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Ralph J. Diclemente - One of the best experts on this subject based on the ideXlab platform.
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Rate of decay in proportion of condom-protected sex acts among adolescents after participation in an HIV Risk-Reduction Intervention.
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2013Co-Authors: Ralph J. Diclemente, Jennifer L. Brown, Jessica M. Sales, Eve RoseAbstract:OBJECTIVE HIV Risk-Reduction Interventions have demonstrated efficacy in enhancing the proportion of condom-protected sex (CPS) acts among diverse populations. Although postIntervention exposure increase in CPS are often observed, there is scant empirical data quantifying decay of Intervention efficacy (declines in CPS after cessation of the Intervention among participants reporting an initial postIntervention increase in CPS). Thus, the objective of this study was to quantify the rate of decay in Intervention efficacy over a 24-month follow-up. DESIGN African American adolescent females (ages: 14-20; n = 349) completed a baseline audio computer-assisted self-administered interview, participated in an HIV Risk-Reduction Intervention, and were assessed at 6-month intervals for 24 months postIntervention. Intervention efficacy was conceptualized as an increase in participants' CPS relative to baseline. METHODS Analyses focused on the subset of participants who reported an initial increase in CPS from baseline to the 6-month postIntervention assessment (n = 121) to quantify the rate of decay in Intervention efficacy over a 24-month follow-up period. RESULTS CPS increased markedly from baseline to 6-month follow-up assessment. However, from 6 to 12 months, a marked decline in CPS was observed. Further CPS declines, though not statistically significant, were observed from 12 to 18 months and 18 to 24 months. Cumulative reductions in CPS over the entire 24-month follow-up resulted in no statistical difference between baseline and 24-month follow-up; indicative of a nonsignificant Intervention effect at 24-month assessment. CONCLUSIONS Innovative postIntervention optimization strategies are needed to minimize CPS decay over protracted time periods by reinforcing, sustaining, and potentially amplifying initial gains in condom use.
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the mediating role of partner communication frequency on condom use among african american adolescent females participating in an hiv prevention Intervention
Health Psychology, 2012Co-Authors: Jessica M. Sales, Gina M. Wingood, Ralph J. Diclemente, Delia L Lang, James W Hardin, Teaniese P Latham, Eve RoseAbstract:Objective: Although effective HIV prevention Interventions have been developed for adolescents few Interventions have explored whether components of the Intervention are responsible for the observed changes in behaviors postIntervention. This study examined the mediating role of partner communication frequency on African American adolescent females condom use postparticipation in a demonstrated efficacious HIV Risk-Reduction Intervention. Methods: As part of a randomized controlled trial African American adolescent females (N = 715) 15-21 years seeking sexual health services completed a computerized interview at baseline (prior to Intervention) and again 6 and 12 months follow-up post-Intervention participation. The interview assessed adolescents sexual behavior and partner communication skills among other variables at each time point. Using generalized estimating equation (GEE) techniques both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Results: Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion of condom-protected sex acts (p = .001) and consistent condom use (p = .001). Conclusion: Partner communication frequency an integral component of this HIV Intervention significantly increased as a function of participating in the Intervention partially explaining the change in condom use observed 12 months postIntervention. Understanding what Intervention components are associated with behavior change is important for future Intervention development.
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evaluation of an hiv std sexual risk reduction Intervention for pregnant african american adolescents attending a prenatal clinic in an urban public hospital preliminary evidence of efficacy
Journal of Pediatric and Adolescent Gynecology, 2010Co-Authors: Ralph J. Diclemente, Gina M. Wingood, Jessica M. Sales, Eve Rose, Richard A CrosbyAbstract:Study Objective To evaluate an Intervention to reduce HIV/STD-associated behaviors and enhance psychosocial mediators for pregnant African-American adolescents.
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efficacy of sexually transmitted disease human immunodeficiency virus sexual risk reduction Intervention for african american adolescent females seeking sexual health services a randomized controlled trial
JAMA Pediatrics, 2009Co-Authors: Ralph J. Diclemente, Gina M. Wingood, Jessica M. Sales, Eve Rose, Delia L Lang, Angela M Caliendo, James W Hardin, Richard A CrosbyAbstract:Objectives To evaluate the efficacy of an Intervention to reduce incident sexually transmitted disease (STD) and enhance STD/human immunodeficiency virus (HIV)–preventive behaviors and psychosocial mediators. Design A randomized controlled trial of an HIV prevention program. Setting Clinic-based sample in Atlanta, Georgia. Participants African American adolescent females (N = 715), aged 15 to 21 years, seeking sexual health services. Participants completed an audio computer-assisted self-interview and provided self-collected vaginal specimens for STD testing. Intervention Intervention participants received two 4-hour group sessions and 4 telephone contacts over a 12-month period, targeting personal, relational, sociocultural, and structural factors associated with adolescents' STD/HIV risk, and were given vouchers facilitating male partners' STD testing/treatment. Main Outcome Measure Incident chlamydial infections. Results Over the 12-month follow-up, fewer adolescents in the Intervention had a chlamydial infection (42 vs 67; risk ratio [RR], 0.65; 95% confidence interval [CI], 0.42 to 0.98; P = .04) or recurrent chlamydial infection (4 vs 14; RR, 0.25; 95% CI, 0.08 to 0.83; P = .02). Adolescents in the Intervention also reported a higher proportion of condom-protected sex acts in the 60 days preceding follow-up assessments (mean difference, 10.84; 95% CI, 5.27 to 16.42; P P = .001). Adolescents in the Intervention were also more likely to report consistent condom use in the 60 days preceding follow-up assessments (RR, 1. 41; 95% CI, 1.09 to 1.80; P = .01) and condom use at last intercourse (RR, 1.30; 95% CI, 1.09 to 1.54; P = .005). Intervention effects were observed for psychosocial mediators of STD/HIV–preventive behaviors. Conclusion Interventions for African American adolescent females can reduce chlamydial infections and enhance STD/HIV–preventive behaviors and psychosocial mediators of STD/HIV–preventive behaviors. Trial Registration clinicaltrials.gov Identifier:NCT00633906
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multidimensional family therapy hiv std risk reduction Intervention an integrative family based model for drug involved juvenile offenders
Family Process, 2009Co-Authors: Francoise Marvel, Ralph J. Diclemente, Cynthia L Rowe, Lissette Colonperez, Howard A LiddleAbstract:Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing Interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/ STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family
Eve Rose - One of the best experts on this subject based on the ideXlab platform.
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Rate of decay in proportion of condom-protected sex acts among adolescents after participation in an HIV Risk-Reduction Intervention.
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2013Co-Authors: Ralph J. Diclemente, Jennifer L. Brown, Jessica M. Sales, Eve RoseAbstract:OBJECTIVE HIV Risk-Reduction Interventions have demonstrated efficacy in enhancing the proportion of condom-protected sex (CPS) acts among diverse populations. Although postIntervention exposure increase in CPS are often observed, there is scant empirical data quantifying decay of Intervention efficacy (declines in CPS after cessation of the Intervention among participants reporting an initial postIntervention increase in CPS). Thus, the objective of this study was to quantify the rate of decay in Intervention efficacy over a 24-month follow-up. DESIGN African American adolescent females (ages: 14-20; n = 349) completed a baseline audio computer-assisted self-administered interview, participated in an HIV Risk-Reduction Intervention, and were assessed at 6-month intervals for 24 months postIntervention. Intervention efficacy was conceptualized as an increase in participants' CPS relative to baseline. METHODS Analyses focused on the subset of participants who reported an initial increase in CPS from baseline to the 6-month postIntervention assessment (n = 121) to quantify the rate of decay in Intervention efficacy over a 24-month follow-up period. RESULTS CPS increased markedly from baseline to 6-month follow-up assessment. However, from 6 to 12 months, a marked decline in CPS was observed. Further CPS declines, though not statistically significant, were observed from 12 to 18 months and 18 to 24 months. Cumulative reductions in CPS over the entire 24-month follow-up resulted in no statistical difference between baseline and 24-month follow-up; indicative of a nonsignificant Intervention effect at 24-month assessment. CONCLUSIONS Innovative postIntervention optimization strategies are needed to minimize CPS decay over protracted time periods by reinforcing, sustaining, and potentially amplifying initial gains in condom use.
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the mediating role of partner communication frequency on condom use among african american adolescent females participating in an hiv prevention Intervention
Health Psychology, 2012Co-Authors: Jessica M. Sales, Gina M. Wingood, Ralph J. Diclemente, Delia L Lang, James W Hardin, Teaniese P Latham, Eve RoseAbstract:Objective: Although effective HIV prevention Interventions have been developed for adolescents few Interventions have explored whether components of the Intervention are responsible for the observed changes in behaviors postIntervention. This study examined the mediating role of partner communication frequency on African American adolescent females condom use postparticipation in a demonstrated efficacious HIV Risk-Reduction Intervention. Methods: As part of a randomized controlled trial African American adolescent females (N = 715) 15-21 years seeking sexual health services completed a computerized interview at baseline (prior to Intervention) and again 6 and 12 months follow-up post-Intervention participation. The interview assessed adolescents sexual behavior and partner communication skills among other variables at each time point. Using generalized estimating equation (GEE) techniques both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Results: Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion of condom-protected sex acts (p = .001) and consistent condom use (p = .001). Conclusion: Partner communication frequency an integral component of this HIV Intervention significantly increased as a function of participating in the Intervention partially explaining the change in condom use observed 12 months postIntervention. Understanding what Intervention components are associated with behavior change is important for future Intervention development.
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evaluation of an hiv std sexual risk reduction Intervention for pregnant african american adolescents attending a prenatal clinic in an urban public hospital preliminary evidence of efficacy
Journal of Pediatric and Adolescent Gynecology, 2010Co-Authors: Ralph J. Diclemente, Gina M. Wingood, Jessica M. Sales, Eve Rose, Richard A CrosbyAbstract:Study Objective To evaluate an Intervention to reduce HIV/STD-associated behaviors and enhance psychosocial mediators for pregnant African-American adolescents.
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efficacy of sexually transmitted disease human immunodeficiency virus sexual risk reduction Intervention for african american adolescent females seeking sexual health services a randomized controlled trial
JAMA Pediatrics, 2009Co-Authors: Ralph J. Diclemente, Gina M. Wingood, Jessica M. Sales, Eve Rose, Delia L Lang, Angela M Caliendo, James W Hardin, Richard A CrosbyAbstract:Objectives To evaluate the efficacy of an Intervention to reduce incident sexually transmitted disease (STD) and enhance STD/human immunodeficiency virus (HIV)–preventive behaviors and psychosocial mediators. Design A randomized controlled trial of an HIV prevention program. Setting Clinic-based sample in Atlanta, Georgia. Participants African American adolescent females (N = 715), aged 15 to 21 years, seeking sexual health services. Participants completed an audio computer-assisted self-interview and provided self-collected vaginal specimens for STD testing. Intervention Intervention participants received two 4-hour group sessions and 4 telephone contacts over a 12-month period, targeting personal, relational, sociocultural, and structural factors associated with adolescents' STD/HIV risk, and were given vouchers facilitating male partners' STD testing/treatment. Main Outcome Measure Incident chlamydial infections. Results Over the 12-month follow-up, fewer adolescents in the Intervention had a chlamydial infection (42 vs 67; risk ratio [RR], 0.65; 95% confidence interval [CI], 0.42 to 0.98; P = .04) or recurrent chlamydial infection (4 vs 14; RR, 0.25; 95% CI, 0.08 to 0.83; P = .02). Adolescents in the Intervention also reported a higher proportion of condom-protected sex acts in the 60 days preceding follow-up assessments (mean difference, 10.84; 95% CI, 5.27 to 16.42; P P = .001). Adolescents in the Intervention were also more likely to report consistent condom use in the 60 days preceding follow-up assessments (RR, 1. 41; 95% CI, 1.09 to 1.80; P = .01) and condom use at last intercourse (RR, 1.30; 95% CI, 1.09 to 1.54; P = .005). Intervention effects were observed for psychosocial mediators of STD/HIV–preventive behaviors. Conclusion Interventions for African American adolescent females can reduce chlamydial infections and enhance STD/HIV–preventive behaviors and psychosocial mediators of STD/HIV–preventive behaviors. Trial Registration clinicaltrials.gov Identifier:NCT00633906
John B. Jemmott - One of the best experts on this subject based on the ideXlab platform.
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partner violence power and gender differences in south african adolescents hiv sexually transmitted infections risk behaviors
Health Psychology, 2016Co-Authors: Anne M Teitelman, John B. Jemmott, Scarlett L. Bellamy, Zolani Ngwane, Larry D. Icard, Ann Oleary, Anita G Heeren, Sarah J RatcliffeAbstract:OBJECTIVES: Low relationship power and victimization by intimate partner violence (IPV) have been linked to HIV risks among adult and adolescent women. This article examines associations of IPV and relationship power with sexual-risk behaviors and whether the associations differ by gender among South African adolescents. METHOD: Sexual-risk behaviors (multiple partners in past 3 months; condom use at last sex), IPV, and relationship power were collected from 786 sexually experienced adolescents (mean age = 16.9) in Eastern Cape Province, South Africa, during the 54-month follow-up of a HIV/sexually transmitted infection (STI) Risk-Reduction Intervention trial. The data were analyzed with logistic regression models. RESULTS: Adolescent boys were less likely to report condom use at last sex (p =.001) and more likely to report multiple partners (p CONCLUSIONS: HIV Risk-Reduction Interventions and policies should address gender differences in sexual-risk consequences of IPV and relationship power among adolescents and promote gender equity. (PsycINFO Database Record(c) 2016 APA, all rights reserved). Language: en
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the reasoned action approach in hiv risk reduction strategies for adolescents
Annals of The American Academy of Political and Social Science, 2012Co-Authors: John B. JemmottAbstract:Adolescents worldwide are at high risk for adverse consequences of sexual activity, including HIV, other sexually transmitted diseases, and unintended pregnancy. Effective Intervention strategies are needed to address this risk. This article discusses the advantages of the reasoned action approach for developing such strategies, including the ability to integrate population-specific qualitative information with the approach to develop an Intervention that is both theoretically grounded and culturally appropriate. It also describes an application of the approach in developing “Let Us Protect Our Future,” a culturally appropriate HIV Risk-Reduction Intervention for adolescents in South Africa, where sexually transmitted HIV infections are having an especially devastating impact. The results of a randomized controlled trial revealed that grade 6 students in schools that received the Intervention were less likely to report having sexual intercourse, unprotected sexual intercourse, and multiple sexual partners...
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cognitive behavioural health promotion Intervention increases fruit and vegetable consumption and physical activity among south african adolescents a cluster randomised controlled trial
Psychology & Health, 2011Co-Authors: John B. Jemmott, Loretta Sweet Jemmott, Scarlett L. Bellamy, Zolani Ngwane, Larry D. Icard, Ann Oleary, Shasta Jones, Richard J Landis, Anita G Heeren, Joanne C. TylerAbstract:Rates of chronic diseases are high among Black South Africans but few studies have tested cognitive-behavioural health-promotion Interventions to reduce this problem. We tested the efficacy of such an Intervention among adolescents in a cluster-randomised controlled trial. We randomly selected 9 of 17 matched pairs of schools and randomised one school in each pair to the cognitive-behavioural health-promotion Intervention designed to encourage health-related behaviours and the other to a human immunodeficiency virus (HIV)/sexually transmitted disease (STD) Risk-Reduction Intervention that served as the control. Interventions were based on social cognitive theory, the theory of planned behaviour and qualitative data from the target population. Data collectors, blind to participants’ Intervention, administered confidential assessments at baseline and 3, 6 and 12 months post-Intervention. Primary outcomes were fruit and vegetable consumption and physical activity. Participants were 1057 grade 6 learners (mea...
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mediation analysis of an effective sexual risk reduction Intervention for women the importance of self efficacy
Health Psychology, 2008Co-Authors: Ann Oleary, Loretta Sweet Jemmott, John B. JemmottAbstract:Objective: Sister-to-Sister: The Black Women's Health Project is a skill-building HIV/STD Risk-Reduction Intervention for African American women that had significant effects in reducing self-reported sexual risk behavior and biologically confirmed sexually transmitted disease (STD) incidence. The present analyses were conducted to identify which theory-based factors that were addressed in the Intervention accounted for its success. Design: The data were collected in the context of a randomized, 5-group Intervention trial with assessments at baseline and at 3, 6, and 12 months following the Intervention. A mediation analysis was conducted with condom use at last sex, self-reported 12 months after the Intervention, as the outcome variable. Mediators were also measured at the 12-month follow-up. Main Outcome Measures: Mediators were derived from social cognitive theory: condom use knowledge, hedonistic beliefs regarding effects of condom use, expected sex partner reactions to condom requests, sex partner approval of condom use, self-efficacy for impulse control, self-efficacy for carrying condoms, and self-efficacy to achieve consistent condom use with partner. Results: The Intervention significantly improved all potential mediators except condom use knowledge (p = .15), hedonistic beliefs (p = .08), and self-efficacy for impulse control (p = .20). Analyses testing each mediator separately revealed that expected partner reaction, partner approval of condom use, self-efficacy for condom carrying, and self-efficacy for condom use were significant mediators. When they were entered into a multivariate mediation analysis, however, only self-efficacy for condom use was significant (p <.001). Conclusion: These results highlight the importance of self-efficacy in explaining the effects of skill-building sexual Risk-Reduction Interventions on women's use of condoms. Self-efficacy was more important than characteristics of male partners.
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the role of mother daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females a prospective study
Journal of Adolescent Health, 2003Co-Authors: Katherine M Hutchinson, John B. Jemmott, Loretta Sweet Jemmott, Paula K Braverman, Geoffrey T FongAbstract:Abstract Purpose To prospectively examine the relationship between mother–daughter communication about sex and selected sexual risk behaviors among inner-city adolescent females. Methods Participants were 219 sexually experienced females, 12 to 19 years of age, recruited from an inner-city adolescent medicine clinic in Philadelphia, PA, and randomly assigned to the control group of an HIV-risk reduction Intervention study. Analyses were limited to data from control group participants to avoid confounding Intervention effects. Poisson regression was employed to model three self-reported sexual risk behaviors: number of male sexual partners, number of episodes of sexual intercourse, and number of episodes of unprotected intercourse. Mediation effects were evaluated using variables from the Theory of Planned Behavior. Data were analyzed using Poisson regression. Results Higher levels of mother–daughter sexual risk communication were associated with fewer episodes of sexual intercourse and unprotected intercourse at 3-month follow-up. There was evidence that the relationship of communication to unprotected intercourse was mediated by condom use self-efficacy. Mother–daughter sexual risk communication was not significantly associated with adolescents' reports of numbers of male sexual partner. Conclusions This prospective study supports the notion that mothers who communicate with their daughters about sex can affect their daughters' sexual behaviors in positive ways. These findings lend support for the design and implementation of family-based approaches to improve parent–adolescent sexual risk communication as one means of reducing HIV-related sexual risk behaviors among inner-city adolescent females.
Jessica M. Sales - One of the best experts on this subject based on the ideXlab platform.
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Rate of decay in proportion of condom-protected sex acts among adolescents after participation in an HIV Risk-Reduction Intervention.
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2013Co-Authors: Ralph J. Diclemente, Jennifer L. Brown, Jessica M. Sales, Eve RoseAbstract:OBJECTIVE HIV Risk-Reduction Interventions have demonstrated efficacy in enhancing the proportion of condom-protected sex (CPS) acts among diverse populations. Although postIntervention exposure increase in CPS are often observed, there is scant empirical data quantifying decay of Intervention efficacy (declines in CPS after cessation of the Intervention among participants reporting an initial postIntervention increase in CPS). Thus, the objective of this study was to quantify the rate of decay in Intervention efficacy over a 24-month follow-up. DESIGN African American adolescent females (ages: 14-20; n = 349) completed a baseline audio computer-assisted self-administered interview, participated in an HIV Risk-Reduction Intervention, and were assessed at 6-month intervals for 24 months postIntervention. Intervention efficacy was conceptualized as an increase in participants' CPS relative to baseline. METHODS Analyses focused on the subset of participants who reported an initial increase in CPS from baseline to the 6-month postIntervention assessment (n = 121) to quantify the rate of decay in Intervention efficacy over a 24-month follow-up period. RESULTS CPS increased markedly from baseline to 6-month follow-up assessment. However, from 6 to 12 months, a marked decline in CPS was observed. Further CPS declines, though not statistically significant, were observed from 12 to 18 months and 18 to 24 months. Cumulative reductions in CPS over the entire 24-month follow-up resulted in no statistical difference between baseline and 24-month follow-up; indicative of a nonsignificant Intervention effect at 24-month assessment. CONCLUSIONS Innovative postIntervention optimization strategies are needed to minimize CPS decay over protracted time periods by reinforcing, sustaining, and potentially amplifying initial gains in condom use.
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the mediating role of partner communication frequency on condom use among african american adolescent females participating in an hiv prevention Intervention
Health Psychology, 2012Co-Authors: Jessica M. Sales, Gina M. Wingood, Ralph J. Diclemente, Delia L Lang, James W Hardin, Teaniese P Latham, Eve RoseAbstract:Objective: Although effective HIV prevention Interventions have been developed for adolescents few Interventions have explored whether components of the Intervention are responsible for the observed changes in behaviors postIntervention. This study examined the mediating role of partner communication frequency on African American adolescent females condom use postparticipation in a demonstrated efficacious HIV Risk-Reduction Intervention. Methods: As part of a randomized controlled trial African American adolescent females (N = 715) 15-21 years seeking sexual health services completed a computerized interview at baseline (prior to Intervention) and again 6 and 12 months follow-up post-Intervention participation. The interview assessed adolescents sexual behavior and partner communication skills among other variables at each time point. Using generalized estimating equation (GEE) techniques both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Results: Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion of condom-protected sex acts (p = .001) and consistent condom use (p = .001). Conclusion: Partner communication frequency an integral component of this HIV Intervention significantly increased as a function of participating in the Intervention partially explaining the change in condom use observed 12 months postIntervention. Understanding what Intervention components are associated with behavior change is important for future Intervention development.
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evaluation of an hiv std sexual risk reduction Intervention for pregnant african american adolescents attending a prenatal clinic in an urban public hospital preliminary evidence of efficacy
Journal of Pediatric and Adolescent Gynecology, 2010Co-Authors: Ralph J. Diclemente, Gina M. Wingood, Jessica M. Sales, Eve Rose, Richard A CrosbyAbstract:Study Objective To evaluate an Intervention to reduce HIV/STD-associated behaviors and enhance psychosocial mediators for pregnant African-American adolescents.
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efficacy of sexually transmitted disease human immunodeficiency virus sexual risk reduction Intervention for african american adolescent females seeking sexual health services a randomized controlled trial
JAMA Pediatrics, 2009Co-Authors: Ralph J. Diclemente, Gina M. Wingood, Jessica M. Sales, Eve Rose, Delia L Lang, Angela M Caliendo, James W Hardin, Richard A CrosbyAbstract:Objectives To evaluate the efficacy of an Intervention to reduce incident sexually transmitted disease (STD) and enhance STD/human immunodeficiency virus (HIV)–preventive behaviors and psychosocial mediators. Design A randomized controlled trial of an HIV prevention program. Setting Clinic-based sample in Atlanta, Georgia. Participants African American adolescent females (N = 715), aged 15 to 21 years, seeking sexual health services. Participants completed an audio computer-assisted self-interview and provided self-collected vaginal specimens for STD testing. Intervention Intervention participants received two 4-hour group sessions and 4 telephone contacts over a 12-month period, targeting personal, relational, sociocultural, and structural factors associated with adolescents' STD/HIV risk, and were given vouchers facilitating male partners' STD testing/treatment. Main Outcome Measure Incident chlamydial infections. Results Over the 12-month follow-up, fewer adolescents in the Intervention had a chlamydial infection (42 vs 67; risk ratio [RR], 0.65; 95% confidence interval [CI], 0.42 to 0.98; P = .04) or recurrent chlamydial infection (4 vs 14; RR, 0.25; 95% CI, 0.08 to 0.83; P = .02). Adolescents in the Intervention also reported a higher proportion of condom-protected sex acts in the 60 days preceding follow-up assessments (mean difference, 10.84; 95% CI, 5.27 to 16.42; P P = .001). Adolescents in the Intervention were also more likely to report consistent condom use in the 60 days preceding follow-up assessments (RR, 1. 41; 95% CI, 1.09 to 1.80; P = .01) and condom use at last intercourse (RR, 1.30; 95% CI, 1.09 to 1.54; P = .005). Intervention effects were observed for psychosocial mediators of STD/HIV–preventive behaviors. Conclusion Interventions for African American adolescent females can reduce chlamydial infections and enhance STD/HIV–preventive behaviors and psychosocial mediators of STD/HIV–preventive behaviors. Trial Registration clinicaltrials.gov Identifier:NCT00633906
Mary E. Cooley - One of the best experts on this subject based on the ideXlab platform.
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Enhancing behavioral change among lung cancer survivors participating in a lifestyle risk reduction Intervention: a qualitative study
Supportive Care in Cancer, 2019Co-Authors: Darryl Somayaji, Amanda C. Blok, Laura L. Hayman, Yolanda Colson, Michael Jaklisch, Mary E. CooleyAbstract:Purpose Early detection and improved treatment have increased lung cancer survival. Lung cancer survivors have more symptom distress and lower function compared with other cancer survivors; however, few Interventions are available to improve health-related quality of life (HR-QOL). Lifestyle risk reduction Interventions have improved HR-QOL in other cancer survivors. The purpose of this study was to explore lung cancer survivor perspectives on making behavioral changes in the context of a lifestyle risk reduction Intervention. Methods Twenty-two lung cancer survivors participated in interviews after completing the Healthy Directions (HD) Intervention. Interviews were audiotaped, transcribed, and analyzed using inductive content analysis. Demographic and clinical characteristics were gathered through a survey and analyzed using descriptive statistics. Results Five main themes were identified: (1) the diagnosis was a motivator for behavior change, (2) participants had to deal with disease consequences, (3) the coach provided guidance, (4) strategies for change were initiated, and (5) social support sustained behavioral changes. Other important subthemes were the coach helped interpret symptoms, which supported self-efficacy and goal setting, and survivors employed self-monitoring behaviors. Several participants found the recommended goals for physical activity were difficult and were discouraged if unable to attain the goal. Findings underscore the need for individualized prescriptions of physical activity, especially for sedentary survivors. Conclusions Lung cancer survivors described the benefits of coaching to enhance their engagement in behavioral change. Additional research is needed to validate the benefit of the HD Intervention to improve HR-QOL among this vulnerable and understudied group of cancer survivors.
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enhancing behavioral change among lung cancer survivors participating in a lifestyle risk reduction Intervention a qualitative study
Supportive Care in Cancer, 2019Co-Authors: Darryl Somayaji, Amanda C. Blok, Laura L. Hayman, Yolanda Colson, Michael Jaklisch, Mary E. CooleyAbstract:Early detection and improved treatment have increased lung cancer survival. Lung cancer survivors have more symptom distress and lower function compared with other cancer survivors; however, few Interventions are available to improve health-related quality of life (HR-QOL). Lifestyle risk reduction Interventions have improved HR-QOL in other cancer survivors. The purpose of this study was to explore lung cancer survivor perspectives on making behavioral changes in the context of a lifestyle risk reduction Intervention. Twenty-two lung cancer survivors participated in interviews after completing the Healthy Directions (HD) Intervention. Interviews were audiotaped, transcribed, and analyzed using inductive content analysis. Demographic and clinical characteristics were gathered through a survey and analyzed using descriptive statistics. Five main themes were identified: (1) the diagnosis was a motivator for behavior change, (2) participants had to deal with disease consequences, (3) the coach provided guidance, (4) strategies for change were initiated, and (5) social support sustained behavioral changes. Other important subthemes were the coach helped interpret symptoms, which supported self-efficacy and goal setting, and survivors employed self-monitoring behaviors. Several participants found the recommended goals for physical activity were difficult and were discouraged if unable to attain the goal. Findings underscore the need for individualized prescriptions of physical activity, especially for sedentary survivors. Lung cancer survivors described the benefits of coaching to enhance their engagement in behavioral change. Additional research is needed to validate the benefit of the HD Intervention to improve HR-QOL among this vulnerable and understudied group of cancer survivors.
