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PubMed2003

An AIDS risk reduction program for Dutch drug users: an intervention mapping approach to planning.

This article presents the development of a theory- and evidence-based AIDS prevention program targeting Dutch drug users and aimed at promoting condom use. The emphasis is on the development of the program using a five-step intervention development protocol called intervention mapping (IM). Preceding Step 1 of the IM process, an assessment of the HIV problem among drug users was conducted. The product of IM Step 1 was a series of program objectives specifying what drug users should learn in order to use condoms consistently. In Step 2, theoretical methods for influencing the most important determinants were chosen and translated into practical strategies that fit the program objectives. The main strategy chosen was behavioral journalism. In Step 3, leaflets with role-model stories based on authentic interviews with drug users were developed and pilot tested. Finally, the need for cooperation with program users is discussed in IM Steps 4 and 5.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The attitudes of clinic staff as factors in women's selection of Norplant implants for their contraception.

Medical and counseling staff at 13 family planning clinics in Texas, U.S.A., were surveyed regarding their opinions and level of information about the contraceptive Norplant. These responses were used to assess the relationships between clinicians' information and attitudes about the contraceptive and the use of that method by their patients. No differences were associated with respondents' clinical responsibilities or with their type of professional training. However, significant variations in the numbers of patients receiving Norplant from individual providers, and in the proportion receiving the method from certain clinics, were associated with responses to some attitudinal questions. These findings suggest that the opinions about Norplant held by personnel staffing family planning clinics influence the method selection of their patients.

Adolescent↗
PubMed2002

Condom use as a function of time in new and established adolescent sexual relationships.

OBJECTIVES: This study sought to describe condom use over time in new and established adolescent relationships. METHODS: The outcome variable was time (in days) until first unprotected coital event. Analyses involved comparisons of Kaplan-Meier survival curves and Cox proportional hazards models. RESULTS: Survival functions for the 2 relationship groups were significantly different. However, by 21 days the curves had converged: 43% of new and 41% of established relationships involved no unprotected coital events. Time to first unprotected coital event was significantly longer in new than in established relationships. CONCLUSIONS: Prolongation of condom use in ongoing relationships may be a useful intervention to prevent sexually transmitted diseases.

Adolescent↗
PubMedDate not supplied

Applying the transtheoretical model to pregnancy and STD prevention: a review of the literature.

PURPOSE: To conduct a systematic review of the peer-reviewed literature on the Transtheoretical Model (TTM) and pregnancy and STD prevention. DATA SOURCES: Computer database search (Applied Social Science Index and Abstracts [ASSIA], Biological Abstracts, Criminal Justice Abstracts, CINAHL-Allied Health, Current Contents, Current Index to Journals in Education, Education Index, ERIC, Excerpta Medica, Family Index, Index Medicus, Medline, Multicultural Education Abstracts, PsychInfo, Psychological Abstracts, Research Alert, Social Science Citation Index, Social Work Abstracts, and Sociological Abstracts), and manual journal search. STUDY INCLUSION AND EXCLUSION CRITERIA: All English, peer-reviewed, original articles on the TTM as it relates to pregnancy and STD prevention published prior to December 31, 2001, were included. Editorials, commentaries, thesis/dissertations, unpublished studies, technical reports, and books were not included. DATA EXTRACTION METHODS: Articles were categorized as Intervention, Population (stage distribution), or Validation studies. Within each category, articles were subdivided into groups, summarized, and analyzed. DATA SYNTHESIS: The 32 articles reviewed included 9 intervention studies, 11 population studies, and 12 validation studies. Studies represented a variety of U.S. populations of a broad demographic range. Evidence both for and against criterion-related and construct validity of the TTM was found. MAJOR CONCLUSIONS: Age, partner type, gender, reasons for engaging in safer sex behaviors (i.e., pregnancy vs. disease prevention), self-efficacy, sexual assertiveness, and perceived advantages and disadvantages of condom use were related to stage of change. The use of the TTM to reduce risk of pregnancy and STDs is a relatively new, but important, area of research. However, because of the wide-ranging differences in methodologies and samples, no strong conclusions about its effectiveness can yet be made.

Algorithms↗
PubMedDate not supplied

The association between multiple youth assets and sexual behavior.

PURPOSE: To investigate the possible positive cumulative effects that youth assets may have on youth sexual behaviors. DESIGN: Cross-sectional data were collected from a randomly selected population by in-home, in-person interviews. Mantel-Haenszel chi-square test and logistic regression were conducted to determine the potential cumulative effects that youth assets may have on youth sexual behaviors and to test for significant asset by sexual risk behavior trends. SETTING: Racially diverse inner-city neighborhoods in two midwestern cities. Subjects. Teenagers (n = 1350; mean age = 15.2 years) and parents of the teenagers (n = 1350). The response rate was 51%. MEASURES: Demographic factors, nine youth assets, and five sexual behavior outcomes. RESULTS: Significant (p < .05) trends and odds ratios (ORs) were found for three of the five youth sexual behavior outcomes. Youths with more assets were more likely to have never participated in sexual intercourse (OR = 1.32). Of sexually active youths, those with more assets were more likely to have delayed first intercourse until at least 17 years of age (OR = 1.47) and to have used birth control at last sexual intercourse (OR = 1.18). Nonsignificant (p > .05) results were found for current sexual activity and number of sexual partners. CONCLUSIONS: The results generally support the notion that the more assets adolescents possess, the more likely they are to engage in positive behavior. Practitioners planning asset-based teenage pregnancy prevention programs might consider promoting several specific youth assets.

Adolescent↗
PubMed2003

[Objective and subjective knowledge of HIV/AIDS as predictor of condom use in adolescents].

OBJECTIVE: To evaluate the association between objective and subjective knowledge on HIV/AIDS and condom use. MATERIAL AND METHODS: Analysis of a database from an anonymous, self-applied, randomized survey conducted between 1995 and 1996. Study subjects were 1,410 adolescents of four socioeconomic strata from Guadalajara, Mexico. Objective knowledge was assessed with 24 questions regarding HIV/AIDS, and subjective knowledge with the question "how much do you think you know about HIV/AIDS?" The variables associated with condom use were identified using logistic regression analysis and by calculating odds ratios with a 95% confidence interval. RESULTS: The degree of objective knowledge was "average", differentiated by socioeconomic strata (p < 0.001), and was higher in adolescents from medium and high socioeconomic strata (p < 0.008). Regarding subjective knowledge, adolescents from the low, medium, and high socioeconomic strata claimed to know "a little", and the ones from the lowest stratum claimed to know "very little". Condom use was higher in males (35.4%), and in adolescents from high socioeconomic strata (p < 0.005), than in females (15.3%) (p < 0.001). Although there was a correlation between objective and subjective knowledge (r = 0.37, p < 0.001), a higher degree of subjective knowledge was associated with condom use (p < 0.001). CONCLUSIONS: Subjective knowledge, belonging to medium and high socioeconomic strata and being male, were predictors of condom use.

Adolescent↗
PubMed1980

Attitudinal and nonattitudinal determinants of contraception: a cross-cultural study.

Survey data from women in pregnancy risk in Venezuela and Kenya are used to examine the determinants of contraceptive intention, use, and the intention/use consistency. The five ranking determinants of contraceptive use are: intention to contracept, social support, accessibility, conjugal communication, and desire for additional children. All five determinants have direct and additive effects on contraception, but their relative impacts vary significantly between the two cultures. Contraceptive intention and use are highly consistent, while level of consistency varies significantly between the two samples and within each by various combinations of ranking variables and by parity. Major research and policy implications of the results are reviewed.

Adolescent↗
PubMed1998

Postpartum contraceptive use in Bangladesh: understanding users' perspectives.

Qualitative and quantitative data are used to explore postpartum contraceptive use in two populations in Bangladesh. Findings from in-depth interviews with contraceptive users illustrate that women are primarily concerned with their own and their newborn child's health and well-being in the period following childbirth. In addition, women are aware of a diminished risk of pregnancy during the period of postpartum amenorrhea. These perceptions, plus a belief that modern methods of contraception are "strong" and potentially damaging to health, mean that the majority of women are reluctant to adopt family planning methods soon after birth, despite a desire to avoid closely spaced pregnancies. Supplementation of the child's diet is also shown to be an important factor determining the timing of postpartum contraceptive initiation. The findings suggest that current policies promoting contraception to women in the immediate postpartum period are inappropriate for many Bangladeshi women.

Adolescent↗
PubMedDate not supplied

Choosing and using contraception: toward a theory of women's contraceptive self-care.

Thirty women of varying ethnicity and socioeconomic status, who were actively seeking to avoid pregnancy, were interviewed concerning their lifetime experience with contraceptive use. The resulting description, Women's Contraceptive Self-Care, was divided into four processes: the central process, Choosing and Using Contraception, and three contextual processes. Forestalling Pregnancy was defined as using contraceptive methods or behaviors to prevent or delay childbearing. Assigning the Burden of Contraceptive Responsibility was defined as assuming responsibility for contraception or shifting that responsibility to a partner. Negotiating with Those who Control Contraception was defined as maneuvering among individuals and agencies that permit or hinder access to contraceptive methods and behaviors. Each process is comprised of thematic clusters and/or themes that are defined and illustrated.

Adult↗

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