Bibliography
Bibliography — HIV/AIDS & STDs
This section contains articles that address factors associated with health behavior & health status and school-based strategies for HIV and STD prevention among children and adolescents.
Research
The Role of Policy Advocacy in Assuring Comprehensive Family Life Education in California
Jeffrey Jensen Arnett
Health Education & Behavior, (August 2006).
The widespread belief that peer influence is the primary cause of adolescent smoking initiation is examined and called into question. Correlational and longitudinal studies purporting to demonstrate peer influence are analyzed, and their limitations described. Qualitative interview studies of adolescent smoking initiation are presented as depicting the more complex role of the peer context. Finally, a new model of the role of peers in smoking initiation is offered, with an emphasis on how adolescents’ characteristics lead to the selection of their friends, who then provide a peer context that may or may not support smoking.
Who Benefits From Community-Based Participatory Research? A Case Studyof the Positive Youth Project
Sarah Flicker
Health Education & Behavior 2008; 35; 70 originally published online May 31, 2006;
Community-based participatory research (CBPR) has evolved as a popular new paradigm in health research. This shift is exciting, yet there is still much to discover about how various stake holders are affected. This article uses a critical social science perspective to explore who benefits from these changes through an analysis of a CBPR case study (The Positive Youth Project). Two major categories of beneficiaries emerged: the research itself and the partner-stake holders. The benefits, how ever, were not gained with out substantial human resource investment, nor were they necessarily equitably spread. Participation costs included heavy demands of time, an added burden of work, frustration with the process, missing other opportunities, risking loss of anonymity, and loss of control. Care needs to be taken to ensure that concrete benefits accrue for all project partners and costs are minimized. Another way of framing benefits is to look at the community capacities built to address future health and social issues.
Exploring Implementation and Fidelity of Evidence-Based Behavioral Inter
ventions for HIV Prevention: Lessons Learned From the Focus on Kids Diffusion Case Study
Jennifer S. Galbraith, Bonita Stanton, Bradley Boekeloo, Winifred King, Sharon Desmond, Donna Howard, Maureen M. Black and James W. Carey
Health Education & Behavior 2009; 36; 532 originally published online Apr 29, 2008;
Evidence-based interventions (EBIs) are used in public health to prevent HIV infection among youth and other groups. EBIs include core elements, features that are thought to be responsible for the efficacy of interventions. The authors evaluate experiences of organizations that adopted an HIV-prevention EBI, Focus on Kids (FOK), and their fidelity to the intervention’s eight core elements. A cross-sectional telephone survey was administered to 34 staff members from organizations that had previously implemented FOK. Questions assessed how the organization adhered to, adapted, dropped, or altered the intervention. None of the organizations implemented all eight core elements. This study underscores the importance for HIV intervention researchers to clearly identify and describe core elements. More effort is needed to reflect the constraints practitioners face in non-research settings. To ensure intervention effectiveness, additional research and technical assistance are needed to help organizations implement HIV prevention EBIs with fidelity.
Personal Involvement of Young People in HIV Prevention Campaign Messages: The Role of Message Format, Culture, and Gender
Cynthia Waszak Geary, Holly M. Burke, Laura Johnson, Jennifer Liku, Laure Castelnau,
Shailes Neupane and Cheikh Niang
Health Education & Behavior 2008; 35; 190 originally published online Nov 17, 2006;
To examine young people’s reactions to and understanding of HIV prevention messages developed for MTV’s global HIV prevention campaign Staying Alive, videotaped campaign materials were shown to focus group discussion (FGD) participants living in urban areas of Brazil, Kenya, Nepal, and Senegal. Responses related to “personal involvement” with the message were identified in the data from these FGDs and were examined in relationship to the emerging message themes, the message format (public service announcements [PSAs] vs. documentary), cultural context (site), and participant gender. Across groups, greater personal involvement (measured by personal connections, emotional reactions, and lessons learned) was found in responses about the documentary format compared to the PSA format. Exceptions were found for specific PSAs that were considered more relevant within specific gender or cultural contexts. Implications of findings for global campaigns were considered.
Is Abstinence Education Theory Based? The Underlying Logic of Abstinence Education Programs in Texas
Patricia Goodson, B. E. Pruitt, Sandy Suther, Kelly Wilson and Eric Buhi
Health Education & Behavior, 2006; 33; 252.
Authors examined the logic (or the implicit theory) underlying 16 abstinence-only-until-marriage programs in Texas (50% of all programs funded under the federal welfare reform legislation during 2001 and 2002). Defined as a set of propositions regarding the relationship between program activities and their intended outcomes, program staff’s implicit theories were summarized and compared to (a) data from studies on adolescent sexual behavior, (b) a theory-based model of youth abstinent behavior, and (c) preliminary findings from the national evaluation of Title V programs. Authors interviewed 62 program directors and instructors and employed selected principles of grounded theory to analyze interview data. Findings indicated that abstinence education staff could clearly articulate the logic guiding program activity choices. Comparisons between interview data and a theory-based model of adolescent sexual behavior revealed striking similarities. Implications of these findings for conceptualizing and evaluating abstinence-only-until-marriage (or similar) programs are examined.
Validation of a Parent-Adolescent Communication Scale for Use in STD/HIV Prevention Interventions
Jessica McDermott Sales, Robin R. Milhausen, Gina M. Wingood, Ralph J. DiClemente, Laura F. Salazar and Richard A. Crosby
Health Education & Behavior 2008; 35; 332 originally published online Dec 15, 2006;
This study reports on the validation of a scale to assess adolescent girls’ frequency of sexual communication with their parents. The Parent-Adolescent Communication Scale (PACS) was administered to 522 African American female adolescents ranging in age from 14 to 18. The PACS demonstrated satisfactory internal consistency (across multiple administrations) and acceptable test-retest reliability over a 12-month follow-up period. Concurrently, scores on the PACS were correlated with frequency of sexual communication with partner, sexual communication self-efficacy (boyfriend), perceived parental knowledge, family support, depression, and condom use with steady male sex partners. Prospectively, baseline PACS scores were correlated with frequency of sexual communication with partner and condom use. The present investigation indicates that the PACS is a reliable and valid measure of frequency of sexual communication between female adolescents and their parents. Utility of the PACS for researchers and practitioners is discussed.
Predicting Willingness to Engage in Unsafe Sex and Intention to Perform Sexual Protective Behaviors Among Adolescents
Ingri Myklestad and Jostein Rise
Health Education & Behavior 2007; 34; 686 originally published online Aug 2, 2006;
This article examines the sociocognitive processes contributing to intention to use contraception and willingness to engage in unsafe sex, using extended versions of the theory of planned behavior (TPB) and the Prototype/Willingness model (Gibbons & Gerrard, 1995, 1997). Data were obtained from a questionnaire delivered to all the pupils in ninth grade (N = 196) at three schools in Oslo. Hierarchical multiple regression analysis was used to predict intention and willingness. The results showed that subjective norm was the most important predictor of intentions for girls, whereas moral norm was most important for boys’ intentions and willingness. Prototypes were the most important predictor for girls’ willingness. Implications of the findings are discussed.
Estimates of Intraclass Correlation for Variables Related to Behavioral HIV/STD Prevention in a Predominantly African American and Hispanic Sample of Young Women
Sherri L. Pals, Brenda L. Beaty, Samuel F. Posner and Sheana S. Bull
Health Education & Behavior2009; 36; 182.
Studies designed to evaluate HIV and STD prevention interventions often involve random assignment of groups such as neighborhoods or communities to study conditions (e.g., to intervention or control). Investigators who design group-randomized trials (GRTs) must take the expected intraclass correlation coefficient (ICC) into account in sample size estimation to have adequate power; however, few published ICC estimates exist for outcome variables related to HIV and STD prevention. The Prevention Options for Women Equal Rights (POWER) study was a GRT designed to evaluate a campaign to increase awareness and use of condoms among young African American and Hispanic women. The authors used precampaign and postcampaign data from the POWER study to estimate ICCs (unadjusted and adjusted for covariates) for a variety of sexual behavior and other variables. To illustrate the impact of ICCs on power, the authors present sample-size calculations and demonstrate how ICCs of differing magnitude will affect estimates of required sample size.
Ecodevelopmental x Intrapersonal Risk: Substance Use and Sexual Behavior in Hispanic Adolescents
Guillermo J. Prado, Seth J. Schwartz, Mildred Maldonado-Molina, Shi Huang, Hilda M. Pantin, Barbara Lopez and Jose Szapocznik
Health Education & Behavior 2009; 36; 45 originally published online Mar 6, 2008;
Hispanic adolescents are a rapidly growing population and are highly vulnerable to substance abuse and HIV infection. Many interventions implemented thus far have been “one size fits all” models that deliver the same dosage and sequence of modules to all participants. To more effectively prevent substance use and HIV in Hispanic adolescents, different risk profiles must be considered. This study’s purpose is to use intrapersonal and ecodevelopmental risk processes to identify Hispanic adolescent subgroups and to compare substance use rates and sexual behavior by risk subgroup. The results indicate that a larger proportion with high ecodevelopmental risk (irrespective of the intrapersonal risk for substance use) report lifetime and past 90-day cigarette and illicit drug use. In contrast, a larger proportion with high intrapersonal risk for unsafe sex (irrespective of ecodevelopmental risk) report early sex initiation and sexually transmitted disease incidence. Implications for intervention development are discussed in terms of these Hispanic adolescent subgroups.
A Brief, Low-Cost, Theory-Based Intervention to Promote Dual Method Use by Black and Latina Female Adolescents: A Randomized Clinical Trial
Carol Roye, Paula Perlmutter Silverman and Beatrice Krauss
Health Education & Behavior2007; 34; 608 originally published online May 31, 2006;
HIV/AIDS disproportionately affects young women of color. Young women who use hormonal contraception are less likely to use condoms. Brief, inexpensive HIV-prevention interventions are needed for high-volume clinics. This study was a randomized clinical trial of two interventions: (a) a video made for this study and (b) an adaptation of Project RESPECT counseling. Four hundred Black and Latina teenage women completed a questionnaire about their sexual behaviors and were randomly assigned to (a) see the video, (b) get counseling, (c) see the video and get counseling, or (d) receive usual care. At 3-month follow-up, those who saw the video and received counseling were 2.5 times more likely to have used a condom at last intercourse with their main partner than teens in the usual care group. These differences did not persist at 12-month follow-up. This suggests that a brief intervention can positively affect condom use in the short term.
Effects of a Televised Two-City Safer Sex Mass Media Campaign Targeting High-Sensation-Seeking and Impulsive-Decision-Making Young Adults
Rick S. Zimmerman, Philip M. Palmgreen, Seth M. Noar, Mia Liza A. Lustria, Hung-Yi Lu and Mary Lee Horosewski
Health Education & Behavior 2007; 34; 810 originally published online Jun 29, 2007;
This study evaluates the ability of a safer sex televised public service announcement (PSA) campaign to increase safer sexual behavior among at-risk young adults. Independent, monthly random samples of 100 individuals were surveyed in each city for 21 months as part of an interrupted-time-series design with a control community. The 3-month high-audience-saturation campaign took place in Lexington, KY, with Knoxville, TN, as a comparison city. Messages were especially designed and selected for the target audience (those above the median on a composite sensation-seeking/impulsive-decision-making scale). Data indicate high campaign exposure among the target audience, with 85%-96% reporting viewing one or more PSAs. Analyses indicate significant 5-month increases in condom use, condom-use self-efficacy, and behavioral intentions among the target group in the campaign city with no changes in the comparison city. The results suggest that a carefully targeted, intensive mass media campaign using televised PSAs can change safer sexual behaviors.
Practice
This section contains articles addressing the effectiveness and practical application of child and adolescent school health HIV and STD prevention programs and policies.
Using Community Ties to Facilitate School-Based Prevention Research
Pamela K. Cupp, Rick S. Zimmerman, Christi Sporl Massey, Jennifer R. Howell and Rachel Swan
Health Promotion Practice 2006; 7; 459 originally published online Jul 13, 2006;
One of the greatest obstacles to conducting school-based HIV/STD/pregnancy prevention research with adolescents is the reluctance of administrators or site-based decision-making councils to commit their teachers and students to participation in a project designed and managed by an outside group of researchers. A major concern is that researchers may not understand or agree with community sensitivities about such personal topics. By first establishing a collaborative relationship with health district educators currently working in Appalachian schools and residing in those communities, one finds a distinct advantage in terms of gaining admittance to area schools. The presence of local health educators at formative meetings also allays many concerns of community members, as they view these local participants as monitors of outsider research efforts, thereby protecting the community culture from undue outside influence. During the course of the current study, health educators found they also learned more about their communities and about HIV prevention.
Girl World: A Primary Prevention Program for Mexican American Girls
Patricia J. Kelly, Tess J. Bobo, Kate McLachlan, Shana Avery and Sandra K. Burge
Health Promotion Practice 2006; 7; 174
Theories about women’s health have not traditionally been extended to include the healthy development of young women. This article applies a women’s health perspective to the implementation and evaluation processes of a gender-specific primary prevention program that worked with 9- to 14-year-old Hispanic girls in a low-income community. Although community-based after-school programs can be an important venue for education and girls’ development, long-term effects are elusive to evaluate. The authors used ethnographic techniques to learn more about girls and their interactions with the program and to assess short-term program impact. Three themes were found: Program environment can contribute to girls’ expression and behavior, issues of struggling families can slide girls into early adulthood, and mentoring can benefit both girls and adult women. Community-based primary prevention programs, although an essential part of a social safety net available to low-income girls, provide researchers with a unique set of evaluation challenges.
Acknowledging Adult Bias: A Focus-Group Approach to Utilizing Beauty Salons as Health-Education Portals for Inner-City Adolescent Girls
Alexis Lieberman and Diana Harris
Health Promotion Practice 2007; 8; 205 originally published online Sep 15, 2006;
To assess the feasibility of using beauticians as health literacy agents and beauty salons as health-education portals for adolescent, inner-city, African American girls, the authors conducted focus groups with 25 women: salon clients, salon owners, and medical students. Facilitators to program development included (a) beautician-client relationships, (b) teens’ access to health information, and (c) beauticians as information resources. Barriers included (a) adult opinions of teen behaviors, (b) teen mistrust of adults, and (c) low health literacy of beauticians. In developing a health-education program for this population, beauticians and salons may be excellent health information agents and portals if barriers including beautician poor health literacy, adolescent mistrust in adults, and adults’ anti-adolescent bias are improved. Program implementation must not solely focus on teens but should also include adult salon users, with the goal of reaching the teens first through these adults and, with time and trust, reaching the teens directly.
BART to HIVEd: Adapting an HIV Education Prevention Program
Georgia N. L. J. Polacek, Jennifer Coker, Kayan L. Lewis, Monica Minter, Verónica Villela-Perez and Anthony A. Scott
Health Promot Pract 2008; 9; 45
One of the fastest growing segments of the population infected with HIV is the nation’s youths. Thus, prevention in this high-risk population is vital. The authors detail the process of adapting an evidence-based HIV/AIDS educational program (HIVEd) to the unique needs of high-risk youths in adjudicated and detained facilities and alternative high schools. The HIVEd program derives from St. Lawrence’s Becoming A Responsible Teen (BART) curriculum. This article describes the modification of BART into HIVEd, identifies the challenges encountered and lessons learned, and suggests future directions for HIVEd as a useful tool for prevention of HIV/AIDS and sexually transmitted infection in high-risk youths.
Getting to Social Action: The Youth Empowerment Strategies (YES!) Project
Nance Wilson, Meredith Minkler, Stefan Dasho, Nina Wallerstein and Anna C. Martin
Health Promot Pract 2008; 9; 395 originally published online Jun 27, 2006;
This article describes the social action component of the Youth Empowerment Strategies (YES!) project funded by the Centers for Disease Control and Prevention through its community-based prevention research (CBPR) initiative. YES! is designed to promote problem-solving skills, social action, and civic participation among underserved elementary and middle school youth. The after-school program focuses on identifying and building youths’ capacities and strengths as a means of ultimately decreasing rates of alcohol, tobacco, and other drug use and other risky behaviors. The article discusses the conceptual models of risk and intervention and factors contributing to successful social action work, including group dynamics, intra-group leadership, facilitator skills, and school-community contexts. Attention is focused on how the nature of the projects themselves played a key role in determining the likelihood of experiencing success. Implications and recommendations for other youth-focused empowerment education projects are discussed, including the effective use of Photovoice in such projects.
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