Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander artikel

Gepubliceerd in: Journal of Behavioral Medicine 2/2015

01-04-2015

Mediators of behavior change resulting from a sexual risk reduction intervention for STI patients, Cape Town, South Africa

Auteurs: Eileen V. Pitpitan, Seth C. Kalichman, Randi L. Garcia, Demetria Cain, Lisa A. Eaton, Leickness C. Simbayi

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 2/2015

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Theory-based sexual risk reduction interventions are often demonstrated effective, but few studies have examined the mechanisms that mediate their behavior changes. In addition, critical contextual factors, such as alcohol use, are often not accounted for by social cognitive theories and may add to the explanatory value of intervention effects. The purpose of this study is to examine the underlying mechanisms driving condom use following a brief sexual risk reduction intervention grounded in the information, motivation, behavioral skills (IMB) model of behavior change. We examined IMB theoretical constructs and alcohol-related contextual factors as potential mediators in separate models. Patients (n = 617) from an STI clinic in Cape Town, South Africa were randomly assigned to either a brief risk reduction intervention or an education-only control condition. We assessed IMB, and alcohol-related variables at baseline, 3, 6, 9, and 12 months and modeled IMB constructs and alcohol-related factors as mediators of behavior change. Results of growth-curve mediational modeling showed that 1 year after counseling, the intervention indirectly affected sexual risk behavior through alcohol-related constructs, but not IMB constructs. Alcohol use and related factors play critical roles in explaining HIV and STI risk reduction intervention effects. Interventions that directly address alcohol use as a factor in sexual risk behavior and behavior change should be the focus of future research.
Literatuur
go back to reference Aarons, G. A., Goldman, M. S., Greenbaum, P. E., & Coovert, M. D. (2003). Alcohol expectancies: Integrating cognitive science and psychometric approaches. Addictive Behaviors, 28, 947–961. CrossRefPubMed Aarons, G. A., Goldman, M. S., Greenbaum, P. E., & Coovert, M. D. (2003). Alcohol expectancies: Integrating cognitive science and psychometric approaches. Addictive Behaviors, 28, 947–961. CrossRefPubMed
go back to reference Anderson, E. S., Wagstaff, D. A., Heckman, T. G., Winett, R. A., Roffman, R. A., Solomon, L. J., et al. (2006). Information–motivation–behavioral skills (IMB) model: Testing direct and mediated treatment effects on condom use among women in low-income housing. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 31, 70–79. doi: 10.​1207/​s15324796abm3101​_​11 CrossRef Anderson, E. S., Wagstaff, D. A., Heckman, T. G., Winett, R. A., Roffman, R. A., Solomon, L. J., et al. (2006). Information–motivation–behavioral skills (IMB) model: Testing direct and mediated treatment effects on condom use among women in low-income housing. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 31, 70–79. doi: 10.​1207/​s15324796abm3101​_​11 CrossRef
go back to reference Babor, T. F., Grant, M., Acuda, W., Burns, F. H., Campillo, C., DelBoca, F. K., et al. (1994). A randomized clinical trial of brief interventions in primary care: Summary of a WHO project. Addiction (Abingdon, England), 89, 657–660. (discussion 660–678). CrossRef Babor, T. F., Grant, M., Acuda, W., Burns, F. H., Campillo, C., DelBoca, F. K., et al. (1994). A randomized clinical trial of brief interventions in primary care: Summary of a WHO project. Addiction (Abingdon, England), 89, 657–660. (discussion 660–678). CrossRef
go back to reference Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological Review, 84, 191–215. CrossRefPubMed Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological Review, 84, 191–215. CrossRefPubMed
go back to reference Bandura, A. (1997). Self-efficacy: The exercise of control (1st ed.). New York: Worth Publishers. Bandura, A. (1997). Self-efficacy: The exercise of control (1st ed.). New York: Worth Publishers.
go back to reference Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238. CrossRefPubMed Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238. CrossRefPubMed
go back to reference Bollen, K. A., & Stine, R. (1990). Direct and indirect effects: Classical and bootstrap estimates of variability. Sociological Methodology, 20, 15–140. CrossRef Bollen, K. A., & Stine, R. (1990). Direct and indirect effects: Classical and bootstrap estimates of variability. Sociological Methodology, 20, 15–140. CrossRef
go back to reference Brown, S. A., Christiansen, B. A., & Goldman, M. S. (1987). The Alcohol Expectancy Questionnaire: An instrument for the assessment of adolescent and adult alcohol expectancies. Journal of Studies on Alcohol, 48, 483–491. CrossRefPubMed Brown, S. A., Christiansen, B. A., & Goldman, M. S. (1987). The Alcohol Expectancy Questionnaire: An instrument for the assessment of adolescent and adult alcohol expectancies. Journal of Studies on Alcohol, 48, 483–491. CrossRefPubMed
go back to reference Brown, S. A., Goldman, M. S., Inn, A., & Anderson, L. R. (1980). Expectations of reinforcement from alcohol: Their domain and relation to drinking patterns. Journal of Consulting and Clinical Psychology, 48, 419–426. CrossRefPubMed Brown, S. A., Goldman, M. S., Inn, A., & Anderson, L. R. (1980). Expectations of reinforcement from alcohol: Their domain and relation to drinking patterns. Journal of Consulting and Clinical Psychology, 48, 419–426. CrossRefPubMed
go back to reference Carey, M. P., & Schroder, K. E. E. (2002). Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Education and Prevention: Official Publication of the International Society for AIDS Education, 14, 172–182. CrossRef Carey, M. P., & Schroder, K. E. E. (2002). Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Education and Prevention: Official Publication of the International Society for AIDS Education, 14, 172–182. CrossRef
go back to reference Conigrave, K. M., Hall, W. D., & Saunders, J. B. (1995). The AUDIT questionnaire: Choosing a cut-off score. Addiction, 90, 1349–1356. CrossRefPubMed Conigrave, K. M., Hall, W. D., & Saunders, J. B. (1995). The AUDIT questionnaire: Choosing a cut-off score. Addiction, 90, 1349–1356. CrossRefPubMed
go back to reference Cook, R. L., & Clark, D. B. (2005). Is there an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sexually Transmitted Diseases, 32, 156–164. CrossRefPubMed Cook, R. L., & Clark, D. B. (2005). Is there an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sexually Transmitted Diseases, 32, 156–164. CrossRefPubMed
go back to reference Cornman, D. H., Schmiege, S. J., Bryan, A., Joseph Benziger, T., & Fisher, J. D. (2007). An information–motivation–behavioral skills (IMB) model-based HIV prevention intervention for truck drivers in India. Social Science and Medicine, 64, 1572–1584. CrossRefPubMed Cornman, D. H., Schmiege, S. J., Bryan, A., Joseph Benziger, T., & Fisher, J. D. (2007). An information–motivation–behavioral skills (IMB) model-based HIV prevention intervention for truck drivers in India. Social Science and Medicine, 64, 1572–1584. CrossRefPubMed
go back to reference De Silva, P., Jayawardana, P., & Pathmeswaran, A. (2008). Concurrent validity of the alcohol use disorders identification test (AUDIT). Alcohol and Alcoholism (Oxford, Oxfordshire), 43, 49–50. doi: 10.​1093/​alcalc/​agm061 CrossRef De Silva, P., Jayawardana, P., & Pathmeswaran, A. (2008). Concurrent validity of the alcohol use disorders identification test (AUDIT). Alcohol and Alcoholism (Oxford, Oxfordshire), 43, 49–50. doi: 10.​1093/​alcalc/​agm061 CrossRef
go back to reference Eaton, L. A., Huedo-Medina, T. B., Kalichman, S. C., Pellowski, J. A., Sagherian, M. J., Warren, M., et al. (2012). Meta-analysis of single-session behavioral interventions to prevent sexually transmitted infections: Implications for bundling prevention packages. American Journal of Public Health, 102, e34–e44. doi: 10.​2105/​AJPH.​2012.​300968 CrossRefPubMedCentralPubMed Eaton, L. A., Huedo-Medina, T. B., Kalichman, S. C., Pellowski, J. A., Sagherian, M. J., Warren, M., et al. (2012). Meta-analysis of single-session behavioral interventions to prevent sexually transmitted infections: Implications for bundling prevention packages. American Journal of Public Health, 102, e34–e44. doi: 10.​2105/​AJPH.​2012.​300968 CrossRefPubMedCentralPubMed
go back to reference Fisher, J. D., Fisher, W. A., Williams, S. S., & Malloy, T. E. (1994). Empirical tests of an information–motivation–behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychology, 13, 238. CrossRefPubMed Fisher, J. D., Fisher, W. A., Williams, S. S., & Malloy, T. E. (1994). Empirical tests of an information–motivation–behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychology, 13, 238. CrossRefPubMed
go back to reference Hall, W., Saunders, J. B., Babor, T. F., Aasland, O. G., Amundsen, A., Hodgson, R., et al. (1993). The structure and correlates of alcohol dependence: WHO collaborative project on the early detection of persons with harmful alcohol consumption—III. Addiction (Abingdon, England), 88, 1627–1636. CrossRef Hall, W., Saunders, J. B., Babor, T. F., Aasland, O. G., Amundsen, A., Hodgson, R., et al. (1993). The structure and correlates of alcohol dependence: WHO collaborative project on the early detection of persons with harmful alcohol consumption—III. Addiction (Abingdon, England), 88, 1627–1636. CrossRef
go back to reference Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55. CrossRef Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55. CrossRef
go back to reference Jöreskog, K. G., & Sörbom, D. (1978). LISREL IV: Analysis of linear structural relationships by the method of maximum likelihood. Chicago: International Educational Services. Jöreskog, K. G., & Sörbom, D. (1978). LISREL IV: Analysis of linear structural relationships by the method of maximum likelihood. Chicago: International Educational Services.
go back to reference Kalichman, S., Malow, R., Dévieux, J., Stein, J. A., & Piedman, F. (2005). HIV risk reduction for substance using seriously mentally ill adults: Test of the information–motivation–behavior skills (IMB) model. Community Mental Health Journal, 41, 277–290. CrossRefPubMedCentralPubMed Kalichman, S., Malow, R., Dévieux, J., Stein, J. A., & Piedman, F. (2005). HIV risk reduction for substance using seriously mentally ill adults: Test of the information–motivation–behavior skills (IMB) model. Community Mental Health Journal, 41, 277–290. CrossRefPubMedCentralPubMed
go back to reference Kalichman, S. C., Simbayi, L. C., Kaufman, M., Cain, D., & Jooste, S. (2007a). Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prevention Science: The Official Journal of the Society for Prevention Research, 8, 141–151. doi: 10.​1007/​s11121-006-0061-2 CrossRef Kalichman, S. C., Simbayi, L. C., Kaufman, M., Cain, D., & Jooste, S. (2007a). Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prevention Science: The Official Journal of the Society for Prevention Research, 8, 141–151. doi: 10.​1007/​s11121-006-0061-2 CrossRef
go back to reference Kalichman, S. C., Simbayi, L. C., Vermaak, R., Cain, D., Jooste, S., & Peltzer, K. (2007b). HIV/AIDS risk reduction counseling for alcohol using sexually transmitted infections clinic patients in Cape Town, South Africa. Journal of Acquired Immune Deficiency Syndromes (1999), 44, 594–600. doi: 10.​1097/​QAI.​0b013e3180415e07​ CrossRef Kalichman, S. C., Simbayi, L. C., Vermaak, R., Cain, D., Jooste, S., & Peltzer, K. (2007b). HIV/AIDS risk reduction counseling for alcohol using sexually transmitted infections clinic patients in Cape Town, South Africa. Journal of Acquired Immune Deficiency Syndromes (1999), 44, 594–600. doi: 10.​1097/​QAI.​0b013e3180415e07​ CrossRef
go back to reference Kamb, M. L., Fishbein, M., Douglas, J. M, Jr, Rhodes, F., Rogers, J., Bolan, G., et al. (1998). Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial. Project RESPECT Study Group. The Journal of the American Medical Association, 280, 1161–1167. CrossRef Kamb, M. L., Fishbein, M., Douglas, J. M, Jr, Rhodes, F., Rogers, J., Bolan, G., et al. (1998). Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial. Project RESPECT Study Group. The Journal of the American Medical Association, 280, 1161–1167. CrossRef
go back to reference Kline, R. B. (2010). Principles and practice of structural equation modeling. New York: The Guilford Press. Kline, R. B. (2010). Principles and practice of structural equation modeling. New York: The Guilford Press.
go back to reference Metcalf, C. A., Douglas, J. M, Jr, Malotte, C. K., Cross, H., Dillon, B. A., Paul, S. M., et al. (2005). Relative efficacy of prevention counseling with rapid and standard HIV testing: A randomized, controlled trial (RESPECT-2). Sexually Transmitted Diseases, 32, 130–138. CrossRefPubMed Metcalf, C. A., Douglas, J. M, Jr, Malotte, C. K., Cross, H., Dillon, B. A., Paul, S. M., et al. (2005). Relative efficacy of prevention counseling with rapid and standard HIV testing: A randomized, controlled trial (RESPECT-2). Sexually Transmitted Diseases, 32, 130–138. CrossRefPubMed
go back to reference Morojele, N. K., Kachieng’a, M. A., Mokoko, E., Nkoko, M. A., Parry, C. D. H., Nkowane, A. M., et al. (2006). Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science & Medicine (1982), 62, 217–227. doi: 10.​1016/​j.​socscimed.​2005.​05.​031 CrossRef Morojele, N. K., Kachieng’a, M. A., Mokoko, E., Nkoko, M. A., Parry, C. D. H., Nkowane, A. M., et al. (2006). Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science & Medicine (1982), 62, 217–227. doi: 10.​1016/​j.​socscimed.​2005.​05.​031 CrossRef
go back to reference Patterson, T. L., Mausbach, B., Lozada, R., Staines-Orozco, H., Semple, S. J., Fraga-Vallejo, M., et al. (2008). Efficacy of a brief behavioral intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. American Journal of Public Health, 98, 2051–2057. doi: 10.​2105/​AJPH.​2007.​130096 CrossRefPubMedCentralPubMed Patterson, T. L., Mausbach, B., Lozada, R., Staines-Orozco, H., Semple, S. J., Fraga-Vallejo, M., et al. (2008). Efficacy of a brief behavioral intervention to promote condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. American Journal of Public Health, 98, 2051–2057. doi: 10.​2105/​AJPH.​2007.​130096 CrossRefPubMedCentralPubMed
go back to reference Rhodes, T. (2002). The [] risk environment’: A framework for understanding and reducing drug-related harm. International Journal of Drug Policy, 13, 85–94. CrossRef Rhodes, T. (2002). The [] risk environment’: A framework for understanding and reducing drug-related harm. International Journal of Drug Policy, 13, 85–94. CrossRef
go back to reference Robertson, A. A., Stein, J. A., & Baird-Thomas, C. (2006). Gender differences in the prediction of condom use among incarcerated juvenile offenders: Testing the information–motivation–behavior skills (IMB) model. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 38, 18–25. doi: 10.​1016/​j.​jadohealth.​2004.​08.​013 CrossRef Robertson, A. A., Stein, J. A., & Baird-Thomas, C. (2006). Gender differences in the prediction of condom use among incarcerated juvenile offenders: Testing the information–motivation–behavior skills (IMB) model. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 38, 18–25. doi: 10.​1016/​j.​jadohealth.​2004.​08.​013 CrossRef
go back to reference Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422. CrossRefPubMed Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422. CrossRefPubMed
go back to reference Weinhardt, L. S., & Carey, M. P. (2000). Does alcohol lead to sexual risk behavior? Findings from event-level research. Annual Review of Sex Research, 11, 125–157. PubMedCentralPubMed Weinhardt, L. S., & Carey, M. P. (2000). Does alcohol lead to sexual risk behavior? Findings from event-level research. Annual Review of Sex Research, 11, 125–157. PubMedCentralPubMed
Metagegevens
Titel
Mediators of behavior change resulting from a sexual risk reduction intervention for STI patients, Cape Town, South Africa
Auteurs
Eileen V. Pitpitan
Seth C. Kalichman
Randi L. Garcia
Demetria Cain
Lisa A. Eaton
Leickness C. Simbayi
Publicatiedatum
01-04-2015
Uitgeverij
Springer US
Gepubliceerd in
Journal of Behavioral Medicine / Uitgave 2/2015
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-014-9591-4