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Barreto M, Tran TA, Gaynor ST. A Single-Session of Acceptance and Commitment Therapy for Health-Related behavior change: An Open Trial with a nonconcurrent matched comparison group. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Xie S, Lin H, Meng Y, Zhu J, Zhang Y, Zhang L, Li G. Analysis and determinants of Chinese navy personnel health status: a cross-sectional study. Health Qual Life Outcomes 2018; 16:138. [PMID: 29996861 PMCID: PMC6042426 DOI: 10.1186/s12955-018-0961-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There have been very few studies analyzing the relationship of physical and mental health status with health behaviors and deployment status in Chinese navy personnel. Thus, we undertook this survey to assess this relationship and identify specific factors affecting the physical and mental health status. METHODS The subjects enrolled in this study were selected from four units of the active-duty navy personnel in China, based on a cluster random sampling design. A total of 1200 Chinese navy personnel participated and completed the questionnaire survey that included veteran SF-36 form and a self-designed questionnaire regarding their sociodemographic characteristics, deployment status, self-rated health status and health behaviors. Totally 1200 questionnaires were distributed to different participants, while 1083 valid questionnaires were included in the final analysis. All data were analyzed using SPSS18.0 software. RESULTS Based on the information provided by navy personnel, 17.82, 35.09 and 23.08% rated their health as excellent, very good and good, respectively. The mean score of physical component summary (PCS) and mental component summary (MCS) was 50.53 and 41.39, respectively. Length of service, binge drinking, regular drinking and BMI appeared to be associated with PCS score, while household income, binge drinking and BMI affected MCS score. Deployment status and smoking exhibited no significant association with PCS and MCS scores. CONCLUSIONS Our study suggested that the sociodemographic factors like length of service and household income, along with behavioral risk factors like binge drinking, regular drinking and body mass index (BMI), seem to affect the physical and mental health status of Chinese navy personnel. However, additional data collection and more detailed analysis would still be required to develop a systematic, comprehensive and corresponding health education program to promote overall health status.
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Affiliation(s)
- Shali Xie
- Department of Health Education, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038 China
| | - Hui Lin
- Department of Tropical Epidemiology, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038 China
| | - Yi Meng
- Department of Social Work, Social and Public Management School, Chongqing Technology and Business University, Chongqing, 400067 China
| | - Jundong Zhu
- Department of Nutrition and Food Hygiene, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038 China
| | - Yanqi Zhang
- Department of Health Statistics, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038 China
| | - Ling Zhang
- Department of Health Education, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038 China
| | - Gaoming Li
- Department of Health Statistics, College of Military Preventive Medicine, Army Medical University, Chongqing, 400038 China
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Pinyaphong J, Srithanaviboonchai K, Chariyalertsak S, Phornphibul P, Tangmunkongvorakul A, Musumari PM. Inconsistent Condom Use Among Male University Students in Northern Thailand. Asia Pac J Public Health 2018; 30:147-157. [PMID: 29409333 DOI: 10.1177/1010539517753931] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
University students are at increased risk of HIV infection, but little is known about the determinants of inconsistent condom use among them. The study aims to assess the association of sociodemographic, individual, dyadic, and social factors with inconsistent condom use among male university students. Of 1091 participants, 67.0% had sexual intercourse, though 64.4% had inconsistent condom use. It was found that "did not use a condom at first sexual intercourse" (adjusted odds ratio [AOR] 6.1; CI, 3.7-10.1), "history of STIs" (AOR, 2.1; CI, 1.0-4.2), low "self-efficacy" (AOR, 2.4; CI, 1.3-4.7), "perception that condom use reduces pleasure" (AOR, 1.4; CI, 1.0-2.1), and "high subjective norm" (AOR, 1.9; CI, 1.3-2.8) were associated with increased odds of inconsistent condom use. Condom use should be promoted from the onset of sexual activity to establish a habit of safe sex practices and for improvement in self-efficacy of condom use. Emphasis must be laid on pleasure-enhancing benefits of condom use and changing social norms.
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Wade R, Harper GW, Bauermeister JA. Psychosocial Functioning and Decisional Balance to Use Condoms in a Racially/Ethnically Diverse Sample of Young Gay/Bisexual Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:195-204. [PMID: 28233112 PMCID: PMC5569003 DOI: 10.1007/s10508-016-0912-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 10/19/2016] [Accepted: 11/25/2016] [Indexed: 06/06/2023]
Abstract
Young gay/bisexual and other men who have sex with men (YGBMSM; ages 18-24) are experiencing an increase in HIV infection rates, particularly if they are Black or Latino. Psychosocial functioning is consistently implicated in HIV risk behaviors; however, less is known about the role of these factors in YGBMSM's decision-making process to use condoms (i.e., decisional balance to use condoms; DBC). We examined whether YGBMSM's psychological functioning was associated differentially with their DBC across racial/ethnic groups. Using data from a cross-sectional web-survey of single YGBMSM (N = 1380; 9.9% Black; 18.6% Latino; 71.5% White), we performed racial/ethnic-specific multivariable regression models to explore the association between DBC and psychological factors (e.g., depression, anxiety), demographics (e.g., age, education, HIV status, prior STI diagnosis), and perceived difficulty implementing safer sex strategies. Black YGBMSM reported lower DBC if they reported higher depression symptoms (β = -.31, p < .05), were HIV-negative (β = -.20, p < .05), and had greater difficulty implementing safer sex strategies (β = -.32, p < .001). Latino participants reported greater DBC to use condoms if they reported greater anxiety symptoms (β = .21, p < .05). White participants reported greater DBC if they were younger (β = -.09, p < .01), did not report a prior STI (β = .10, p < .001), and had fewer difficulties implementing safer sex strategies (β = -.27, p < .001); DBC had no association to psychological well-being among White participants. Psychological factors may be differentially associated with DBC across racial/ethnic group categories. Health promotion initiatives targeting condom use may benefit from culturally tailored interventions that address psychosocial functioning and its role in YGBMSM's condom use decision-making.
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Affiliation(s)
- Ryan Wade
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - José A Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, 19104, USA.
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Freira S, Lemos MS, Williams G, Ribeiro M, Pena F, Machado MDC. Effect of Motivational Interviewing on depression scale scores of adolescents with obesity and overweight. Psychiatry Res 2017; 252:340-345. [PMID: 28327447 DOI: 10.1016/j.psychres.2017.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/02/2017] [Accepted: 03/10/2017] [Indexed: 11/30/2022]
Abstract
UNLABELLED The aim of this study was to compare the effect of motivational interview (MI) with conventional care on the depression scale scores of adolescents with obesity/overweight. It was a controlled cluster randomized trial with parallel design, including two groups: intervention group [Motivational Interview Group (MIG)], control group [Conventional Intervention Group (CIG)]. INTERVENTION three face-to-face 30min' interviews three months apart (only MIG interviews were based on MI principles). OUTCOMES change in Children Depression Inventory (CDI) scores. We used a mixed repeated-measures ANOVAs analysis to assess the group vs time interaction. Effect size was calculated for ANOVA with difference of means of the total score (DOMTS). CDI scores were compared by a paired t-test. Eighty-three (84%) adolescents finished the intervention. There was a significant time vs group interaction both groups. While in the CIG scores significantly increased, in the MIG the scores significantly decreased. The DOMTS was significantly different between the two groups. We concluded that MI showed a positive effect on depression scale scores over time relatively to conventional intervention.
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Affiliation(s)
- Silvia Freira
- Department of Pediatrics, Faculty of Medicine, Hospital de Santa Maria, University of Lisbon, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal.
| | - Marina Serra Lemos
- Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen 535, Porto, Portugal.
| | - Geoffrey Williams
- University of Rochester Medical Center, 46 Prince St., Ste 3001, Rochester, NY 14617, United States.
| | - Marta Ribeiro
- Department of Pediatrics, Faculty of Medicine, Hospital de Santa Maria, University of Lisbon, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal.
| | - Fernanda Pena
- Unit of Continuing Care, Largo da Mundet - Bairro Novo, 2840-264 Seixal, Portugal.
| | - Maria do Céu Machado
- Department of Pediatrics, Faculty of Medicine, Hospital de Santa Maria, University of Lisbon, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal.
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Starosta AJ, Cranston E, Earleywine M. Safer sex in a digital world: A Web-based motivational enhancement intervention to increase condom use among college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2016; 64:184-193. [PMID: 26700487 DOI: 10.1080/07448481.2015.1107835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE This study is a randomized trial of a Web-based intervention to increase condom use among college women. PARTICIPANTS From October 2012 to March 2013, N = 422 completed baseline questionnaires and intervention procedures. n = 216 completed 3-month follow-up. METHODS Participants completed a decisional balance exercise examining their sex acts over the past 3 months and wrote an essay encouraging young girls to use condoms. All procedures were conducted online. RESULTS The intervention improved intentions to use and attitudes towards condoms for 3 subscales of condom attitudes. Attitudes following the intervention significantly predicted condom use at 3-month follow-up, and this relationship was mediated by condom intentions immediately post intervention. The relationship between intentions and condom use was moderated by group. CONCLUSIONS The intervention improved condom attitudes and intentions immediately post intervention, and immediately post intervention intentions had a greater impact on condom use at 3-month follow-up among those in the condom intervention compared with those in the control group.
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Affiliation(s)
- Amy J Starosta
- a Department of Psychology , University at Albany, State University of New York , Albany , New York , USA
| | - Emma Cranston
- a Department of Psychology , University at Albany, State University of New York , Albany , New York , USA
| | - Mitch Earleywine
- a Department of Psychology , University at Albany, State University of New York , Albany , New York , USA
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Collins SE, Kirouac M, Lewis MA, Witkiewitz K, Carey KB. Randomized controlled trial of web-based decisional balance feedback and personalized normative feedback for college drinkers. J Stud Alcohol Drugs 2015; 75:982-92. [PMID: 25343656 DOI: 10.15288/jsad.2014.75.982] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Web-based personalized feedback interventions, particularly personalized normative feedback (PNF), are efficacious in improving college drinking outcomes; however, no personalized feedback interventions to date have provided college drinkers with feedback about their own decisional balance. This study tested the relative efficacy of a novel decisional balance feedback (DBF) intervention, PNF, and an assessment-only control condition. METHOD Participants (N = 724; 56% female) were undergraduate students at a 4-year university in the U.S. Pacific Northwest and were randomized to receive one-time exposure to web-based DBF, PNF, or assessment only. Web-based assessment occurred at baseline and at 1-, 6-, and 12-month follow-ups and included measures of motivation to change, drinking quantity norms, drinking frequency/quantity, and alcohol-related problems. RESULTS At the 1-month follow-up, DBF and PNF participants reported reductions in alcohol-related problems; however, only PNF participants reduced their drinking frequency and quantity. At the 6-month follow-up, only DBF participants showed significant reductions in drinking quantity and alcohol-related problems. Neither group maintained reductions in alcohol use or alcohol-related problems at the 12-month follow-up. CONCLUSIONS This study provided preliminary evidence that web-based DBF and PNF are efficacious interventions for college drinkers, with DBF having somewhat longer lasting effects.
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Affiliation(s)
- Susan E Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington-Harborview Medical Center, Seattle, Washington
| | - Megan Kirouac
- Department of Psychiatry and Behavioral Sciences, University of Washington-Harborview Medical Center, Seattle, Washington
| | - Melissa A Lewis
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Kate B Carey
- Brown University School of Public Health, Providence, Rhode Island
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Davis KC, Schraufnagel TJ, Kajumulo KF, Gilmore AK, Norris J, George WH. A qualitative examination of men's condom use attitudes and resistance: "it's just part of the game". ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:631-43. [PMID: 23912776 PMCID: PMC3859530 DOI: 10.1007/s10508-013-0150-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Revised: 05/17/2012] [Accepted: 05/22/2012] [Indexed: 05/08/2023]
Abstract
The purpose of this study was to investigate the variability in young heterosexual men's perceptions of the advantages and disadvantages of condom use in their casual sexual relationships. Because men who perceive greater disadvantages of condom use may be more likely to resist using them, we also explored the tactics that men employ to avoid using condoms. Semi-structured focus groups were conducted with single men who have sex with women (n = 60), aged 21-35 years, all of whom reported using condoms inconsistently. Transcripts were analyzed using a framework analysis approach. As expected, participants reported advantages and disadvantages to condom use that pertained to the likelihood and quality of sex, physical sensations during intercourse, and the risk of sexually transmitted infections and unwanted pregnancies. Within each of these topics, however, participants' appraisals of the relative pros and cons of condom use varied considerably. Additionally, participants reported that men use a wide range of condom use resistance tactics, including seduction, deception, and condom sabotage, and that the use of these tactics was viewed as normative behavior for men their age. These findings suggest that the effectiveness of sexual health prevention efforts could be enhanced by increasing young men's motivations to use condoms and by targeting social norms regarding condom use resistance. Additionally, the issue of men's condom use resistance clearly merits increased empirical investigation and intervention attention.
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Affiliation(s)
- Kelly Cue Davis
- School of Social Work, University of Washington, 4101 15th Ave NE, Box 354900, Seattle, WA, 98105, USA,
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Croughs M, Remmen R, Van den Ende J. The effect of pre-travel advice on sexual risk behavior abroad: a systematic review. J Travel Med 2014; 21:45-51. [PMID: 24354921 DOI: 10.1111/jtm.12084] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Travelers often have casual sex abroad and the risk of acquiring a sexually transmitted infection (STI) associated with casual travel sex is considered to be threefold higher compared to the risk of casual sex in the home country. Consequently, international guidelines recommend including STI advice in the pre-travel consultation. We performed a systematic review on the effect of a pre-travel STI intervention on sexual risk behavior abroad. METHODS In September 2012, a systematic analysis and meta-analysis of peer reviewed literature were performed on the relation between pre-travel STI advice for travelers and sexual risk behavior abroad. Primary outcome measure consisted of the number of travelers with a new sexual partner abroad; secondary outcome measure entailed the proportion of consistent condom use. RESULTS Six studies were identified for inclusion in the review, of which three clinical trials on the effect of a motivational intervention compared to standard pre-travel STI advice qualified for the meta-analysis. Two of these trials were performed in US marines deployed abroad and one in visitors of a travel clinic. The extensive motivational training program of the marines led to a reduction in sexual risk behavior, while the brief motivational intervention in the travel clinic was not superior to standard advice. The meta-analysis established no overall effect on risk behavior abroad. No clinical trials on the effect of a standard pre-travel STI discussion were found, but a cohort study reported that no relation was found between the recall of a nonstructured pre-travel STI discussion and sexual risk behavior, while the recall of reading the STI information appeared to be related to more consistent condom use. CONCLUSIONS Motivational pre-travel STI intervention was not found to be superior to standard STI advice, while no clinical trials on the effect of standard pre-travel STI advice were found.
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Affiliation(s)
- Mieke Croughs
- Department of General Health, GGD Hart voor Brabant,'s-, Hertogenbosch, The Netherlands; Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Motivational interviewing and decisional balance: contrasting responses to client ambivalence. Behav Cogn Psychother 2013; 43:129-41. [PMID: 24229732 DOI: 10.1017/s1352465813000878] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A recommendation in original descriptions of motivational interviewing (MI) was to "explore ambivalence". Contrasting procedures for doing so have been clarified through the evolution of MI. AIMS This article describes two conceptually distinct methods for responding to ambivalence: decisional balance (DB) and MI's evocation of change talk, and reviews empirical evidence to recommend when each procedure is appropriate (and inappropriate) in clinical practice. METHOD The authors summarize findings of clinical outcome research to examine how these two interventions impact the resolution of client ambivalence. RESULTS With ambivalent people, a DB intervention tends to decrease commitment to change, whereas evocation (a key element of MI) promotes change. When a person has already made the decision to change, evocation is unnecessary and may deter change, whereas DB may further strengthen commitment. CONCLUSIONS DB is an appropriate procedure when the clinician wishes to maintain neutrality and not favor the resolution of ambivalence in any particular direction. Evocation is appropriate when the clinician intends to help clients resolve ambivalence in the direction of change.
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August EM, Daley E, Kromrey J, Baldwin J, Romero-Daza N, Salmeron J, Lazcano-Ponce E, Villa LL, Bryant CA, Giuliano AR. Age-related variation in sexual behaviours among heterosexual men residing in Brazil, Mexico and the USA. ACTA ACUST UNITED AC 2013; 40:261-9. [PMID: 24099979 DOI: 10.1136/jfprhc-2012-100564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare the prevalence of demographic characteristics and sexual behaviours across age groups and to estimate their significance in predicting sexual risk factors by age cohort. METHODS This cohort study examined sexually transmitted infection (STI) prevalence among heterosexual men in Brazil, Mexico and the USA (N=3047). Participants completed a sexual risk factor questionnaire and were tested for chlamydia, gonorrhoea, syphilis and genital herpes. We examined sexual risk in the study population through a composite measure of STI positivity by age cohort (young: 18-30 years; middle-aged: 31-44 years; older: 45-70 years). Multivariable logistic regression models were used to generate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS We found that STI positivity varied significantly by age group among heterosexual men by a number of covariates. In younger men, having more advanced education had a protective effect (16 years: AOR=0.37, 95% CI 0.15- 0.92), whereas higher numbers of sexual partners elevated the risk for STIs (20-49 partners: AOR=2.06, 95% CI 1.04-4.06; ≥ 50 partners: AOR=4.33, 95% CI 1.74-10.76). Middle-aged men who were black (AOR=1.64, 95% CI 1.10-2.42) and divorced/separated/widowed (AOR=1.91, 95% CI 1.21-3.02) had an increased risk for a positive STI test. Among older men, a younger age at first vaginal sexual encounter (AOR=3.75, 95% CI 1.45-9.74) and a history of exchanging sex for money or drugs heightened STI risk (AOR=2.30, 95% CI 1.0-5.04). CONCLUSIONS These findings demonstrate that age-related life experiences among heterosexual men influence sexual risk and STI transmission. This topic warrants further investigation to support the development and implementation of targeted interventions that may potentially reduce adverse sexual health outcomes.
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Affiliation(s)
- Euna M August
- Research Coordinator, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen Daley
- Associate Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Jeffrey Kromrey
- Professor, Department of Educational Measurement and Research, College of Education, University of South Florida, Tampa, FL, USA
| | - Julie Baldwin
- Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Nancy Romero-Daza
- Associate Professor, Department of Anthropology, College of Arts and Sciences, University of South Florida, Tampa, FL, USA
| | - Jorge Salmeron
- Professor, Unidad de Investigación Epidemiológica en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México
| | - Eduardo Lazcano-Ponce
- Director, Centro de Investigación Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Luisa L Villa
- Professor, Faculty of Medical Sciences of Santa Casa of São Paulo, São Paulo, Brazil
| | - Carol A Bryant
- Distinguished Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Anna R Giuliano
- Director, Center for Infection Research in Cancer, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Widome R, Laska MN, Gulden A, Fu SS, Lust K. Health risk behaviors of Afghanistan and Iraq war veterans attending college. Am J Health Promot 2012; 26:101-8. [PMID: 22040391 DOI: 10.4278/ajhp.090826-quan-278] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE. The population of military veterans attending college is rapidly growing as veterans return from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). We sought to describe patterns of student veterans' health-related behaviors and how they might differ from their nonveteran peers. DESIGN. We analyzed data from the 2008 Boynton College Student Health Survey (CSHS). SETTING. CSHS participants completed an anonymous online survey. SUBJECTS. The CSHS sampled students (n = 8651) attending public, private, 2-year, and 4-year postsecondary educational institutions in Minnesota. MEASURES. The CSHS included items on substance use (including alcohol and tobacco), safety, nutrition, and physical activity. ANALYSIS. We described demographics of OEF/OIF veteran, non-OEF/OIF veteran, and nonveteran students and used Poisson regression to compute adjusted relative risks (ARRs) with 95% confidence intervals (CIs) to characterize associations between veteran status and health behaviors. RESULTS. After controlling for demographics, veteran students reported more safety-, tobacco-, and alcohol-related risk behaviors compared to nonveteran students. For instance, compared to the nonveteran reference group, the ARR for past year smokeless tobacco use and physical fighting among for OEF/OIF veterans was 1.76 (95% CI = 1.31-2.35) and 1.48 (95% CI = 1.22-1.79) respectively. Veteran and nonveteran students display similar weight-related behaviors, though OEF/OIF veteran students were more likely to engage in strengthening exercises. CONCLUSIONS. There are specific health risk behaviors that are particularly relevant for veterans attending postsecondary institutions. As veterans enroll in postsecondary education, there is a unique window of opportunity for health promotion in this population.
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Affiliation(s)
- Rachel Widome
- Center for Chronic Disease Outcomes Research (CCDOR), Minneapolis Veterans Affairs Medical Center, Minnesota, USA.
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Moore MJ, Werch CE, Bian H. Pilot of a computer-based brief multiple-health behavior intervention for college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2012; 60:74-80. [PMID: 22171732 DOI: 10.1080/07448481.2011.574765] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Given the documented multiple health risks college students engage in, and the dearth of effective programs addressing them, the authors developed a computer-based brief multiple-health behavior intervention. This study reports immediate outcomes and feasibility of a pilot of this program. PARTICIPANTS Two hundred students attending a midsized university participated. METHODS Participants were randomly assigned to the intervention or control program, both delivered via computer. Immediate feedback was collected with the computer program. RESULTS Results indicate that the intervention had an early positive impact on alcohol and cigarette use intentions, as well as related constructs underlying the Behavior-Image Model specific to each of the 3 substances measured. Based on the implementation process, the program proved to be feasible to use and acceptable to the population. CONCLUSION Results support the potential efficacy of the intervention to positively impact behavioral intentions and linkages between health promoting and damaging behaviors among college students.
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Affiliation(s)
- Michele J Moore
- Department of Public Health, University of North Florida, Jacksonville, Florida 32224-2645, USA.
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Dermen KH, Thomas SN. Randomized controlled trial of brief interventions to reduce college students' drinking and risky sex. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2011; 25:583-94. [PMID: 21928866 PMCID: PMC3232340 DOI: 10.1037/a0025472] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The present study tested the proposition that an intervention to reduce alcohol use among college students will also reduce their risky sexual behavior. In a randomized controlled trial, 154 heavy-drinking, predominantly White, heterosexual college students at behavioral risk for infection with HIV and other sexually transmitted diseases were assigned to receive no intervention or a two-session, in-person, motivational interviewing-based intervention focused on (a) reducing alcohol risk behavior, (b) reducing HIV risk behavior, or (c) reducing both alcohol and HIV risk behavior. Three-month retrospective assessments of alcohol use and sexual behavior were conducted at intake and at 3-, 6-, 9-, 12-, and 15-month follow-up appointments. During follow-up, participants who received the single-focus alcohol risk-reduction intervention drank less frequently and consumed fewer drinks per drinking day as compared with no-intervention control participants, but did not differ from control participants in their frequency of intercourse without a condom or number of sexual partners. Participants who received the single-focus HIV risk-reduction intervention evidenced fewer unprotected sex events during follow-up, as compared with control participants. The number of sexual partners reported during follow-up did not differ by condition. Effects of the interventions did not vary significantly over time and were not moderated by participant gender. Results suggest that intervening to reduce alcohol use may not reduce risky sexual behavior among nonminority college students, but that a brief motivational intervention targeting HIV risk behavior may have utility for reducing the frequency of unprotected sex in this population.
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Affiliation(s)
- Kurt H Dermen
- Research Institute on Addictions, University at Buffalo, State University of New York, Buffalo, NY 14203, USA.
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James CA, Hart TA, Roberts KE, Ghai A, Petrovic B, Lima MD. Religion versus ethnicity as predictors of unprotected vaginal intercourse among young adults. Sex Health 2011; 8:363-71. [PMID: 21851777 DOI: 10.1071/sh09119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Accepted: 11/16/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND Young adults in North America are at increasing risk for contracting HIV and sexually transmissible infections (STI). Racial differences in HIV or STI risk are well documented, but other cultural and demographic factors contributing to HIV or STI risk are poorly understood. Although religion may play an important role in sexual behaviour, little research has explored its association with sexual attitudes, beliefs and practices. The present study examined how ethnicity, religion, HIV knowledge and attitudes, and other demographic factors are associated with engaging in unprotected vaginal intercourse (UVI) in a diverse sample of unmarried young adults. METHODS A cross-sectional study of 666 unmarried university students was conducted from 2005 to 2007, with participants completing an anonymous questionnaire on sexual attitudes and health for course credit. RESULTS Approximately 50% of the respondents had engaged in any vaginal intercourse and 32.2% had engaged in UVI in the past 6 months. Multivariable analyses showed that increasing age, being in a relationship for more than 6 months, greater HIV knowledge, stronger attitudes supporting the use of condoms, and religion (but not ethnicity) were associated with engaging in UVI. Among the sexually active subset of the sample (n=332), religion was the only predictor of engaging in UVI. CONCLUSION Ethnicity, which is often considered an important variable in sexual health research, does not appear to be associated with UVI when taking into account other demographic variables, particularly religion. Consideration of religion may be important in devising HIV prevention interventions, in order to implement them in accordance with particular religious beliefs.
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Affiliation(s)
- Carolyn A James
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
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Naar-King S. Motivational interviewing in adolescent treatment. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:651-7. [PMID: 22114919 DOI: 10.1177/070674371105601103] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper briefly reviews the research literature on motivational interviewing (MI) and behaviour change in adolescents and then discusses the implications of adolescent cognitive and social-emotional developmental processes for the relational and technical components of MI. Research suggests that MI is efficacious in improving substance use in adolescents. Research has been slower to emerge in other behaviours, but available randomized controlled trials suggest that MI has great promise for improving mental and physical health outcomes in this developmental period. The relational and technical components of MI are highly relevant for the adolescent developmental period, and studies have shown that these components are related to outcomes in this population. There are several ways to include MI in clinical interventions for adolescents, ranging from MI in brief settings to using MI as a platform from which all other treatments are offered. Future research is necessary to test the effects of MI in adolescent group settings and the full integration of MI into other adolescent treatment approaches.
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Affiliation(s)
- Sylvie Naar-King
- Associate Professor, Wayne State University, Carman and Ann Adams Department of Pediatrics, Detroit, Michigan 48201, USA.
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Lee CS, Baird J, Longabaugh R, Nirenberg TD, Mello MJ, Woolard R. Change plan as an active ingredient of brief motivational interventions for reducing negative consequences of drinking in hazardous drinking emergency-department patients. J Stud Alcohol Drugs 2011; 71:726-33. [PMID: 20731978 DOI: 10.15288/jsad.2010.71.726] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Few studies have examined the effects of brief motivational intervention components, such as change-plan completion, on treatment outcomes. This secondary analysis of an opportunistically recruited emergency-department sample of hazardous injured drinkers examines the potential predictive role of an alcohol-related change plan on treatment outcomes after accounting for pretreatment readiness. Written change plans were independently rated. METHOD A mediational analysis framework tested directional hypotheses between pretreatment readiness, change plan, and treatment outcomes using linear regressions. The baseline total Drinker Inventory of Consequences (DrInC) score was covaried on 12-month DrInC total score, in all analyses. Participants who completed a brief motivational intervention and a change plan were included (N = 333). RESULTS Pretreatment readiness was negatively associated with alcohol consequences at 12 months, (beta = -.09, t(254) = -2.07, p < .05, and good-quality change plans, (beta = .18, t(320) = 4.37, p < .001. With change plan and readiness in the same model, the relationship between readiness and treatment outcomes became nonsignificant, but change plan remained a significant predictor of treatment outcomes in the expected direction, beta = -.17, t(254) = -2.89, p < .01. Follow-up generalized linear modeling including an interaction term (change plan and pretreatment readiness) revealed that those with high readiness and a good-quality change plan versus those with low readiness and a poor-quality change plan had better-than-predicted outcomes for either readiness or change plan alone. CONCLUSIONS Study findings suggest that the change plan in brief motivational intervention may be an active ingredient of treatment associated with better outcomes over and above the influence of pretreatment readiness.
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Affiliation(s)
- Christina S Lee
- Center for Alcohol and Addiction Studies, Brown University, 121 South Main Street, Room 530, Providence, Rhode Island 02903, USA.
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Blank L, Baxter SK, Payne N, Guillaume LR, Pilgrim H. Systematic review and narrative synthesis of the effectiveness of contraceptive service interventions for young people, delivered in educational settings. J Pediatr Adolesc Gynecol 2010; 23:341-51. [PMID: 20493736 DOI: 10.1016/j.jpag.2010.03.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 03/22/2010] [Indexed: 12/01/2022]
Abstract
STUDY OBJECTIVE This review was undertaken to determine the effectiveness of contraception service interventions for young people that were delivered in educational settings. DESIGN We conducted a systematic review and narrative synthesis. SETTING Interventions were included where they were delivered in educational institutions, including schools, colleges, and pupil referral units. PARTICIPANTS Young people aged 19 and under. Studies of wider age groups were included if the majority of participants were aged under 19 years. INTERVENTIONS We included interventions which consisted of contraceptive service provision, and also interventions to encourage young people to use existing contraceptive services. MAIN OUTCOME MEASURES The main outcome measures used in the studies were: rate of teenage pregnancy, rate of contraceptive use, and sexual behavior. Many outcome measures were self reported. RESULTS Twenty-nine papers were included which reported on interventions to prevent adolescent pregnancy (and repeat pregnancy), school-based health centers, contraceptive use in college students, and multicomponent interventions. Intensive case management intervention conducted by a culturally matched school-based social worker (along with other components including peer education) were shown to be effective in preventing repeat adolescent pregnancy, at least for the duration of the intervention. Also, school-based health centers appear to be most effective when contraception provision is made available on site. CONCLUSIONS The evidence from these papers is limited, in terms of both quality and quantity, along with consistency of findings, but some recommendations in relation to effective interventions can be made.
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Affiliation(s)
- Lindsay Blank
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
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Magill M, Apodaca TR, Barnett NP, Monti PM. The route to change: within-session predictors of change plan completion in a motivational interview. J Subst Abuse Treat 2010; 38:299-305. [PMID: 20149571 DOI: 10.1016/j.jsat.2009.12.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 11/24/2009] [Accepted: 12/31/2009] [Indexed: 10/19/2022]
Abstract
This study is the first to examine within-session therapist and client language/process predictors of a client's decision to complete a written Change Plan in an alcohol-focused motivational interview (MI). Data were from an ongoing hospital-based clinical trial (N = 291). Trained raters coded audiorecorded MI sessions using the Motivational Interviewing Skill Code. Logistic regression analyses found that therapist MI-consistent behaviors (b = .023, p < .001) and client change talk (b = .063, p < .001) were positive predictors, and client counter change talk (b = -.093, p < .001) was a negative predictor of the decision to complete a Change Plan regarding alcohol use. Mean comparisons showed that compared to noncompletion, Change Plan completion did not result in significantly greater changes in client motivational readiness. Completion of a Change Plan is a proximal outcome in MI that is associated with client intention to change (change talk) and may predict follow-up alcohol outcomes. Analyses of such theory-driven proximal client mechanisms provide a more complete model of MI process and may inform MI providers of necessary treatment ingredients.
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Affiliation(s)
- Molly Magill
- Brown University, Center for Alcohol and Addiction Studies, Providence, RI 02912, USA.
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Everett B, Salamonson Y, Zecchin R, Davidson PM. Reframing the dilemma of poor attendance at cardiac rehabilitation: an exploration of ambivalence and the decisional balance. J Clin Nurs 2009; 18:1842-9. [PMID: 19220609 DOI: 10.1111/j.1365-2702.2008.02612.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
AIM To discuss the problem of poor attendance at cardiac rehabilitation from the alternative perspective of patient ambivalence. BACKGROUND Evidence supports the benefits of cardiac rehabilitation as a means for secondary prevention of coronary heart disease, yet current literature continues to document poor attendance at these programmes. Whilst extrinsic factors, such as transportation and lack of physician support have been identified as barriers, patients who choose not to attend these programmes are often described as lacking motivation or being non-compliant. However, it is possible that non-attendance is the result of ambivalence - the experience of simultaneously wanting to and yet not wanting to, or the 'I want to, but I don't want to' dilemma. DESIGN Discussion paper. METHOD This discussion paper draws on the literature of ambivalence and decision-making theory to reframe the issue of poor attendance at cardiac rehabilitation. CONCLUSIONS This paper has demonstrated that the problem of poor attendance may be explained from the perspective of patient ambivalence and that using strategies such as the decisional balance may assist these individuals in exploring their ambivalence to engage in secondary prevention programmes. RELEVANCE TO CLINICAL PRACTICE Understanding the dynamics of ambivalence provides an alternative to thinking of patients as lacking motivation, being non-compliant, or even resistant. Helping patients to explore and resolve their ambivalence may be all that is needed to help them make a decision and move forward.
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Affiliation(s)
- Bronwyn Everett
- School of Nursing, University of Western Sydney, Bankstown Campus, Building 3, Locked Bag 1797, Penrith South DC 1797, Sydney, NSW, Australia.
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Abstract
BACKGROUND The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, educational interventions addressing contraception often have no stated theoretical base. OBJECTIVES Review randomized controlled trials that tested a theoretical approach to inform contraceptive choice; encourage contraceptive use; or promote adherence to, or continuation of, a contraceptive regimen. SEARCH STRATEGY We searched computerized databases for trials that tested a theory-based intervention for improving contraceptive use (MEDLINE, POPLINE, CENTRAL, PsycINFO, EMBASE, ClinicalTrials.gov, and ICTRP). We also wrote to researchers to find other trials. SELECTION CRITERIA Trials tested a theory-based intervention for improving contraceptive use. We excluded trials focused on high-risk groups. Interventions addressed the use of one or more contraceptive methods. The reports provided evidence that the intervention was based on a specific theory or model. The primary outcomes were pregnancy, contraceptive choice, initiating or changing contraceptive use, contraceptive regimen adherence, and contraception continuation. DATA COLLECTION AND ANALYSIS The primary author evaluated abstracts for eligibility. Two authors extracted data from included studies. We calculated the odds ratio for dichotomous outcomes and the mean difference for continuous data. No meta-analysis was conducted due to intervention differences. MAIN RESULTS Of 26 trials, 12 interventions addressed contraception (other than condoms), while 14 focused on condom use for preventing HIV or STIs. In 2 of 10 trials with pregnancy or birth data, a theory-based group showed better results. Four of nine trials with contraceptive use (other than condoms) showed better outcomes in an experimental group. For condom use, a theory-based group had favorable results in 14 of 20 trials, but the number was halved in a subgroup analysis. Social Cognitive Theory was the main theoretical basis for 12 trials, and 10 showed positive results. Of the other 14 trials, favorable results were shown for other social cognition models (N=2), motivational interviewing (N=5), and the AIDS Risk Reduction Model (N=2). No major patterns were detected by type of theory, intervention, or target population. AUTHORS' CONCLUSIONS Family planning researchers and practitioners could apply the relevant theories and effective interventions from HIV and STI prevention. More thorough use of single theories would help inform the field about what works. Better reporting is needed on research design and intervention implementation.
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Affiliation(s)
- Laureen M Lopez
- Behavioral and Biomedical Research, Family Health International, P.O. Box 13950, Research Triangle Park, North Carolina 27709, USA.
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