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PubMedDate not supplied

Use of behavioral risk factor surveys to predict alcohol-related motor vehicle events.

The relationship between acute alcohol intoxication and increased risk of traffic violations, crashes, and injuries is well known. We designed this study to investigate the usefulness of behavioral risk factor surveys (BRFSs) in identifying drivers at risk for subsequent motor vehicle violations and crashes. We carried out a retrospective cohort study in a random sample of members of a health maintenance organization, who were followed for five years after ascertainment of alcohol use. Reported problem drinking behavior increased the risk of motor vehicle violations or crashes for women drivers and older drivers (older than 65 years of age) of both sexes. Women "binge drinkers" had an age-adjusted relative risk (RR) for violations of 1.7 (95% confidence interval [CI] = 1.1, 2.8) and an age-adjusted RR for crashes of 1.9 (95% CI = 1.1, 3.2). Older drivers reporting drinking and driving or multiple drinking problems had an increased risk of motor vehicle crashes (sex-adjusted RR = 2.7; 95% CI = 1.2, 5.8, and 3.0; 95% CI = 1.1, 8.4). A CAGE score of 2 or more identified older drivers at increased risk for both violations and crashes. We found no increased risk for male drivers under 65 years of age for any of the problem drinking behaviors. We conclude that BRFSs in a general population can help identify high-risk drivers among women and drivers older than 65 years of age.

Accidents, Traffic↗
PubMed2005

The association between childhood and adolescent sexual abuse and proxies for sexual risk behavior: a random sample of the general population of Sweden.

OBJECTIVE: Several studies with small and "high risk" samples have demonstrated that a history of childhood or adolescent sexual abuse (CASA) is associated with sexual risk behaviors (SRBs). However, few studies with large random samples from the general population have specifically examined the relationship between CASA and SRBs with a comprehensive set of measures. DESIGN: The study was a cross-sectional retrospective survey of past and current sexual health and behavior. METHODS: A random sample of 4781 persons from the Swedish Post Address Register was obtained, which included 6,119,000 Swedish citizens in 1996. Of those persons, 2810 participants agreed to participate in the study. Participants were interviewed as well as administered a questionnaire regarding their sexual health and behavior. RESULTS: Using Mann-Whitney U tests, a history of CASA was found to be associated with younger age at first intercourse; younger age at diagnosis of first sexually transmitted infection (STI); greater frequency of unintended pregnancy; greater likelihood of participation in group sex; higher likelihood of not interrupting sexual intercourse despite the risk of pregnancy or risk of an STI; greater likelihood of exchanging sex for money or other necessities/drugs; more frequent substance use in the last 48 hours; and higher likelihood of adult sexual and physical assault. CONCLUSIONS: The findings of this study confirm previous research, which has reported an association between CASA and SRBs in smaller and high-risk samples. Clinicians working with adults with a history of CASA should be aware of the relationship between CASA and SRBs and be prepared to address such issues during therapy.

Adolescent↗
PubMed1992

Ineffectiveness of AIDS education and HIV antibody testing in reducing high-risk behaviors among injection drug users.

The effectiveness of education in reducing high-risk human immunodeficiency virus (HIV) transmission behaviors was examined in 313 injection drug users. Involvement in high-risk behaviors was assessed via structured interview at study entry and 4 months following the intervention. Subjects were randomly assigned to (1) AIDS education, (2) AIDS education with optional HIV antibody testing, or (3) a wait list. The sample as a whole decreased its involvement in high-risk behaviors, but there were no significant differences as a function of experimental group assignment.

AIDS Serodiagnosis↗
PubMed2001

Health-risk behaviors and protective factors among adolescents with mobility impairments and learning and emotional disabilities.

PURPOSE: To identify the risk involvement of three groups of young people with disabilities relative to a comparison group: mobility impairments, learning disabilities, and emotional disabilities. Protective factors are explored to identify which individual, family, and school factors are associated with diminished risk. METHODS: Analyses are based on the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of 20,780 seventh- through 12(th)-grade youth in the United States. Five negative health outcomes were studied: suicide attempts, sexual abuse, regular cigarette smoker, alcohol use, and marijuana use. For bivariate analyses Student's t-test and Chi-square were used, and logistic regressions were performed on all dichotomized dependent variables. RESULTS: For most risk behaviors studied, youth with disabilities were more involved than peers. Factors that predisposed to risk varied little between those with and without disabilities. Likewise, there was substantial consistency between groups as to protective factors. What distinguished each group of young people with disabilities from peers is that they reported significantly more exposure to risk factors and significantly fewer protective factors.

Adolescent↗
PubMed2004

Racial differences in hepatitis B and hepatitis C and associated risk behaviors in veterans with severe mental illness.

Racial differences in the seroprevalence of and risks for hepatitis B (HBV) and hepatitis C (HCV) were examined in military veterans with severe mental illnesses (SMI). Participants (376; 155 Caucasian, 221 African American) were inpatients at a Veterans Affairs (VA) psychiatric unit in Durham, N.C., from 1998 to 2000. Prevalence rates of HBV and HCV were 21.3% and 18.9%, respectively. African Americans had a higher HBV seroprevalence than did Caucasians: 27.6% versus 12.3%; odds ratio (OR) 2.73; 95% confidence interval (CI)=1.55, 4.79. Although not statistically significant, HCV seroprevalence was also higher for African Americans than it was for Caucasians: 21.3% versus 15.5%; OR=1.47; 95% CI=0.86, 2.53. No racial difference was observed for injection drug use (IDU), the strongest risk indicator for both HBV and HCV. Multivariable analyses indicated that African-American race, IDU, and multiple sex partners in the past six months were related to an increased risk of HBV, whereas IDU and smoking crack cocaine were both independently related to an increased risk of HCV. Thus, veterans with SMI--particularly African-American veterans--have high rates of HBV and HCV infection. African-American veterans have significantly higher rates of HBV than do Caucasian veterans, which persist after controlling for prominent risk behaviors.

Adult↗
PubMed1997

Behavioral risk for HIV infection among adults with a severe and persistent mental illness: patterns and psychological antecedents.

Behaviors associated with transmission of the human immunodeficiency virus (HIV) were measured in a sample of 60 adults with a severe and persistent mental illness (SPMI). Results revealed that 68% had sex in the last year; 13% of men and 30% of women reported two or more male partners, and 24% of men also reported two or more female partners. Condom use was inconsistent. Sex partners were often met in a psychiatric clinic or bar, and a substantial number were injection drug users or known to be non-monogamous. Overall, 48% of men and 37% of women reported at least one risk factor. Hypothesized psychological antecedents of HIV-related risk behavior were also measured, including knowledge, motivation for risk reduction, and self-efficacy regarding risk-reduction. Many participants were misinformed regarding HIV-transmission and risk reduction. Motivational indices indicated that attitudes toward condoms were slightly positive, and that social norms were generally supportive of condom use. However, participants tended to rate themselves at only slight risk for infection, undermining their motivation for condom use. Participants indicated only modest levels of self-efficacy in situations requiring sexual assertiveness. These findings, coupled with the elevated seroprevalence of HIV among persons having a SPMI, point to the need for risk assessment and counseling by mental health care providers.

Adult↗
PubMed2003

Correlates of sexual risk behaviors among HIV-positive men who have sex with men.

This study examines correlates of unprotected sexual risk practices of an ethnically diverse sample of HIV-seropositive men who have sex with men (MSM) from the New York City and San Francisco metropolitan areas. Participants completed a self-report survey that assessed sexual risk behaviors and potential correlates. A total of 367 men reported sex with a casual male partner in the previous 3 months. Participants were divided into three groups based on level of HIV-transmission risk with HIV negative or unknown-status partners: no unprotected anal sex (58.9%), unprotected receptive anal sex only (14.2%), and unprotected insertive anal sex (22.6%). Multivariate logistic regression analyses indicated that men reporting unprotected anal insertive sex perceived less responsibility to protect their partners from HIV. Men reporting no unprotected anal sex also reported less use of nitrate inhalants, lower temptation for unsafe sex, and fewer HIV-negative and unknown-status partners. Men reporting unprotected receptive anal sex were less anxious than the other two groups but also reported greater depression than those not reporting unprotected anal sex and greater loneliness than those reporting unprotected anal insertive sex. Implications for interventions with HIV-positive MSM are presented.

Adolescent↗
PubMed1993

Sexual risk behavior among injection drug-using human immunodeficiency virus positive clients.

This study examined sexual risk behavior of 154 seropositive Hispanic injection drug-using clients who were a subsample of a larger study. The results revealed that while nearly 71% followed safe sex practices at a 6-month follow-up, the other 29% were following risky sexual behaviors. Among males who were 25 years of age or younger, slightly over 58% were practicing unsafe sex. Among females, those in the 31-35 age group were all following risky sexual behaviors. Generally, those who lived with their sexual partners, females, and younger clients tended to follow risky sexual behaviors. These findings are very significant in the light of the heterosexual transmission of Human Immunodeficiency Virus (HIV). Educational and case management programs are needed to provide such clients with an understanding of the possibility of HIV transmission to their sexual partners and to their children in case of pregnancies.

Adult↗
PubMed2002

Behavioral risk factors and use of preventive services among veterans in Washington State.

BACKGROUND: Little is known about the special preventive health needs of U.S. veterans and the 3.6 million users of VA health care. METHODS: The Washington State version of the 1999 Behavioral Risk Factor Survey included three new questions about veteran status and use of VA health care. Data on this population-based sample of 3,608 adults were used to compare sociodemographic, health, and behavioral characteristics between veterans and nonveterans and between VA users and nonusers. RESULTS: Veterans were nearly 13 years older than nonveterans. VA users were socioeconomically worse off and had poorer health status than nonusers. Current smoking among males was more common among veterans than among nonveterans (24% vs 18%). This difference persisted after controlling for age, race, education, and income and held across all age groups. Use of several screening tests varied little in relation to veteran or VA user status. CONCLUSIONS: The BRFSS has become a rich source of data on veteran health. Veterans and VA users have distinct sociodemographic profiles that must be considered when comparing health-related characteristics. Cigarette smoking is especially prevalent among veterans--an excess unexplained by sociodemographic differences.

Adult↗
PubMed2003

Parental consent and adolescent risk behavior research.

PURPOSE: To identify methodological issues related to the use of active or passive parental consent in school-based research on adolescent risk behavior research and to propose recommendations consistent with current legal and ethical standards in the United States. METHODS: Review and synthesis of the professional literature related to adolescents and parental consent, federal regulations and guidelines in the United States, and the author's experience presenting these arguments and issues to institutional review boards and funding agencies for over 10 years. FINDINGS: The procedures used for parental consent affect a study's participation rates, costs, and selection bias. When active parental consent is required, parental permission is typically obtained for only 30%-60% of students, compared to 93%-100% when passive consent is used. Extensive follow-up may result in 55%-100% of parents giving permission, but at significant cost (typically $20-$25 per student). Active consent results in the exclusion of minorities, students having problems in school, and students already engaged in or at risk for problem behaviors. Strong methodological reasons were identified for using passive parental consent procedures when possible. Current federal regulations include four areas for possible waiver or alterations in parental consent procedures, including the use of passive parental consent. CONCLUSIONS: Health researchers must understand the methodological, legal, and ethical issues related to parental consent to produce high-quality, valid research about adolescents and to provide evidence for laws, policies, and regulations.

Adolescent↗
PubMed2001

Reducing postrelease risk behavior among HIV seropositive prison inmates: the health promotion program.

The prevalence of AIDS is five times higher among prison inmates than in the general population. Because recidivism is common and many inmates are serving short sentences for parole violation, HIV-seropositive inmates move frequently between prison and their home communities. We designed an eight-session prerelease intervention for HIV seropositive inmates to decrease sexual and drug-related risk behavior and to increase use of community resources after release. The intervention sessions were delivered at the prison by community service providers. We found that a prerelease risk reduction intervention for HIV seropositive inmates was feasible. Descriptive results support the effectiveness of the program in reducing sexual and drug-related behaviors and in increasing use of community resources after release. Compared with men who signed up for the intervention but were unable to attend, men who received the intervention reported more use of community resources and less sexual and drug-related risk behavior in the months following release. We recommend dissemination and continued evaluation of this risk-reduction intervention.

Adult↗
PubMed2003

Health risk behaviors in smoking and non-smoking young women.

PURPOSE: To compare the health, health risk behaviors and stress levels of college female smokers and non-smokers. DATA SOURCES: Forty-one college women, ages 18-21 years, participated in an interview and completed a health survey and the Derogatis Stress Profile. CONCLUSIONS: The smokers perceived themselves to be more overweight (Chi square, p = < .001). Smokers used more marijuana (Chi square, p = < .003) and had higher scores on depression [t (39) = 2.29, p = .028], hostility [t (39) = 2.562, p = .014] and perceived quality of health [t (39) = 2.72, p = .01]. In the interview, smokers identified social situations involving alcohol as the time they would most likely smoke. Smokers did not smoke when ill and all were interested in quitting. The non-smoking women support smoking cessation for their peers. IMPLICATIONS FOR PRACTICE: College alcohol and substance use prevention and treatment programs should address tobacco cessation. The majority of college women are not smokers and could be resources to encourage smoking cessation among their peers. Smoking cessation at this age has dramatic implications for future health.

Adolescent↗
PubMed1994

Risk behaviors of persons with heterosexually acquired HIV infection in the United States: results of a multistate surveillance project.

To describe past risk behaviors among persons with heterosexually acquired human immunodeficiency virus (HIV) infection, we interviewed 497 persons > or = 18 years of age with heterosexually acquired HIV infection reported to 11 state and city health departments in the United States. Thirty-nine percent of persons reported using noninjection drugs in the past 5 years; noninjection drug use was highest among men whose sex partners injected drugs (53%). Sixteen percent of all persons used crack, and 17% were classified as potential alcoholics; among men, 29% were classified as potential alcoholics. Of the 49% of men who reported paying a woman for sex, 86% did so multiple times. Most persons had multiple sex partners in the past 5 years; however, 35% of the women had only one sex partner. Thirty-four percent of the women and 50% of the men had been treated for a sexually transmitted disease in the past 10 years. Seventy-four percent of the women and 68% of the men had never used condoms in the 5 years before they knew they were HIV positive. Among these people with heterosexually acquired HIV, noninjection drug use was common, many men have paid someone for sex, and many women have not had multiple sex partners. These findings have important implications for the types of prevention programs that can most successfully lessen the spread of HIV among heterosexuals.

Adult↗
PubMed2003

Walking trends among U.S. adults: the Behavioral Risk Factor Surveillance System, 1987-2000.

OBJECTIVE: To examine trends in walking among adults in 31 states. METHODS: Trends by sociodemographic strata were analyzed from respondents who participated in the Behavioral Risk Factor Surveillance System (BRFSS). RESULTS: The prevalence of walking among men increased 3.8% (95% confidence interval [CI]=2.4-5.2), from 26.2% (95% CI=25.1-25.3) in 1987 to 30.1% (95% CI=29.4-30.8) in 2000. In women, walking increased 6.6% (95% CI=5.4-7.8), from 40.4% (95% CI=-39.4-41.1) to 46.9% (95% CI=46.2-47.6) during the same time period. However, the prevalence of walking three times a week for 30 minutes duration remained constant across all years. The largest increases occurred in minority subpopulations: 8.7% (95% CI=3.2-14.2) in Hispanic women, 8.5% (95% CI=4.4-12.6) non-Hispanic black women, and 7.0% (95% CI=2.3-11.7) in non-Hispanic black men. Walking was the most frequently reported activity among adults who met the national recommendations for regular physical activity (defined as five or more times a week for > or =30 minutes per session). CONCLUSIONS: Given the acceptability of walking across all sociodemographic subgroups, efforts to increase the frequency of walking could markedly increase the percentage of U.S. adults who engage in regular physical activity, a national priority identified in the Healthy People 2010 objectives for the nation.

Adolescent↗
PubMed1992

Trends in prevalences of behavioral risk factors: recent Hawaiian experience.

Recent time trends were studied for the prevalences of behavioral risk factors in Hawaii during the 5-year period from 1986 through 1990. The presence of linear time trend was analyzed by the multiple logistic regression method on weighted data, adjusting for confounding factors. The risk factors studied were seatbelt nonuse, lack of exercise, obesity, hypertension, smoking, acute drinking, chronic drinking, and driving while intoxicated. Seatbelt nonuse showed a significant decline, from 8.6% to 4.8%, with a mean annual decrease of 0.9 percentage point. Lack of exercise and obesity increased steadily, from 48.0% to 62.4% and from 16.7% to 21.6%, respectively, with respective annual mean increases of 3.3 and 1.4 percentage points.

Chronic Disease↗
PubMed2005

Effects of parental viewing of children's risk behavior on home safety practices.

OBJECTIVE: To examine the effects of parent viewing of their child's actual risk behavior on home safety practices. METHODS: Sixty-one 4-to 7-year-old children and their caregivers participated in a three session project. Parents were exposed to one of three videos: (a) their own child with simulated home hazards, (b) a pilot child with hazards, or (c) a control child development video. Observations of home hazards as well as parent measures of supervision and vulnerability were completed pre and post-intervention. RESULTS: Exposure to a video of a parent's own child playing with simulated hazards resulted in improved home safety practices. Exposure to a pilot child interacting with home hazards did not increase parent safety behaviors. No group differences in levels of vulnerability were found. CONCLUSIONS: Parental attitudes are an important consideration in designing successful injury interventions. Increasing parental awareness of their child's risk to injury may be a valuable tool to change safety behaviors.

Accidents, Home↗
PubMed2000

Health status and risk behavior of adolescents in the north of Madrid, Spain.

PURPOSE: To study the health status and risk behavior in an adolescent population of Madrid, Spain. METHODS: An anonymous self-administered questionnaire was completed by 2831 pupils aged 14-20 years from urban, suburban, and rural populations in the north of Madrid. A large number of questions were from the Minnesota Adolescent Health Survey questionnaire, which included sociodemographics, health status, drug use, sexual practices, suicidal thoughts, emotional problems, and injury risk. Student's t-test, analysis of variance, and Chi-square statistics are used for analyzing associations between the different variables. RESULTS: A majority (80%) of students thought they are in good or very good health (better for males than females); 18.3% had had intercourse, the average age of the first intercourse was 15.4 years +/- 1.68 SD for males and 16.1 years +/- 1.46 SD for females. Most (73%) had used some kind of contraception. Eighty-five percent had tried alcohol, and regular use (frequently or every day) was as high as 24%. Males drank more than females (28% vs. 20%); 58.2% of the population drink only during weekends, the percentage increasing with age. Seventy percent of the sample had smoked at least once; 34. 5% reported regular tobacco use and this increased with age. Males smoked less than females (27% vs. 42%); 3.2% smoked more than 20 cigarettes/day. The consumption of illegal drugs was very low (20% had tasted cannabis and use by males was higher). Cocaine, heroin, etc. were used by less than 5%. CONCLUSION: In general, our adolescents are in good health with most problems being preventable. Sexual activity was lower than in other European and American countries. The consumption of tobacco and alcohol started early and in general was high. Our study confirms the relationship among different health-compromising behaviors. There is a need to implement health promotion and preventive programs for adolescents.

Adolescent↗