that a range of interventions can increase knowledge. Future studies should assess what aspects are most effective, the benefits of including provider feedback, and the extent to which educational interventions can facilitate behavior change and attainment of reproductive health goals. THEME INFORMATION This article is part of a theme issue entitled Updating the Systematic Reviews Used to Develop the U.S. Recommendations for Providing Quality Family Planning Services, which is sponsored by the Office of Population Affairs, U.S. Department of Health and Human Services.
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Affiliation(s)
- Karen Pazol
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Lauren B Zapata
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christine Dehlendorf
- Department of Family and Community Medicine, University of California, San Francisco (UCSF), San Francisco, California; Obstetrics, Gynecology and Reproductive Sciences, UCSF, San Francisco, California; Epidemiology and Biostatistics, UCSF, SanFrancisco, California
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Cianelli R, Villegas N. Social Determinants of Health for HIV Among Hispanic Women. HISPANIC HEALTH CARE INTERNATIONAL 2018; 14:4-9. [PMID: 27257185 DOI: 10.1177/1540415316629672] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Zhang Y, Li X, Qiao S, Zhou Y, Shen Z. Information Communication Technology (ICT) use among PLHIV in China: A promising but underutilized venue for HIV prevention and care. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2018. [DOI: 10.1016/j.ijinfomgt.2017.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mesheriakova VV, Tebb KP. Effect of an iPad-Based Intervention to Improve Sexual Health Knowledge and Intentions for Contraceptive Use Among Adolescent Females at School-Based Health Centers. Clin Pediatr (Phila) 2017; 56:1227-1234. [PMID: 28950721 PMCID: PMC5641984 DOI: 10.1177/0009922816681135] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVES The use of effective contraception can decrease the incidence of unplanned pregnancy among adolescents. This study aims to examine the effectiveness of an iPad-based application (app) on improving adolescent girls' sexual health knowledge and on its ability to influence their intentions to use effective contraception. STUDY DESIGN This was a prospective study of girls aged 12 to 18 years recruited from 3 school-based health centers in California. RESULTS A total of 120 racially/ethnically diverse participants used the iPad app; 54% were sexually active, with only 26% using effective contraception at baseline. The average score on baseline sexual health knowledge assessment was 58%. After using the app, 68% of the sexually active participants reported intention to use effective contraception in the future, and sexual health knowledge improved significantly to 79% ( P < .001). CONCLUSIONS This iPad-based app is a promising intervention to educate adolescents about sexual health and support them in selecting an effective contraception method.
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Affiliation(s)
- Veronika V. Mesheriakova
- Division of Adolescent and Young Adult Medicine UCSF Benioff Children’s Hospital University of California, San Francisco, CA, USA
| | - Kathleen P. Tebb
- Division of Adolescent and Young Adult Medicine UCSF Benioff Children’s Hospital University of California, San Francisco, CA, USA
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Fiellin LE, Hieftje KD, Pendergrass TM, Kyriakides TC, Duncan LR, Dziura JD, Sawyer BG, Mayes L, Crusto CA, Forsyth BW, Fiellin DA. Video Game Intervention for Sexual Risk Reduction in Minority Adolescents: Randomized Controlled Trial. J Med Internet Res 2017; 19:e314. [PMID: 28923788 PMCID: PMC5625130 DOI: 10.2196/jmir.8148] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 08/09/2017] [Accepted: 08/14/2017] [Indexed: 11/13/2022] Open
Abstract
Background Human immunodeficiency virus (HIV) disproportionately impacts minority youth. Interventions to decrease HIV sexual risk are needed. Objective We hypothesized that an engaging theory-based digital health intervention in the form of an interactive video game would improve sexual health outcomes in adolescents. Methods Participants aged 11 to 14 years from 12 community afterschool, school, and summer programs were randomized 1:1 to play up to 16 hours of an experimental video game or control video games over 6 weeks. Assessments were conducted at 6 weeks and at 3, 6, and 12 months. Primary outcome was delay of initiation of vaginal/anal intercourse. Secondary outcomes included sexual health attitudes, knowledge, and intentions. We examined outcomes by gender and age. Results A total of 333 participants were randomized to play the intervention (n=166) or control games (n=167): 295 (88.6%) were racial/ethnic minorities, 177 (53.2%) were boys, and the mean age was 12.9 (1.1) years. At 12 months, for the 258 (84.6%) participants with available data, 94.6% (122/129) in the intervention group versus 95.4% (123/129) in the control group delayed initiation of intercourse (relative risk=0.99, 95% CI 0.94-1.05, P=.77). Over 12 months, the intervention group demonstrated improved sexual health attitudes overall compared to the control group (least squares means [LS means] difference 0.37, 95% CI 0.01-0.72, P=.04). This improvement was observed in boys (LS means difference 0.67, P=.008), but not girls (LS means difference 0.06, P=.81), and in younger (LS means difference 0.71, P=.005), but not older participants (LS means difference 0.03, P=.92). The intervention group also demonstrated increased sexual health knowledge overall (LS means difference 1.13, 95% CI 0.64-1.61, P<.001), in girls (LS means difference 1.16, P=.001), boys (LS means difference 1.10, P=.001), younger (LS means difference 1.18, P=.001), and older (LS means difference=1.08, P=.002) participants. There were no differences in intentions to delay the initiation of intercourse between the two groups (LS means difference 0.10, P=.56). Conclusions An interactive video game intervention improves sexual health attitudes and knowledge in minority adolescents for at least 12 months. Trial Registration Clinicaltrials.gov NCT01666496; https://clinicaltrials.gov/ct2/show/NCT01666496 (Archived by WebCite at http://www.webcitation.org/6syumc9C0).
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Affiliation(s)
- Lynn E Fiellin
- play2PREVENT Lab, Yale School of Medicine, Yale University, New Haven, CT, United States.,Yale Child Study Center, New Haven, CT, United States.,Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, CT, United States.,Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Kimberly D Hieftje
- play2PREVENT Lab, Yale School of Medicine, Yale University, New Haven, CT, United States.,Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, CT, United States.,Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Tyra M Pendergrass
- play2PREVENT Lab, Yale School of Medicine, Yale University, New Haven, CT, United States.,Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, CT, United States.,Yale School of Medicine, Yale University, New Haven, CT, United States
| | | | - Lindsay R Duncan
- play2PREVENT Lab, Yale School of Medicine, Yale University, New Haven, CT, United States.,McGill University, Montreal, QC, Canada
| | - James D Dziura
- Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Benjamin G Sawyer
- play2PREVENT Lab, Yale School of Medicine, Yale University, New Haven, CT, United States.,Digitalmill, Freeport, ME, United States
| | - Linda Mayes
- Yale Child Study Center, New Haven, CT, United States.,Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Cindy A Crusto
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, CT, United States.,Yale School of Medicine, Yale University, New Haven, CT, United States.,University of Pretoria, Department of Psychology, Pretoria, South Africa
| | - Brian Wc Forsyth
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, CT, United States.,Yale School of Medicine, Yale University, New Haven, CT, United States
| | - David A Fiellin
- play2PREVENT Lab, Yale School of Medicine, Yale University, New Haven, CT, United States.,Center for Interdisciplinary Research on AIDS, Yale School of Public Health, Yale University, New Haven, CT, United States.,Yale School of Medicine, Yale University, New Haven, CT, United States.,Yale School of Public Health, Yale University, New Haven, CT, United States
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Seplovich G, Horvath KJ, Haughton LJ, Blackstock OJ. Get+Connected: Development and Pilot Testing of an Intervention to Improve Computer and Internet Attitudes and Internet Use Among Women Living With HIV. JMIR Res Protoc 2017; 6:e50. [PMID: 28363879 PMCID: PMC5392213 DOI: 10.2196/resprot.6391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 01/25/2017] [Accepted: 02/18/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND For persons living with chronic medical conditions, the Internet can be a powerful tool for health promotion, and allow for immediate access to medical information and social support. However, women living with human immunodeficiency virus (HIV) in the United States face numerous barriers to computer and Internet use. Health behavior change models suggest that the first step towards adopting a new health behavior is to improve attitudes towards that behavior. OBJECTIVE To develop and pilot test Get+Connected, an intervention to improve computer and Internet attitudes and Internet use among women living with HIV. METHODS To develop Get+Connected, we reviewed the extant literature, adapted an existing curriculum, and conducted a focus group with HIV-positive women (n=20) at a community-based organization in the Bronx, New York. Get+Connected was comprised of five weekly sessions covering the following topics: basic computer knowledge and skills, identifying reliable health-related websites, setting up and using email and Facebook accounts, and a final review session. We recruited 12 women to participate in pilot testing. At baseline, we collected data about participants' sociodemographic information, clinical characteristics, and technology device ownership and use. At baseline, intervention completion, and three months postintervention, we collected data regarding attitudes towards computers and the Internet (Attitudes Towards Computers and the Internet Questionnaire [ATCIQ]; possible scores range from 5-50) as well as frequency of Internet use (composite measure). To examine changes in ATCIQ scores and Internet use over time, we used generalized estimating equations. We also collected qualitative data during intervention delivery. RESULTS Among women in our sample, the median age was 56 years (interquartile range=52-63). All participants were black/African American and/or Latina. Seven participants (7/12, 58%) had a high school diploma (or equivalent) or higher degree. Ten participants (10/12, 83%) reported owning a mobile phone, while only one (1/12, 8%) reported owning a computer or tablet. Only one participant (1/12, 8%) reported having ever used the Internet or email. Internet nonusers cited lack of computer/Internet knowledge (6/11, 54%) and lack of access to a computer or similar device (4/11, 36%) as the main barriers to use. Over time, we observed an improvement in attitudes towards computers and the Internet (ATCIQ scores: 33.5 at baseline, 35 at intervention completion, and 36 at three months postintervention; P=.008). No significant increase in Internet use was observed (P=.61). Qualitative findings indicated excitement and enthusiasm for the intervention. CONCLUSIONS In our sample of urban, technology-inexperienced HIV-positive women, participation in Get+Connected was associated with an improvement in attitudes towards computers and the Internet, but not Internet use. Changing attitudes is the first step in many health behavior change models, indicating that with improved access to computer and Internet resources, frequency of Internet use may also have increased. Future studies should consider addressing issues of access to technology in conjunction with Get+Connected.
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Affiliation(s)
- Gabriela Seplovich
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Keith J Horvath
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, United States
| | - Lorlette J Haughton
- Montefiore Medical Center/Albert Einstein College of Medicine, Division of General Internal Medicine, Bronx, NY, United States
| | - Oni J Blackstock
- Montefiore Medical Center/Albert Einstein College of Medicine, Division of General Internal Medicine, Bronx, NY, United States
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Orji R, Moffatt K. Persuasive technology for health and wellness: State-of-the-art and emerging trends. Health Informatics J 2016; 24:66-91. [PMID: 27245673 DOI: 10.1177/1460458216650979] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The evolving field of persuasive and behavior change technology is increasingly targeted at influencing behavior in the area of health and wellness. This paper provides an empirical review of 16 years (85 papers) of literature on persuasive technology for health and wellness to: (1.) answer important questions regarding the effectiveness of persuasive technology for health and wellness, (2.) summarize and highlight trends in the technology design, research methods, motivational strategies, theories, and health behaviors targeted by research to date, (3.) uncover pitfalls of existing persuasive technological interventions for health and wellness, and (4.) suggest directions for future research.
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Rasmussen E. Theoretical Underpinnings of Reducing the Media’s Negative Effect on Children: Person-Centered, Negatively-Valenced Evaluative Mediation within a Persuasion Framework. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/23808985.2013.11679156] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pazol K, Zapata LB, Tregear SJ, Mautone-Smith N, Gavin LE. Impact of Contraceptive Education on Contraceptive Knowledge and Decision Making: A Systematic Review. Am J Prev Med 2015; 49:S46-56. [PMID: 26190846 PMCID: PMC4532374 DOI: 10.1016/j.amepre.2015.03.031] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/23/2015] [Accepted: 03/23/2015] [Indexed: 11/16/2022]
Abstract
CONTEXT Educational interventions can help increase knowledge of available contraceptive methods, enabling individuals to make informed decisions and use contraception more effectively. This systematic review evaluated contraceptive education interventions to guide national recommendations on quality family planning services. EVIDENCE ACQUISITION Three databases (CINAHL, PubMed, and PsycINFO) were searched from 1985 through 2012 for peer-reviewed articles on educational interventions, with supplemental searches conducted through 2015. Primary outcomes were knowledge, participation in and comfort with decision making, and attitudes toward contraception. Secondary outcomes included contraceptive use behaviors and unintended pregnancy. EVIDENCE SYNTHESIS Database searches in 2011 identified 5,830 articles; 17 met inclusion criteria and were abstracted into evidence tables. Searches in 2012 and 2015 identified four additional studies. Studies used a wide range of tools (decision aids, written materials, audio/videotapes, and interactive games), with and without input from a healthcare provider or educator. Of 15 studies that examined the impact of educational interventions on knowledge, 14 found significant improvement using a range of tools, with and without input from a healthcare provider or educator. Fewer studies evaluated outcomes related to decision making, attitudes toward contraception, contraceptive use behaviors, or unintended pregnancy. CONCLUSIONS Results from this systematic review are consistent with evidence from the broader healthcare field suggesting that a range of educational interventions can increase knowledge. Future studies should assess what aspects of educational interventions are most effective, the extent to which it is necessary to include a healthcare provider or educator, and the extent to which educational interventions can impact behaviors.
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Affiliation(s)
- Karen Pazol
- Division of Reproductive Health, CDC, Atlanta, Georgia.
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Devine S, Leeds C, Shlay JC, Leytem A, Beum R, Bull S. Methods to assess youth engagement in a text messaging supplement to an effective teen pregnancy program. J Biomed Inform 2015; 56:379-86. [PMID: 26173038 DOI: 10.1016/j.jbi.2015.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 07/02/2015] [Accepted: 07/06/2015] [Indexed: 11/25/2022]
Abstract
Youth are prolific users of cell phone minutes and text messaging. Numerous programs using short message service text messaging (SMS) have been employed to help improve health behaviors and health outcomes. However, we lack information on whether and what type of interaction or engagement with SMS program content is required to realize any benefit. We explored youth engagement with an automated SMS program designed to supplement a 25-session youth development program with demonstrated efficacy for reductions in teen pregnancy. Using two years of program data, we report on youth participation in design of message content and response frequency to messages among youth enrolled in the intervention arm of a randomized controlled trial (RCT) as one indicator of engagement. There were 221 youth between the ages of 14-18 enrolled over two years in the intervention arm of the RCT. Just over half (51%) were female; 56% were Hispanic; and 27% African American. Youth were sent 40,006 messages of which 16,501 were considered bi-directional where youth were asked to text a response. Four-fifths (82%) responded at least once to a text. We found variations in response frequency by gender, age, and ethnicity. The most popular types of messages youth responded to include questions and quizzes. The first two months of the program in each year had the highest response frequency. An important next step is to assess whether higher response to SMS results in greater efficacy. This future work can facilitate greater attention to message design and content to ensure messages are engaging for the intended audience.
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Affiliation(s)
- Sharon Devine
- University of Colorado, Colorado School of Public Health, Department of Community and Behavioral Health, Denver, CO, United States
| | - Caroline Leeds
- Denver Health and Hospital Authority, Denver Public Health, Denver, CO, United States
| | - Judith C Shlay
- Denver Health and Hospital Authority, Denver Public Health, Denver, CO, United States; University of Colorado, School of Medicine, Department of Family Medicine, Aurora, CO, United States
| | - Amber Leytem
- Denver Health and Hospital Authority, Denver Public Health, Denver, CO, United States
| | - Robert Beum
- Denver Health and Hospital Authority, Denver Public Health, Denver, CO, United States
| | - Sheana Bull
- University of Colorado, Colorado School of Public Health, Department of Community and Behavioral Health, Denver, CO, United States.
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Cianelli R, Villegas N, Azaiza K, Henderson S, Hooshmand M, Peragallo N. Developing and testing an online breastfeeding training among undergraduate nursing students. ACTA ACUST UNITED AC 2014; 3:82-88. [PMID: 27766266 DOI: 10.5430/cns.v3n1p82] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The benefits of breastfeeding for mothers and babies have been well documented in the scientific literature, with new evidence about the benefits continuing to emerge. The Surgeon General's call to action to support breastfeeding recommends mandatory breastfeeding education and training for all healthcare providers that deliver care to mothers and babies. The purpose of this study is to analyze the development of an online computer based breastfeeding training (BT) and the preliminary outcomes of this training. The development of this training included consultation with content and technology experts. The collection of preliminary outcomes related to breastfeeding knowledge data and evaluation of the online BT was pre and posttest study. Eighty six undergraduate nursing students completed the online BT using Blackboard Learn. The online component of the BT consisted of five modules with a combined length of approximately 16 hours. After the completion of the modules, the students increased their levels of knowledge related to breastfeeding and the majority believed that they were fully able to perform skills to support breastfeeding. The results of this study indicate that a successful BT for nursing students can be effectively designed, which can in the future be disseminated to other healthcare providers and students. In addition, this online BT was cost-efficient and effective in improving students' knowledge and skills to support breastfeeding.
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Affiliation(s)
- Rosina Cianelli
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Natalia Villegas
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Khitam Azaiza
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Shakira Henderson
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA; South Miami Hospital, Miami, Florida, USA
| | - Mary Hooshmand
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
| | - Nilda Peragallo
- School of Nursing and Health Studies, University of Miami, Coral Gables, USA
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Use of digital media technology for primary prevention of STIs/HIV in youth. J Pediatr Adolesc Gynecol 2014; 27:244-57. [PMID: 24332613 DOI: 10.1016/j.jpag.2013.07.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 07/22/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVE The relevant literature was reviewed to identify issues in research evaluating digital media technology (DMT) interventions for the primary prevention of STIs/HIV in adolescents and young adults. METHOD A literature search with relevant key terms was conducted in PubMed, for articles with studies that included: (a) participants between 11-29 years; (b) use of one or more of the following forms of DMT: interactive digital video or CD-ROM, computer, text messaging, or Internet; (c) evaluation of an STI/HIV primary prevention intervention; and (d) use of a cognitive, psychosocial, behavioral, or biological outcome. RESULTS Twenty-nine studies were identified and included in the review. Based on the review of these studies, 7 main issues were discussed and recommendations for improving future research were offered. The 7 main issues were: (a) need for a balance between universal application and specific sub-group focus, (b) lack of a developmental framework, (c) challenge of applying DMT in resource limited contexts, (d) rapidly changing nature of DMT, (e) lack of biological outcomes, (f) lack of comparison/control groups to assess the impact of DMT, and (g) limited temporal follow-up. CONCLUSIONS There is increasing literature evaluating the effectiveness of DMT for preventing STIs/HIV among adolescents and young adults. A careful consideration of 7 main issues identified in the literature can improve the design and evaluation of these interventions and enhance our understanding of their effectiveness.
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Shegog R, Peskin MF, Markham C, Thiel M, Karny E, Addy RC, Johnson KA, Tortolero S. It's Your Game-Tech: Toward Sexual Health in the Digital Age. CREATIVE EDUCATION 2014; 5:1428-1447. [PMID: 25705561 PMCID: PMC4334143 DOI: 10.4236/ce.2014.515161] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adolescent sexually transmitted infection (STI) and birth rates indicate a need for effective middle school HIV/STI, and pregnancy prevention curricula to delay, or mitigate consequences of, early sexual activity. Individual and organizational barriers to adoption, implementation, and maintenance, however, can hamper dissemination of evidence-based sexual health curricula, adversely impacting fidelity and reach. Internet-based approaches may help mitigate these barriers. This paper describes the development and feasibility testing of It's Your Game (IYG)-Tech, a stand-alone 13-lesson Internet-based sexual health life-skills curriculum adapted from an existing effective sexual health curriculum-It's Your Game… Keep it Real (IYG). IYG-Tech development adaptation steps were to: 1) Select a suitable effective program and gather the original program materials; 2) Develop "proof of concept" lessons and test usability and impact; 3) Develop the program design document describing the core content, scope, and methods and strategies; and 4) produce the new program. Lab- and school-based tests with middle school students demonstrated high ratings on usability parameters and immediate impact on selected psychosocial factors related to sexual behavior-perceptions of friends' beliefs, reasons for not having sex, condom use self-efficacy, abstinence intentions, negotiating with others to protect personal rules, and improved knowledge about what constitutes healthy relationships (all p < .05). Youth rated IYG-Tech is favorably compared to other learning channels (>76.2% agreement) and rated the lessons as helpful in making healthy choices, selecting personal rules, detecting challenges to those rules, and protecting personal rules through negotiation and refusal skills (89.5% - 100%). Further efficacy testing is indicated for IYG-Tech as a potential strategy to deliver effective HIV/STI, and pregnancy prevention to middle school youth.
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Affiliation(s)
- Ross Shegog
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Melissa F. Peskin
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Christine Markham
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Melanie Thiel
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Efrat Karny
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Robert C. Addy
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Kimberly A. Johnson
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Susan Tortolero
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
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Albritton T, Hodge-Sallah S, Akers A, Blumenthal C, O'Brien S, Council B, Muhammad M, Corbie-Smith G. A Process Evaluation of an HIV/STI Intervention for Rural African American Youth. QUALITATIVE HEALTH RESEARCH 2014; 24:969-982. [PMID: 24939390 PMCID: PMC4379123 DOI: 10.1177/1049732314540053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We evaluated the fidelity and implementation of an HIV/AIDS and sexually transmitted infections intervention for rural African American youth. Using a community-based evaluation approach, community partners and researchers monitored four core process-evaluation components: reach, fidelity, dose delivered, and dose received. Researchers collected evaluation data through session observations, facilitator debriefing interviews, a youth focus group, and a satisfaction survey. For reach, more than half of the participants attended the 13 sessions. Participation varied between 62% and 100%. For fidelity, not all sessions were implemented as intended; multiple modifications occurred across sessions. For dose delivered, some lessons were missing materials and content was omitted; facilitators omitted content when there was insufficient time to complete a lesson. For dose received, engagement varied across lessons but youth reported high levels of satisfaction with the intervention. This formative process evaluation enabled us to identify and address multiple challenges to implementation.
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Affiliation(s)
| | | | - Aletha Akers
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Connie Blumenthal
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah O'Brien
- Center for AIDS Prevention Studies, San Francisco, California, USA
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Ajie WN, Chapman-Novakofski KM. Impact of computer-mediated, obesity-related nutrition education interventions for adolescents: a systematic review. J Adolesc Health 2014; 54:631-45. [PMID: 24534357 DOI: 10.1016/j.jadohealth.2013.12.019] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 12/13/2013] [Accepted: 12/17/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this systematic review was to evaluate recent research regarding the use of computer-based nutrition education interventions targeting adolescent overweight and obesity. METHODS Online databases were systematically searched using key words, and bibliographies of related articles were manually searched. Inclusion/exclusion criteria were applied and included studies evaluated for their ability to achieve their objectives and for quality using the Nutrition Evidence Library appraisal guidelines for research design and implementation. RESULTS Of the 15 studies included, 10 were randomized controlled trials. Two studies targeted weight loss, 2 targeted weight maintenance, and 11 targeted dietary improvement with or without physical activity. At least half of in-school (60%) and nonschool interventions (80%) exhibited significantly positive effects on nutrition- or obesity-related variables. Small changes in diet, physical activity, knowledge, and self-efficacy were shown; however, few results were sustained long term. CONCLUSIONS Recommendations included application of health behavior theory and computer tailoring for feedback messages. Future research should include thorough description of intervention content (messages, theory, multimedia, etc.), application of rigorous methodology, as well as consideration of covariates such as parental involvement and gender. With further research and evidentiary support, this approach to obesity-related nutrition education has the potential to be successful.
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Affiliation(s)
- Whitney N Ajie
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois.
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Rintamaki LS, Yang ZJ. Advancing the extended parallel process model through the inclusion of response cost measures. JOURNAL OF HEALTH COMMUNICATION 2014; 19:759-774. [PMID: 24730535 DOI: 10.1080/10810730.2013.864722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study advances the Extended Parallel Process Model through the inclusion of response cost measures, which are drawbacks associated with a proposed response to a health threat. A sample of 502 college students completed a questionnaire on perceptions regarding sexually transmitted infections and condom use after reading information from the Centers for Disease Control and Prevention on the health risks of sexually transmitted infections and the utility of latex condoms in preventing sexually transmitted infection transmission. The questionnaire included standard Extended Parallel Process Model assessments of perceived threat and efficacy, as well as questions pertaining to response costs associated with condom use. Results from hierarchical ordinary least squares regression demonstrated how the addition of response cost measures improved the predictive power of the Extended Parallel Process Model, supporting the inclusion of this variable in the model.
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Affiliation(s)
- Lance S Rintamaki
- a Department of Communication , University at Buffalo, The State University of New York , Buffalo , New York , USA
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Early adolescent pregnancy increases risk of incident HIV infection in the Eastern Cape, South Africa: a longitudinal study. J Int AIDS Soc 2014; 17:18585. [PMID: 24650763 PMCID: PMC3962027 DOI: 10.7448/ias.17.1.18585] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 11/25/2013] [Accepted: 12/19/2013] [Indexed: 11/16/2022] Open
Abstract
Introduction Adolescents having unprotected heterosexual intercourse are at risk of HIV infection and unwanted pregnancy. However, there is little evidence to indicate whether pregnancy in early adolescence increases the risk of subsequent HIV infection. In this paper, we tested the hypothesis that adolescent pregnancy (aged 15 or younger) increases the risk of incident HIV infection in young South African women. Methods We assessed 1099 HIV-negative women, aged 15–26 years, who were volunteer participants in a cluster-randomized, controlled HIV prevention trial in the predominantly rural Eastern Cape province of South Africa. All of these young women had at least one additional HIV test over two years of follow-up. Outcomes were HIV incidence rates per 100 person years and HIV incidence rate ratios (IRRs) estimated by Poisson multivariate models. Three pregnancy categories were created for the Poisson model: early adolescent pregnancy (a first pregnancy at age 15 years or younger); later adolescent pregnancy (a first pregnancy at age 16 to 19 years); and women who did not report an adolescent pregnancy. Models were adjusted for study design, age, education, time since first sexual experience, socio-economic status, childhood trauma and herpes simplex virus type 2 infection. Results HIV incidence rates were 6.0 per 100 person years over two years of follow-up. The adjusted IRR was 3.02 (95% CI 1.50–6.09) for a pregnancy occurring at age 15 or younger. Women with pregnancies occurring between 16 and 19 years of age did not have a higher incidence of HIV (IRR 1.08; 95% CI 0.64–1.84). Early adolescent pregnancies were associated with higher partner numbers and a greater age difference with partners. Conclusions Early adolescent pregnancies increase the incidence of HIV among South African women. The higher risk is associated with sexual risk behaviours such as higher partner numbers and a greater age difference with partners rather than a biological explanation of hormonal changes during pregnancy.
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Villegas N, Santisteban D, Cianelli R, Ferrer L, Ambrosia T, Peragallo N, Lara L. The development, feasibility and acceptability of an Internet-based STI-HIV prevention intervention for young Chilean women. Int Nurs Rev 2014; 61:55-63. [PMID: 24512261 PMCID: PMC4002211 DOI: 10.1111/inr.12080] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Young Chilean women between 18 and 24 years of age are at high risk of contracting sexually transmitted infection (STI) and human immunodeficiency virus (HIV). The literature shows a shortage of STI-HIV prevention interventions focused on this specific high-risk population and a unique set of barriers to receiving prevention messages. Internet-based interventions are promising for delivering STI-HIV prevention interventions and avoiding barriers to services. AIMS The study aimed to develop a culturally informed Internet-based STI-HIV prevention intervention for Chilean women between 18 and 24 years of age, to investigate its feasibility and acceptability, and to compile recommendations on what would make the intervention more acceptable and feasible for these women. METHODS The development of the Internet intervention was facilitated by a process that featured consultation with content and technology experts. A pre-post test design was used to test the acceptability and feasibility of the intervention with 40 young Chilean women between 18 and 24 years of age. RESULTS The intervention website consisted of four modules of content and activities that support learning. The intervention was feasible and acceptable for young Chilean women between 18 and 24 years of age. DISCUSSION AND CONCLUSION This study demonstrated the value of engaging multiple expert panels to develop culturally informed and technology-based interventions. The results of this study support the feasibility and acceptability of conducting an Internet-based intervention with multiple sessions, yielding high participation rates in a population in which there are barriers to discussion of STI-HIV prevention and sex-related content. IMPLICATIONS FOR NURSING AND HEALTH POLICY The outcomes have implications for nursing education and clinical practice and they can be used for the legal and judicial systems to promote or reinforce policies that encourage STI-HIV prevention strategies among women.
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Affiliation(s)
- N Villegas
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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23
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Roberto AJ, Eden J, Savage MW, Ramos-Salazar L, Deiss DM. Outcome evaluation results of school-based cybersafety promotion and cyberbullying prevention intervention for middle school students. HEALTH COMMUNICATION 2014; 29:1029-1042. [PMID: 24446820 DOI: 10.1080/10410236.2013.831684] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Guided largely by the Extended Parallel Process Model, the Arizona Attorney General's Social Networking Safety Promotion and Cyberbullying Prevention presentation attempts to shape, change, and reinforce middle school students' perceptions, attitudes, and intentions related to these important social issues. This study evaluated the short-term effects of this presentation in a field experiment using a posttest-only control-group design with random assignment to conditions. A total of 425 sixth, seventh, and eighth graders at a public middle school in a large Southwestern city participated in this study. Results reveal several interesting trends across grade levels regarding cyberbullying perpetration and victimization, and concerning access to various communication technologies. The intervention had the hypothesized main effect on eight of the dependent variables under investigation. Examination of condition by grade interaction effects offered further support for an additional four hypotheses (i.e., the intervention positively affected or reversed a negative trend on four dependent variables in at least one grade). Ideas and implications for future social networking safety promotion and cyberbullying prevention interventions are discussed.
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Affiliation(s)
- Anthony J Roberto
- a Hugh Downs School of Human Communication , Arizona State University
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24
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Can technology be effective in interventions targeting sexual health and substance use in young people; a systematic review. HEALTH AND TECHNOLOGY 2013. [DOI: 10.1007/s12553-013-0059-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Duong J, Bradshaw CP. Using the extended parallel process model to examine teachers' likelihood of intervening in bullying. THE JOURNAL OF SCHOOL HEALTH 2013; 83:422-429. [PMID: 23586887 DOI: 10.1111/josh.12046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 07/12/2012] [Indexed: 06/02/2023]
Abstract
BACKGROUND Teachers play a critical role in protecting students from harm in schools, but little is known about their attitudes toward addressing problems like bullying. Previous studies have rarely used theoretical frameworks, making it difficult to advance this area of research. Using the Extended Parallel Process Model (EPPM), we examined the association between teachers' perceived threat and perceived efficacy and their likelihood of intervening in bullying situations. We also explored whether the school level at which teachers taught (elementary vs secondary), and their years of experience of working at the school moderated these associations. METHODS Data come from 1062 teachers who completed an anonymous Web-based survey regarding their attitudes and responses to bullying. Structural equation modeling and multiple group analyses were used to test the hypothesized relationships and for effect modification by teacher characteristics. RESULTS Perceived threat and efficacy were associated with teachers' likelihood of intervening in bullying situations but varied based on teachers' years of experience at their school. For less experienced teachers, perceived efficacy, but not perceived threat, was strongly associated with likelihood of intervening. For more experienced teachers, both perceived threat and perceived efficacy were significantly associated. Finally, the associations did not differ by the school level. CONCLUSION This is one of few studies examining possible predictors of teachers' likelihood of intervening in bullying situations. EPPM may inform the development of bullying interventions aiming to increase the likelihood that teachers will intervene in bullying situations.
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Affiliation(s)
- Jeffrey Duong
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 886, Baltimore, MD 21205, USA.
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Bailey JV, Murray E, Rait G, Mercer CH, Morris RW, Peacock R, Cassell J, Nazareth I. Cochrane Review: Interactive computer-based interventions for sexual health promotion. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/ebch.885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Mevissen FE, Ruiter RA, Meertens RM, Zimbile F, Schaalma HP. Justify your love: Testing an online STI-risk communication intervention designed to promote condom use and STI-testing. Psychol Health 2011; 26:205-21. [DOI: 10.1080/08870446.2011.531575] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bailey JV, Murray E, Rait G, Mercer CH, Morris RW, Peacock R, Cassell J, Nazareth I. Interactive computer-based interventions for sexual health promotion. Cochrane Database Syst Rev 2010:CD006483. [PMID: 20824850 DOI: 10.1002/14651858.cd006483.pub2] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sexual health promotion is a major public health challenge; there is huge potential for health promotion via technology such as the Internet. OBJECTIVES To determine effects of interactive computer-based interventions (ICBI) for sexual health promotion, considering cognitive, behavioural, biological and economic outcomes. SEARCH STRATEGY We searched more than thirty databases for randomised controlled trials (RCTs) on ICBI and sexual health, including CENTRAL, DARE, MEDLINE, EMBASE, CINAHL, British Nursing Index, and PsycINFO. We also searched reference lists of published studies and contacted authors. All databases were searched from start date to November 2007, with no language restriction. SELECTION CRITERIA RCTs of interactive computer-based interventions for sexual health promotion, involving participants of any age, gender, sexual orientation, ethnicity or nationality. 'Interactive' was defined as packages that require contributions from users to produce tailored material and feedback that is personally relevant. DATA COLLECTION AND ANALYSIS Two review authors screened abstracts, applied eligibility and quality criteria and extracted data. Results of RCTs were pooled using a random-effects model with standardised mean differences (SMDs) for continuous outcomes and odds ratios (ORs) for binary outcomes. We assessed heterogeneity using the I(2) statistic. Separate meta-analyses were conducted by type of comparator: 1) minimal intervention such as usual practice or leaflet, 2) face-to-face intervention or 3) a different design of ICBI; and by type of outcome (cognitive, behavioural, biological outcomes). MAIN RESULTS We identified 15 RCTs of ICBI conducted in various settings and populations (3917 participants). Comparing ICBI to 'minimal interventions' such as usual practice, meta-analyses showed statistically significant effects as follows: moderate effect on sexual health knowledge (SMD 0.72, 95% CI 0.27 to 1.18); small effect on safer sex self-efficacy (SMD 0.17, 95% CI 0.05 to 0.29); small effect on safer-sex intentions (SMD 0.16, 95% CI 0.02 to 0.30); and also an effect on sexual behaviour (OR 1.75, 95% CI 1.18 to 2.59). Data were insufficient for meta-analysis of biological outcomes and analysis of cost-effectiveness.In comparison with face-to-face sexual health interventions, meta-analysis was only possible for sexual health knowledge, showing that ICBI were more effective (SMD 0.36, 95% CI 0.13 to 0.58). Two further trials reported no difference in knowledge between ICBI and face-to-face intervention, but data were not available for pooling. There were insufficient data to analyse other types of outcome.No studies measured potential harms (apart from reporting any deterioration in measured outcomes). AUTHORS' CONCLUSIONS ICBI are effective tools for learning about sexual health, and they also show positive effects on self-efficacy, intention and sexual behaviour. More research is needed to establish whether ICBI can impact on biological outcomes, to understand how interventions might work, and whether they are cost-effective.
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Affiliation(s)
- Julia V Bailey
- Research Department of Primary Care and Population Health, University College London, Upper Third Floor, Royal Free Hospital, Rowland Hill Street, London, UK, NW3 2PF
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Belenko S, Dembo R, Rollie M, Childs K, Salvatore C. Detecting, preventing, and treating sexually transmitted diseases among adolescent arrestees: an unmet public health need. Am J Public Health 2009; 99:1032-41. [PMID: 19372535 PMCID: PMC2679796 DOI: 10.2105/ajph.2007.122937] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2008] [Indexed: 11/04/2022]
Abstract
Studies of detained and incarcerated adolescent offenders in the United States indicate that these juveniles have an elevated risk of sexually transmitted diseases (STDs). However, many more arrestees enter the "front end" of the juvenile justice system than are detained or incarcerated, and research into the STD risk profiles and service needs of this larger group is lacking. An expansion of STD testing (including of asymptomatic youths), prevention, and treatment is needed, as is improved knowledge about gender- and race-specific services. A pilot program in Florida has shown that juvenile justice and public health systems can collaborate to implement STD testing among new arrestees. With integrated linkages to treatment and prevention after release, this model could greatly reduce the STD burden in this underserved, high-risk population.
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Affiliation(s)
- Steven Belenko
- Department of Criminal Justice, Temple University, Philadelphia, PA 19122, USA.
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Effects of an Internet-based intervention for HIV prevention: the Youthnet trials. AIDS Behav 2009; 13:474-87. [PMID: 19037719 DOI: 10.1007/s10461-008-9487-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Accepted: 10/23/2008] [Indexed: 10/21/2022]
Abstract
Youth use the Internet and computers in unprecedented numbers. We have yet to identify interventions that can reach and retain large numbers of diverse youth online and demonstrate HIV prevention efficacy. We tested a single session condom promotion Internet intervention for 18-24 year olds in two RCTs: one sample recruited online and one recruited in clinics. All study elements were carried out on the Internet. Using repeated measures structural equation models we analyzed change in proportion of sex acts protected by condoms (PPA) over time. Among sexually active youth in the Internet sample, persons exposed to the intervention had very slight increases in condom norms, and this was the only factor impacting PPA. We saw no intervention effects in the clinic sample. Internet-based interventions need to be more intensive to see greater effects. We need to do more to reach high risk youth online and keep their attention for multiple sessions.
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Coker-Appiah DS, Akers AY, Banks B, Albritton T, Leniek K, Wynn M, Youmans SE, Parker D, Ellison A, Henderson S, Stith D, Council B, Oxendine-Pitt P, Corbie-Smith G. In their own voices: rural African American youth speak out about community-based HIV prevention interventions. Prog Community Health Partnersh 2009; 3:301-12. [PMID: 20097991 PMCID: PMC4167354 DOI: 10.1353/cpr.0.0093] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The HIV epidemic is a major public health problem in the United States, particularly among rural African American adolescents and young adults. OBJECTIVES We sought to explore young, rural African American's perspectives about key programmatic components to consider when designing youth-targeted, community- based HIV prevention interventions. METHODS We report data from four focus groups with adolescents and young adults aged 16 to 24 (n = 38) conducted as part of a community-based participatory research (CBPR) project designed to develop multilevel HIV risk reduction interventions in two rural North Carolina communities with high HIV rates. Analysis was performed by academic and community partners using a modified grounded theory approach to content analysis. RESULTS Interventions should target preadolescents and early adolescents rather than older adolescents and young adults in an effort to "catch them while they're young." Intervention developers should obtain input from local young people regarding critical programmatic components, such as whom to employ as study recruiters and intervention leaders; intervention format and delivery options, acceptable recruitment and intervention locations, and incentive structures. Participants believe selecting community collaborators representing varied community sectors is critical. Important barriers to address included limited transportation, discomfort communicating about sexual issues, lack of community interest in HIV prevention, and unwillingness to acknowledge and address sexual activity among adolescents. CONCLUSION When designing HIV/AIDS prevention interventions, targeting young people, it is important to form academic-community partnerships that ensure young people's perspectives are integral to the intervention development process.
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