Conditional Economic Incentives for Reducing HIV Risk Behaviors: Integration of Psychology and Behavioral Economics

PubMed Central

Operario, Don; Kuo, Caroline C.; Sosa-Rubí, Sandra G.; Gálarraga, Omar

2014-01-01

Objective This paper reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. Methods We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories end behavioral economics can be combined into new approaches for HIV prevention. Results Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and STI prevalence, HIV testing, HIV medication adherence, and drug use. Conclusion CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PMID:24001243

Addressing the issue of falls off playground equipment: an empirically-based intervention to reduce fall-risk behaviors on playgrounds.

PubMed

Morrongiello, Barbara A; Matheis, Shawn

2007-08-01

The present study evaluated the impact of an intervention to reduce fall-risk behaviors on playgrounds among children 6-11 years of age. Children completed posters indicating risky playground behaviors they would and would not do. In the intervention group, video and audio presentations were used to expose children to injury occurrences so that injury vulnerability was communicated in a fear-evoking way. In the control group, children only completed the pre- and post-intervention measures. Significant decreases in intentions to risk-take were obtained in the intervention, but not the control group. Effectiveness did not vary with children's age or sex, but was greater for those scoring high in sensation-seeking. A fear-appeals approach proved successful to reduce intended fall-risk behaviors, particularly for children high in sensation-seeking whose risk-taking is motivated by affect arousal.

Reduction of cardiovascular risk after preeclampsia: the role of framing and perceived probability in modifying behavior.

PubMed

Bokslag, Anouk; Hermes, Wietske; de Groot, Christianne J M; Teunissen, Pim W

2016-11-01

To reduce cardiovascular risk after preeclampsia, we investigated the effect of framing, the perceived probability and its interaction, on the willingness to modify behavior. Participants scored their willingness to modify behavior on two cases with different probabilities of developing cardiovascular disease. Both cases were either presented as "chance of health" or "risk of disease". 165 questionnaires were analyzed. ANOVA revealed a significant effect of probability, non-significant effect of framing and a non-significant interaction between probability and framing. Perceived probability influences willingness to modify behavior to reduce cardiovascular risk after preeclampsia; framing and the interaction was not of influence.

Factors Associated with Motivation to Change HIV Risk and Substance Use Behaviors among Homeless Youth

PubMed Central

Collins, Jennifer; Slesnick, Natasha

2011-01-01

This study sought to identify and compare variables associated with motivation to change alcohol, drug use, and HIV risk behaviors among a sample of homeless youths. More frequent alcohol use, older age, and childhood sexual abuse was associated with greater motivation to change alcohol use; higher reported negative consequences of substance use was associated with higher motivation to reduce illicit drug use. Shorter periods of current homelessness predicted higher motivation to change HIV risk behaviors. Findings suggest these areas might be fruitful targets of intervention efforts to enhance motivation to reduce alcohol and illicit drug use and HIV risk behaviors. PMID:21765800

Ethnic Differences in HIV Risk Behaviors Among Methadone-Maintained Women Receiving Contingency Management for Cocaine Use Disorders

PubMed Central

Barry, Danielle; Weinstock, Jeremiah; Petry, Nancy M.

2008-01-01

Objective To identify ethnic differences in HIV risk behaviors among cocaine using women receiving methadone maintenance for opioid dependence, and to evaluate the efficacy of contingency management (CM) for cocaine use disorders in reducing HIV risk behaviors. Methods African American (N=47), Hispanic (N=47), and White women (N = 29) were randomized to standard methadone treatment or standard methadone treatment plus a CM intervention. They completed the HIV Risk Behavior Scale (HRBS) indicating frequency of drug use and sexual behaviors across the lifetime, in the month before baseline, and in the 3 months following clinical trial participation. Ethnic group differences and the effect of CM on change in HIV risk behaviors between baseline and follow-up were evaluated. Results White women reported significantly higher lifetime rates of risky drug use and sexual behaviors on the HRBS than African American women; neither group differed significantly from Hispanic women. No ethnic group differences in HIV risk behaviors were identified in the month prior to baseline. At follow-up, African American women reported fewer high-risk drug use behaviors than White or Hispanic women, and Hispanic women reported more high-risk sexual behaviors than White or African American women. CM was associated with reduction in high-risk drug use behaviors regardless of ethnicity, but did not affect high-risk sexual behaviors. Conclusions White women receiving methadone maintenance engage in more lifetime HIV risk behaviors than African American women. CM for cocaine use reduces risky drug use behaviors, but certain ethnic groups may benefit from additional targeted HIV prevention efforts. PMID:18684571

A family intervention to reduce sexual risk behavior, substance use, and delinquency among newly homeless youth.

PubMed

Milburn, Norweeta G; Iribarren, Francisco Javier; Rice, Eric; Lightfoot, Marguerita; Solorio, Rosa; Rotheram-Borus, Mary Jane; Desmond, Katherine; Lee, Alex; Alexander, Kwame; Maresca, Katherine; Eastmen, Karen; Arnold, Elizabeth Mayfield; Duan, Naihua

2012-04-01

We evaluate the efficacy of a short family intervention in reducing sexual risk behavior, drug use, and delinquent behaviors among homeless youth. A randomized controlled trial of 151 families with a homeless adolescent aged 12 to 17 years. Between March 2006 and June 2009, adolescents were recruited from diverse sites in Southern California and were assessed at recruitment (baseline), and at 3, 6, and 12 months later. Families were randomly assigned to an intervention condition with five weekly home-based intervention sessions or a control condition (standard care). Main outcome measures reflect self-reported sexual risk behavior, substance use, and delinquent behaviors over the past 90 days. Sexual risk behavior (e.g., mean number of partners; p < .001), alcohol use (p = .003), hard drug use (p < .001), and delinquent behaviors (p = .001) decreased significantly more during 12 months in the intervention condition compared with the control condition. Marijuana use, however, significantly increased in the intervention condition compared with the control condition (p < .001). An intervention to reengage families of homeless youth has significant benefits in reducing risk over 12 months. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

AIDS and behavioral change to reduce risk: a review.

PubMed Central

Becker, M H; Joseph, J G

1988-01-01

Published reports describing behavioral changes in response to the threat of AIDS (acquired immunodeficiency syndrome) are reviewed. These studies demonstrate rapid, profound, but expectably incomplete alterations in the behavior of both homosexual/bisexual males and intravenous drug users. This is true in the highest risk metropolitan areas such as New York City and in areas with lower AIDS incidence. Risk reduction is occurring more frequently through the modification of sexual or drug-use behavior than through its elimination. In contrast to aggregate data, longitudinal descriptions of individual behavior demonstrate considerable instability or recidivism. Behavioral change in the potentially vulnerable heterosexual adolescent and young adult populations is less common, as is risk reduction among urban minorities. Reports of AIDS-related knowledge and attitudes generally parallel the pattern of behavioral changes. Nonetheless, few studies investigate the relationship of knowledge and attitudes to risk reduction. Future studies should provide much-needed information about the determinants as well as the magnitude of behavioral changes required to reduce the further spread of AIDS. PMID:3279837

A systematic review of effective interventions for reducing multiple health risk behaviors in adolescence.

PubMed

Hale, Daniel R; Fitzgerald-Yau, Natasha; Viner, Russell Mark

2014-05-01

We systematically searched 9 biomedical and social science databases (1980-2012) for primary and secondary interventions that prevented or reduced 2 or more adolescent health risk behaviors (tobacco use, alcohol use, illicit drug use, risky sexual behavior, aggressive acts). We identified 44 randomized controlled trials of universal or selective interventions and were effective for multiple health risk behaviors. Most were school based, conducted in the United States, and effective for multiple forms of substance use. Effects were small, in line with findings for other universal prevention programs. In some studies, effects for more than 1 health risk behavior only emerged at long-term follow-up. Integrated prevention programs are feasible and effective and may be more efficient than discrete prevention strategies.

Examining relationships between multiple health risk behaviors, well-being, and productivity.

PubMed

Evers, Kerry E; Castle, Patricia H; Prochaska, James O; Prochaska, Janice M

2014-06-01

Traditionally, the concept of health promotion has emphasized the reduction of health risk behaviors to reduce disease and impairment. Well-being research expands this focus to include positive constructs such as thriving, productivity, life-evaluation, and emotional and physical health. The objective of the present study was to examine the relationships between health risk behaviors and specific measures of individual well-being. Participants (N = 790) from 49 states completed a one-time online assessment that included the Life-Evaluation Index, Emotional and Physical Health Ladders, the Health Risk Intervention Assessment, and the Work Productivity and Activity Improvement Questionnaire for General Health. Life Evaluation and physical and emotional health were all inversely related to the number of health risk behaviors, with higher well-being scores associated with lower number of risk behaviors. Across the three Life Evaluation categories (Suffering, Struggling, and Thriving) the number of health risk behaviors decreased, productivity loss decreased, and emotional and physical health increased. The results add to previous research on how reducing multiple health risk behaviors can be combined with well-being, i.e., an emphasis on increasing life-evaluation, emotional and physical health, better functioning, and productivity.

Reliability and validity of a treatment fidelity assessment for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.

PubMed

Seng, Elizabeth K; Lovejoy, Travis I

2013-12-01

This study psychometrically evaluates the Motivational Interviewing Treatment Integrity Code (MITI) to assess fidelity to motivational interviewing to reduce sexual risk behaviors in people living with HIV/AIDS. 74 sessions from a pilot randomized controlled trial of motivational interviewing to reduce sexual risk behaviors in people living with HIV were coded with the MITI. Participants reported sexual behavior at baseline, 3-month, and 6-months. Regarding reliability, excellent inter-rater reliability was achieved for measures of behavior frequency across the 12 sessions coded by both coders; global scales demonstrated poor intraclass correlations, but adequate percent agreement. Regarding validity, principle components analyses indicated that a two-factor model accounted for an adequate amount of variance in the data. These factors were associated with decreases in sexual risk behaviors after treatment. The MITI is a reliable and valid measurement of treatment fidelity for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.

Safety Behaviors among Parents of Preschoolers.

ERIC Educational Resources Information Center

Glik, Deborah; And Others

1993-01-01

Telephone survey examined relationships between safety behaviors to reduce the risk of childhood injury and parents' socioeconomic, psychosocial, and situational characteristics. Results indicated socioeconomic status and maternal stress negatively related to safety behaviors, and risk perceptions positively related to safety behaviors, suggesting…

Conditional economic incentives for reducing HIV risk behaviors: integration of psychology and behavioral economics.

PubMed

Operario, Don; Kuo, Caroline; Sosa-Rubí, Sandra G; Gálarraga, Omar

2013-09-01

This article reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories and behavioral economics can be combined into new approaches for HIV prevention. Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and sexually transmitted infection (STI) prevalence, HIV testing, HIV medication adherence, and drug use. CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PsycINFO Database Record (c) 2013 APA, all rights reserved.

A Systematic Review of Effective Interventions for Reducing Multiple Health Risk Behaviors in Adolescence

PubMed Central

Fitzgerald-Yau, Natasha; Viner, Russell Mark

2014-01-01

We systematically searched 9 biomedical and social science databases (1980–2012) for primary and secondary interventions that prevented or reduced 2 or more adolescent health risk behaviors (tobacco use, alcohol use, illicit drug use, risky sexual behavior, aggressive acts). We identified 44 randomized controlled trials of universal or selective interventions and were effective for multiple health risk behaviors. Most were school based, conducted in the United States, and effective for multiple forms of substance use. Effects were small, in line with findings for other universal prevention programs. In some studies, effects for more than 1 health risk behavior only emerged at long-term follow-up. Integrated prevention programs are feasible and effective and may be more efficient than discrete prevention strategies. PMID:24625172

SOCIAL PSYCHOLOGICAL DYNAMICS OF ENHANCED HIV RISK REDUCTION AMONG PEER INTERVENTIONISTS

PubMed Central

Dickson-Gomez, Julia; Weeks, Margaret R.; Convey, Mark; Li, Jianghong

2014-01-01

The authors present a model of interactive social psychological and relational feedback processes leading to human immunodeficiency virus (HIV) risk reduction behavior change among active drug users trained as Peer Health Advocates (PHAs). The model is supported by data from qualitative interviews with PHAs and members of their drug-using networks in the Risk Avoidance Partnership (RAP) project. Results suggest three mutually reinforcing social psychological processes that motivate PHAs to provide HIV prevention intervention to their peers and to reduce their own risk behaviors: development of a prosocial identity, positive social reinforcement from drug users and community members, and cognitive dissonance associated with continued risk behavior while engaging in health advocacy. These processes directly influence peer interventionists’ motivation and efficacy to continue giving intervention to their peers, and to reduce their HIV risk behaviors. The authors discuss implications of the model for continued research on effective HIV prevention in high-risk groups. PMID:25414528

Predicting Cancer-Prevention Behavior: Disentangling the Effects of Risk Aversion and Risk Perceptions.

PubMed

Riddel, Mary; Hales, David

2018-05-16

Experimental and survey research spanning the last two decades concludes that people who are more risk tolerant are more likely to engage in risky health activities such as smoking and heavy alcohol consumption, and are more likely to be obese. Subjective perceptions of the risk associated with different activities have also been found to be associated with health behaviors. While there are numerous studies that link risk perceptions with risky behavior, it is notable that none of these controls for risk aversion. Similarly, studies that control for risk aversion fail to control for risk misperceptions. We use a survey of 474 men and women to investigate the influence of risk aversion, risk misperceptions, and cognitive ability on the choice to engage in behaviors that either increase or mitigate cancer risk. We measure optimism in two dimensions: baseline optimists are those who inaccurately believe their cancer risk to be below its expert-assessed level, while control optimists are those who believe they can reduce their risk of cancer (by changing their lifestyle choices) to a greater extent than is actually the case. Our results indicate that baseline optimism is significantly and negatively correlated with subjects' tendencies to engage in cancer-risk-reducing behaviors, and positively correlated with risky behaviors. Subjects' control misperceptions also appear to play a role in their tendency to engage in risky and prevention behaviors. When controlling for both of these types of risk misperception, risk aversion plays a much smaller role in determining health behaviors than found in past studies. © 2018 Society for Risk Analysis.

Parent-child communication processes: preventing children's health-risk behavior.

PubMed

Riesch, Susan K; Anderson, Lori S; Krueger, Heather A

2006-01-01

Review individual, family, and environmental factors that predict health-risk behavior among children and to propose parent-child communication processes as a mechanism to mediate them. Improving parent-child communication processes may: reduce individual risk factors, such as poor academic achievement or self-esteem; modify parenting practices such as providing regulation and structure and acting as models of health behavior; and facilitate discussion about factors that lead to involvement in health-risk behaviors. Assessment strategies to identify youth at risk for health-risk behavior are recommended and community-based strategies to improve communication among parents and children need development.

Promoting "Healthy Futures" to Reduce Risk Behaviors in Urban Youth: A Randomized Controlled Trial.

PubMed

Lindstrom Johnson, Sarah; Jones, Vanya; Cheng, Tina L

2015-09-01

There is increasing evidence of the interconnection between educational and health outcomes. Unfortunately wide disparities exist by both socioeconomic status and race/ethnicity in educational and vocational success. This study sought to promote urban youths' career readiness as a way to reduce involvement in risk behaviors. Two hundred primarily African-American youth (ages 14-21) were recruited from a pediatric primary care clinic. Youth randomized to the intervention received three motivational interviewing sessions focused around expectations and planning for the future. Baseline and 6-month follow-up assessments included measures of career readiness and risk behavior involvement (i.e., physical fighting, alcohol and marijuana use). At 6-months, youth randomized to the intervention condition showed increased confidence in their ability to perform the behaviors needed to reach their college/career goals. Additionally, youth randomized to the intervention arm showed decreased fighting behavior (adjusted rate ratio: .27) and marijuana use (adjusted rate ratio: .61). Assisting urban youth in thinking and planning about their future holds promise as a way to reduce their involvement in risk behaviors. This study also demonstrated that motivational interviewing could be used to promote positive behaviors (i.e., career readiness).

School-based programs to reduce sexual risk-taking behaviors.

PubMed

Kirby, D

1992-09-01

This article reviews the major approaches implemented during the last two decades to reduce sexual risk-taking behaviors, examines their evidence for success, and provides several recommendations for effective programs and program evaluations. This article does not discuss more broad-based sexuality education programs which address sexuality in a broader context. Instead, this article focuses primarily on programs that educators believed would reduce unprotected sexual intercourse.

Patient and practitioner perspectives on reducing sedentary behavior at an exercise-based cardiac rehabilitation program.

PubMed

Biswas, Aviroop; Faulkner, Guy E; Oh, Paul I; Alter, David A

2017-06-06

To understand the awareness of sedentary behavior, as well as the perceived facilitators and barriers to reducing sedentary behaviors from the perspectives of patients undertaking an exercise-based cardiac rehabilitation program, and from staff involved in supporting patient self-management. A qualitative study was conducted at a large cardiac rehabilitation program in a metropolitan city in Canada. Guided by an ecological framework, semi-structured interviews were conducted individually with 15 patients, and in two focus groups with six staff. Transcribed interviews were analyzed by thematic analysis. Patients placed little importance on reducing sedentary behavior as they were unconvinced of the health benefits, did not perceive themselves to be sedentary, or associated such behaviors with enjoyment and relaxation. While staff were aware of the risks, they saw them as less critical than other health behaviors. Intrapersonal factors (physical and psychosocial health) and environment factors (the information environment, socio-cultural factors) within leisure time, the home, and work, influenced sedentary behavior. While these findings require further testing, future interventions may be effective if aimed at increasing awareness of the health benefits of reducing sedentary behavior, utilizing existing behavior change strategies, and using a participatory approach to tailor strategies to patients. Implications for rehabilitation Cardiac rehabilitation programs effectively use exercise promotion to improve the health of people with established cardiovascular disease. As sedentary lifestyles become more prevalent, recommendations to reduce the health risks of prolonged sedentary behavior that are specific to the characteristics and prognostic profiles of cardiac rehabilitation patients are needed. Cardiac rehabilitation programs must consider extending existing behavior change strategies utilized for exercise promotion towards addressing sedentary behaviors in order to be effective at reducing the sedentary time of patients. A participatory approach involving both patients and health professionals can support patients in reducing their sedentary behavior by providing a supportive environment for behavior change, increasing awareness and understanding of risks, discussing the feasibility of potential strategies, and setting achievable and actionable goals.

Change IS Possible: Reducing High-Risk Drinking Using a Collaborative Improvement Model.

PubMed

Lanter, Patricia L; Wolff, Kristina B; Johnson, Lisa C; Ercolano, Ellyn M; Kilmer, Jason R; Provost, Lloyd

2015-01-01

To describe the adoption of public health and improvement methodologies to address college students' high-risk drinking behaviors and to aid in prevention efforts. Members of 32 colleges and universities, content experts, and staff members of the National College Health Improvement Program (NCHIP). A 2-year learning collaborative developed by NCHIP trained individuals from 32 different college and universities in using the Plan-Do-Study-Act cycle as a method to create and implement initiatives aimed at reducing students' high-risk drinking behaviors and related harms. Participants experienced success ranging from noteworthy increases in type and amount of interventions directed at reducing high-risk drinking, to creating collaboratives across campus, the local community, and stakeholders. Challenges related to data collection and creating lasting cultural change remain. The use of quality improvement methodologies and creation of a national collaborative successfully effected meaningful change in high-risk drinking behaviors on college campuses.

The Distinct Role of Comparative Risk Perceptions in a Breast Cancer Prevention Program

PubMed Central

Dillard, Amanda J.; Ubel, Peter A.; Smith, Dylan M.; Zikmund-Fisher, Brian J.; Nair, Vijay; Derry, Holly A.; Zhang, Aijun; Pitsch, Rosemarie K.; Alford, Sharon Hensley; McClure, Jennifer B.; Fagerlin, Angela

2013-01-01

Background Comparative risk perceptions may rival other types of information in terms of effects on health behavior decisions. Purpose We examined associations between comparative risk perceptions, affect, and behavior while controlling for absolute risk perceptions and actual risk. Methods Women at an increased risk of breast cancer participated in a program to learn about tamoxifen which can reduce the risk of breast cancer. Women reported comparative risk perceptions of breast cancer and completed measures of anxiety, knowledge, and tamoxifen-related behavior intentions. Three months later, women reported their behavior. Results Comparative risk perceptions were positively correlated with anxiety, knowledge, intentions, and behavior three months later. After controlling for participants’ actual risk of breast cancer and absolute risk perceptions, comparative risk perceptions predicted anxiety and knowledge, but not intentions or behavior. Conclusions Comparative risk perceptions can affect patient outcomes like anxiety and knowledge independently of absolute risk perceptions and actual risk information. PMID:21698518

Motivation to Reduce Risk Behaviors While in Prison: Qualitative Analysis of Interviews with Current and Formerly Incarcerated Women

PubMed Central

Abad, Neetu; Carry, Monique; Herbst, Jeffrey H.; Fogel, Catherine I.

2015-01-01

Prison is an environment in which programs can be implemented to change harmful behaviors among high-risk populations. Incarcerated women experience high rates of HIV and other sexually transmitted diseases (STDs), yet little research has examined women’s motivation to reduce risky behaviors during incarceration. In-depth individual interviews were conducted with former and current women prisoners in two North Carolina correctional facilities and analyzed to identify barriers and facilitators of behavior change while in prison. Analyses revealed key motivators of behavior change: Viewing prison as a place to recover from past trauma, removing oneself from negative social networks, gaining access to needed mental and physical health services, and engaging in self-care and self-reflection. Barriers to behavior change include fear of recidivism, stigma of being in prison, and return to undesirable social networks post-release. Moreover, women noted that the provision of mental health services, educational enhancement and housing assistance could help them reduce engagement in high-risk behaviors after their incarceration. These findings can be incorporated into HIV/STD risk reduction interventions to facilitate positive behavior change among incarcerated women prisoners. Prison itself is a tremendous education in the need for patience and perseverance. It is above all a test of one’s commitment.—Nelson Mandela, 1995 PMID:26693183

Motivation to Reduce Risk Behaviors While in Prison: Qualitative Analysis of Interviews with Current and Formerly Incarcerated Women.

PubMed

Abad, Neetu; Carry, Monique; Herbst, Jeffrey H; Fogel, Catherine I

2013-10-01

Prison is an environment in which programs can be implemented to change harmful behaviors among high-risk populations. Incarcerated women experience high rates of HIV and other sexually transmitted diseases (STDs), yet little research has examined women's motivation to reduce risky behaviors during incarceration. In-depth individual interviews were conducted with former and current women prisoners in two North Carolina correctional facilities and analyzed to identify barriers and facilitators of behavior change while in prison. Analyses revealed key motivators of behavior change: Viewing prison as a place to recover from past trauma, removing oneself from negative social networks, gaining access to needed mental and physical health services, and engaging in self-care and self-reflection. Barriers to behavior change include fear of recidivism, stigma of being in prison, and return to undesirable social networks post-release. Moreover, women noted that the provision of mental health services, educational enhancement and housing assistance could help them reduce engagement in high-risk behaviors after their incarceration. These findings can be incorporated into HIV/STD risk reduction interventions to facilitate positive behavior change among incarcerated women prisoners. Prison itself is a tremendous education in the need for patience and perseverance. It is above all a test of one's commitment.-Nelson Mandela, 1995.

Decrease in Behavioral Problems and Trauma Symptoms Among At-Risk Adopted Children Following Web-Based Trauma-Informed Parent Training Intervention

PubMed Central

Razuri, Erin Becker; Hiles Howard, Amanda R.; Parris, Sheri R.; Call, Casey D.; DeLuna, Jamie Hurst; Hall, Jordan S.; Purvis, Karyn B.; Cross, David R.

2016-01-01

Children who have experienced early adversities are at risk for behavioral problems and trauma symptoms. Using a two-group, pre–post intervention design, the authors evaluated the effectiveness of an online parent training for Trust-Based Relational Intervention, a trauma-informed, attachment-based intervention, in reducing behavioral problems and trauma symptoms in at-risk adopted children. Children of parents in the treatment group (n = 48) demonstrated significant decreases in behavioral problems and trauma symptoms after intervention. Scores for children in a matched-sample control group did not change. Findings suggest this intervention can effectively reduce behavioral problems and trauma symptoms in children with histories of adversities. PMID:26072917

Mediation by peer violence victimization of sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors: pooled youth risk behavior surveys.

PubMed

Rosario, Margaret; Corliss, Heather L; Everett, Bethany G; Russell, Stephen T; Buchting, Francisco O; Birkett, Michelle A

2014-06-01

We examined the role of adolescent peer violence victimization (PVV) in sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex sexual attraction, partners, or identity as sexual minority and the remainder as heterosexual. We had 4 indicators of tobacco and alcohol use and 4 of sexual risk and 2 PVV factors: victimization at school and carrying weapons. We stratified associations by gender and race/ethnicity. PVV was related to disparities in cancer-related risk behaviors of substance use and sexual risk, with odds ratios (ORs) of 1.3 (95% confidence interval [CI] = 1.03, 1.6) to 11.3 (95% CI = 6.2, 20.8), and to being a sexual minority, with ORs of 1.4 (95% CI = 1.1, 1.9) to 5.6 (95% CI = 3.5, 8.9). PVV mediated sexual orientation disparities in substance use and sexual risk behaviors. Findings were pronounced for adolescent girls and Asian/Pacific Islanders. Interventions are needed to reduce PVV in schools as a way to reduce sexual orientation disparities in cancer risk across the life span.

Gender-based violence, alcohol use, and sexual risk among female patrons of drinking venues in Cape Town, South Africa.

PubMed

Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Cain, Demetria; Sikkema, Kathleen J; Skinner, Donald; Watt, Melissa H; Pieterse, Desiree

2013-06-01

Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior.

Gender-based Violence, Alcohol use, and Sexual Risk Among Female Patrons of Drinking Venues in Cape Town, South Africa

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Cain, Demetria; Sikkema, Kathleen J.; Skinner, Donald; Watt, Melissa H.; Pieterse, Desiree

2013-01-01

Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior. PMID:22526526

Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up.

PubMed

Feldman, Adina L; Long, Gráinne H; Johansson, Ingegerd; Weinehall, Lars; Fhärm, Eva; Wennberg, Patrik; Norberg, Margareta; Griffin, Simon J; Rolandsson, Olov

2017-03-29

Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk. Population-based prospective cohort study of 35,680 participants aged 30-50 at baseline in 1990-2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes. Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score. These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes burden in the population and might be a suitable target for public health intervention.

Cognitive-Behavioral and Pharmacologic Interventions for Children's Distress during Painful Medical Procedures.

ERIC Educational Resources Information Center

Jay, Susan M.; And Others

1987-01-01

Evaluated efficacy of cognitive-behavioral intervention package and low-risk pharmacologic intervention (oral Valium) as compared with minimal treatment-attention control condition, in reducing children leukemia patients' distress during bone marrow aspirations. The cognitive-behavioral therapy reduced behavioral distress, pain ratings and pulse…

Cumulative Effects of Mothers' Risk and Promotive Factors on Daughters' Disruptive Behavior

ERIC Educational Resources Information Center

van der Molen, Elsa; Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

2012-01-01

Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043).…

The Age of Initiation of Drug Use and Sexual Behavior May Influence Subsequent HIV Risk Behavior: A Systematic Review

PubMed Central

Potrepka, Jessica; Copenhaver, Michael

2013-01-01

Researchers examining injection drug users (IDUs) in drug treatment have been trying for decades to determine the optimal way to intervene to prevent the transmission and spread of human immunodeficiency virus (HIV) in this population. Although efficacious HIV risk reduction interventions are widely available, questions remain about what specific factors are most related to HIV risk behavior and defined as unprotected sexual activity and/or high risk drug use. This review involved an evaluation of the research literature in order to better understand the association between drug use and sexual behavior debut on HIV risk behavior. Findings suggest that drug use debut and sexual behavior debut may be related to subsequent HIV risk behavior. Evidence to date implies that intervening at an earlier age to assist youth to avoid or delay these high risk behaviors may be an additional means of reducing subsequent HIV risk. PMID:24381791

School-based programs to reduce sexual risk behaviors: a review of effectiveness.

PubMed Central

Kirby, D; Short, L; Collins, J; Rugg, D; Kolbe, L; Howard, M; Miller, B; Sonenstein, F; Zabin, L S

1994-01-01

This review was undertaken in recognition of the mounting public health and social problems associated with adolescent sexual behavior and the importance of basing school-affiliated programs designed to reduce sexual risk-taking behavior on sound research. The authors were commissioned by the Division of Adolescent and School Health within the Centers for Disease Control and Prevention, Public Health Service, to review carefully the research on these programs and to assess their impact on behavior. The authors identified 23 studies of school-based programs that were published in professional journals and measured program impact on behavior. They then summarized the results of those studies, identifying the distinguishing characteristics of effective programs, and citing important research questions to be addressed in the future. Not all sex and AIDS education programs had significant effects on adolescent sexual risk-taking behavior, but specific programs did delay the initiation of intercourse, reduce the frequency of intercourse, reduce the number of sexual partners, or increase the use of condoms or other contraceptives. These effective programs have the potential to reduce exposure to unintended pregnancy and sexually transmitted disease, including HIV infection. These programs should be replicated widely in U.S. schools. Additional research is needed to improve the effectiveness of programs and to clarify the most important characteristics of effective programs. PMID:8190857

Cognitive-Behavioral Therapy for PTSD and Depression Symptoms Reduces Risk for Future Intimate Partner Violence among Interpersonal Trauma Survivors

ERIC Educational Resources Information Center

Iverson, Katherine M.; Gradus, Jaimie L.; Resick, Patricia A.; Suvak, Michael K.; Smith, Kamala F.; Monson, Candice M.

2011-01-01

Objective: Women who develop symptoms of posttraumatic stress disorder (PTSD) and depression subsequent to interpersonal trauma are at heightened risk for future intimate partner violence (IPV) victimization. Cognitive-behavioral therapy (CBT) is effective in reducing PTSD and depression symptoms, yet limited research has investigated the…

Motivational interviewing by HIV care providers is associated with patient intentions to reduce unsafe sexual behavior.

PubMed

Flickinger, Tabor E; Rose, Gary; Wilson, Ira B; Wolfe, Hannah; Saha, Somnath; Korthuis, Philip Todd; Massa, Michele; Berry, Stephen; Laws, Michael Barton; Sharp, Victoria; Moore, Richard D; Beach, Mary Catherine

2013-10-01

Motivational interviewing (MI) can promote behavior change, but HIV care providers rarely have training in MI. Little is known about the use of MI-consistent behavior among untrained providers. This study examines the prevalence of such behaviors and their association with patient intentions to reduce high-risk sexual behavior. Audio-recorded visits between HIV-infected patients and their healthcare providers were searched for counseling dialog regarding sexual behavior. The association of providers' MI-consistence with patients' statements about behavior change was assessed. Of 417 total encounters, 27 met inclusion criteria. The odds of patient commitment to change were higher when providers used more reflections (p=0.017), used more MI consistent utterances (p=0.044), demonstrated more empathy (p=0.049), and spent more time discussing sexual behavior (p=0.023). Patients gave more statements in favor of change (change talk) when providers used more reflections (p<0.001) and more empathy (p<0.001), even after adjusting for length of relevant dialog. Untrained HIV providers do not consistently use MI techniques when counseling patients about sexual risk reduction. However, when they do, their patients are more likely to express intentions to reduce sexual risk behavior. MI holds promise as one strategy to reduce transmission of HIV and other sexually transmitted infections. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A longitudinal study of the prevalence, development, and persistence of HIV/sexually transmitted infection risk behaviors in delinquent youth: implications for health care in the community.

PubMed

Romero, Erin Gregory; Teplin, Linda A; McClelland, Gary M; Abram, Karen M; Welty, Leah J; Washburn, Jason J

2007-05-01

Our goal was to examine the prevalence, development, and persistence of drug and sex risk behaviors that place delinquent youth at risk for HIV and other sexually transmitted infections. At the baseline interview, HIV/sexually transmitted infection drug and sex risk behaviors were assessed in a stratified random sample of 800 juvenile detainees aged 10 to 18 years. Participants were reinterviewed approximately 3 years later. The final sample in these analyses (n = 724) included 316 females and 408 males; there were 393 African American participants, 198 Hispanic participants, 131 non-Hispanic white participants, and 2 participants who self-identified their race as "other." More than 60% of youth had engaged in > or = 10 risk behaviors at their baseline interview, and nearly two thirds of them persisted in > or = 10 risk behaviors at follow-up. Among youth living in the community, many behaviors were more prevalent at follow-up than at baseline. Among incarcerated youth, the opposite pattern prevailed. Compared with females, males had higher prevalence rates of many HIV/sexually transmitted infection risk behaviors and were more likely to persist in some behaviors and develop new ones. Yet, injection risk behaviors were more prevalent among females than males and were also more likely to develop and persist. Overall, there were few racial and ethnic differences in patterns of HIV/sexually transmitted infection risk behaviors; most involved the initiation and persistence of substance use among non-Hispanic whites and Hispanics. Because detained youth have a median stay of only 2 weeks, HIV/sexually transmitted infection risk behaviors in delinquent youth are a community public health problem, not just a problem for the juvenile justice system. Improving the coordination among systems that provide HIV/sexually transmitted infection interventions to youth--primary care, education, mental health, and juvenile justice--can reduce the prevalence of risk behaviors and substantially reduce the spread of HIV/sexually transmitted infection in young people.

Effects of a Family Intervention in Reducing HIV Risk Behaviors Among High-Risk Hispanic Adolescents

PubMed Central

Prado, Guillermo; Pantin, Hilda; Huang, Shi; Cordova, David; Tapia, Maria I.; Velazquez, Maria-Rosa; Calfee, Meghan; Malcolm, Shandey; Arzon, Margaret; Villamar, Juan; Jimenez, Giselle Leon; Cano, Nicole; Brown, C. Hendricks; Estrada, Yannine

2013-01-01

Objective To determine the efficacy of a family intervention in reducing human immunodeficiency virus (HIV) risk behaviors among Hispanic delinquent adolescents. Design Randomized controlled trial. Setting Miami–Dade County Public School System and Miami–Dade County’s Department of Juvenile Services, Florida. Participants A total of 242 Hispanic delinquent youth aged 12 to 17 years and their primary caregivers completed outcome assessments at baseline and 3 months after intervention. Intervention Participants were randomized to either Familias Unidas (120 participants), a Hispanic-specific, family intervention designed to reduce HIV risk behaviors among Hispanic youth, or a community practice control condition (122 participants). Main Outcome Measures Self-reported measures included unprotected sexual behavior, engaging in sex while under the influence of alcohol and/or drugs, number of sexual partners, and incidence of sexually transmitted diseases. Family functioning (eg, parent-adolescent communication, positive parenting, and parental monitoring) was also assessed via self-report measures. Results Compared with community practice, Familias Unidas was efficacious in increasing condom use during vaginal and anal sex during the past 90 days, reducing the number of days adolescents were under the influence of drugs or alcohol and had sex without a condom, reducing sexual partners, and preventing unprotected anal sex at the last sexual intercourse. Familias Unidas was also efficacious, relative to community practice, in increasing family functioning and most notably in increasing parent-adolescent communication and positive parenting. Conclusion These results suggest that culturally tailored, family-centered prevention interventions may be appropriate and efficacious in reducing HIV risk behaviors among Hispanic delinquent adolescents. Trial Registration clinicaltrials.gov Identifier: NCT01257022 PMID:21969363

Longitudinal Prediction of Disruptive Behavior Disorders in Adolescent Males from Multiple Risk Domains

PubMed Central

Trentacosta, Christopher J.; Hyde, Luke W.; Goodlett, Benjamin D.; Shaw, Daniel S.

2012-01-01

The disruptive behavior disorders are among the most prevalent youth psychiatric disorders, and they predict numerous problematic outcomes in adulthood. This study examined multiple domains of risk during early childhood and early adolescence as longitudinal predictors of disruptive behavior disorder diagnoses among adolescent males. Early adolescent risks in the domains of sociodemographic factors, the caregiving context, and youth attributes were examined as mediators of associations between early childhood risks and disruptive behavior disorder diagnoses. Participants were 309 males from a longitudinal study of low-income mothers and their sons. Caregiving and youth risk during early adolescence each predicted the likelihood of receiving a disruptive behavior disorder diagnosis. Furthermore, sociodemographic and caregiving risk during early childhood were indirectly associated with disruptive behavior disorder diagnoses via their association with early adolescent risk. The findings suggest that preventive interventions targeting risk across domains may reduce the prevalence of disruptive behavior disorders. PMID:23239427

Lifestyle and risk of premature sexual activity in a high school population of Seventh-Day Adventists: Valuegenesis 1989.

PubMed

Weinbender, M L; Rossignol, A M

1996-01-01

In the past 20 years, sexually transmitted diseases (STDs), including AIDS, and the physical, psychological, and economic difficulties associated with unwanted pregnancy have increased steadily among American adolescents. The objective of this study was to evaluate Adventist lifestyle as a modification of popular American culture which reduces the risk of early sexual activity in adolescents and thus also reduces the risk for both STDs and teen pregnancy. The study was based on 8,321 respondents to a questionnaire concerning specific behaviors, beliefs, and attitudes among Seventh-Day Adventist youth attending 58 high schools in North American. Analysis of the data demonstrated that a wide variety of behaviors were associated with premature sexual activity, including previously reported high-risk behaviors such as drug or alcohol use. In addition, several behaviors that are discouraged within Adventist culture, such as going to a movie theater or participating in competitive sports, also were associated with early sexual activity. It is hypothesized that these latter behaviors may predict the emergence of other high-risk behaviors, such as early sexual activity, in both Adventist and popular cultures, and thus may be "transition-marking behaviors" as described by Jessor and Jessor (1975).

Subjective well-being and cardiometabolic health: An 8-11year study of midlife adults.

PubMed

Boehm, Julia K; Chen, Ying; Williams, David R; Ryff, Carol D; Kubzansky, Laura D

2016-06-01

Individuals who are satisfied and experience frequent positive emotions tend to have reduced risk for coronary heart disease (CHD). However, conflicting evidence exists and little research has investigated whether well-being is associated with early-warning indicators of biological risk that precede CHD. We investigated whether life satisfaction and positive emotions longitudinally predicted reduced risk of incident cardiometabolic conditions and healthier cardiometabolic risk scores, which may provide insight into underlying mechanisms and novel prevention targets. Initially healthy men and women (N=754-854) reported their baseline life satisfaction and positive emotions. During follow-up, presence of manifest cardiometabolic conditions was assessed and a separate cardiometabolic risk score was constructed from eight biomarkers. Poisson and linear regression analyses tested whether life satisfaction and positive emotions were associated with reduced incident disease risk and lower cardiometabolic risk scores 8-11years later. Life satisfaction and positive emotions were each prospectively associated with reduced risk of manifest conditions, controlling for demographics and family history of CHD. Associations were attenuated for positive emotions after adjusting for depressive symptoms and for life satisfaction after adjusting for health behaviors. Life satisfaction was associated with lower cardiometabolic risk scores until adding health behaviors, but positive emotions were not (regardless of the included covariates). Well-being, particularly life satisfaction, is associated with reduced risk for incident cardiometabolic conditions in minimally-adjusted models. However, accounting for underlying behavioral pathways attenuates the association. Low levels of life satisfaction (but not positive emotions) may also provide early warning of cardiometabolic risk prior to disease development. Copyright © 2016 Elsevier Inc. All rights reserved.

Mediation by Peer Violence Victimization of Sexual Orientation Disparities in Cancer-Related Tobacco, Alcohol, and Sexual Risk Behaviors: Pooled Youth Risk Behavior Surveys

PubMed Central

Corliss, Heather L.; Everett, Bethany G.; Russell, Stephen T.; Buchting, Francisco O.; Birkett, Michelle A

2014-01-01

Objectives. We examined the role of adolescent peer violence victimization (PVV) in sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors. Methods. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex sexual attraction, partners, or identity as sexual minority and the remainder as heterosexual. We had 4 indicators of tobacco and alcohol use and 4 of sexual risk and 2 PVV factors: victimization at school and carrying weapons. We stratified associations by gender and race/ethnicity. Results. PVV was related to disparities in cancer-related risk behaviors of substance use and sexual risk, with odds ratios (ORs) of 1.3 (95% confidence interval [CI] = 1.03, 1.6) to 11.3 (95% CI = 6.2, 20.8), and to being a sexual minority, with ORs of 1.4 (95% CI = 1.1, 1.9) to 5.6 (95% CI = 3.5, 8.9). PVV mediated sexual orientation disparities in substance use and sexual risk behaviors. Findings were pronounced for adolescent girls and Asian/Pacific Islanders. Conclusions. Interventions are needed to reduce PVV in schools as a way to reduce sexual orientation disparities in cancer risk across the life span. PMID:24825215

Pilot Study: Implementing a Brief DBT Skills Program in Schools to Reduce Health Risk Behaviors among Early Adolescents

ERIC Educational Resources Information Center

Zapolski, Tamika C. B.; Smith, Gregory T.

2017-01-01

A significant proportion of youth engage in health risk behaviors, which are of concern, as they are associated with adverse health consequences across development. Two factors associated with engagement in such behaviors are emotion dysregulation and impulsivity. Dialectical behavioral therapy (DBT) is an effective intervention that enhances…

Experiential Exposure to Texting and Walking in Virtual Reality: A Randomized Trial to Reduce Distracted Pedestrian Behavior

PubMed Central

Schwebel, David C.; McClure, Leslie A.; Porter, Bryan E.

2017-01-01

Background Distracted pedestrian behavior is a significant public health concern, as research suggests distracted pedestrians have significantly higher risk of injury compared to fully attentive pedestrians. Despite this, efforts to reduce distracted pedestrian behavior are scant. Objective Using a repeated measures experimental research design, we implemented a behavioral intervention to reduce distracted pedestrian behavior in the high-risk environment of an urban college campus and simultaneously monitored behavior on a control urban college campus not exposed to the intervention. We had two primary aims: reduce perceived vulnerability to injury among individual pedestrians and reduce distracted pedestrian behavior in the environment through a change in community-based norms. Methods The hallmark of the behavioral intervention was a week-long opportunity for community members to experience personally the risks of distracted pedestrian behavior by attempting to cross a virtual pedestrian environment street while text-messaging. This was supplemented by traditional and social marketing and publicity through various campus partners. A sample of 219 individuals completed self-report surveys about perceived vulnerability to distracted pedestrian injury before experiencing the distracted virtual street-crossing and again after 2 weeks and 5 months. Observational assessment of distracted pedestrian behavior was conducted at a busy intersection on the campus as well as at a control campus not exposed to the intervention at baseline, post-intervention, 10 weeks, and 6 months. Results The intervention achieved mixed results. Individuals exposed to texting within a simulated pedestrian environment reported changes in their intentions to cross streets while distracted and in perceived vulnerability to risk while crossing streets, but we did not witness evidence of changed community norms based on observed rates of distracted pedestrian behavior before and after the intervention compared to a control campus not exposed to the intervention. Discussion The intervention created some change in self-reported intentions and thoughts but did not create significant behavior change on the campus exposed to it. Further efforts to develop interventions that will yield a reduction in distracted pedestrian behavior are needed. PMID:28279843

Experiential exposure to texting and walking in virtual reality: A randomized trial to reduce distracted pedestrian behavior.

PubMed

Schwebel, David C; McClure, Leslie A; Porter, Bryan E

2017-05-01

Distracted pedestrian behavior is a significant public health concern, as research suggests distracted pedestrians have significantly higher risk of injury compared to fully attentive pedestrians. Despite this, efforts to reduce distracted pedestrian behavior are scant. Using a repeated measures experimental research design, we implemented a behavioral intervention to reduce distracted pedestrian behavior in the high-risk environment of an urban college campus and simultaneously monitored behavior on a control urban college campus not exposed to the intervention. We had two primary aims: reduce perceived vulnerability to injury among individual pedestrians and reduce distracted pedestrian behavior in the environment through a change in community-based norms. The hallmark of the behavioral intervention was a week-long opportunity for community members to experience personally the risks of distracted pedestrian behavior by attempting to cross a virtual pedestrian environment street while text-messaging. This was supplemented by traditional and social marketing and publicity through various campus partners. A sample of 219 individuals completed self-report surveys about perceived vulnerability to distracted pedestrian injury before experiencing the distracted virtual street-crossing and again after 2 weeks and 5 months. Observational assessment of distracted pedestrian behavior was conducted at a busy intersection on the campus as well as at a control campus not exposed to the intervention at baseline, post-intervention, 10 weeks, and 6 months. The intervention achieved mixed results. Individuals exposed to texting within a simulated pedestrian environment reported changes in their intentions to cross streets while distracted and in perceived vulnerability to risk while crossing streets, but we did not witness evidence of changed community norms based on observed rates of distracted pedestrian behavior before and after the intervention compared to a control campus not exposed to the intervention. The intervention created some change in self-reported intentions and thoughts but did not create significant behavior change on the campus exposed to it. Further efforts to develop interventions that will yield a reduction in distracted pedestrian behavior are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Behavioral Health and Performance (BHP) Work-Rest Cycles

NASA Technical Reports Server (NTRS)

Leveton, Lauren B.; Whitmire, Alexandra

2011-01-01

BHP Program Element Goal: Identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration and return to terrestrial life. BHP Requirements: a) Characterize and assess risks (e.g., likelihood and consequences). b) Develop tools and technologies to prevent, monitor, and treat adverse outcomes. c) Inform standards. d) Develop technologies to: 1) reduce risks and human systems resource requirements (e.g., crew time, mass, volume, power) and 2) ensure effective human-system integration across exploration mission.

Setting government priorities in preventing HIV / AIDS.

PubMed

Ainsworth, M

1998-03-01

Since no cure has yet been found for AIDS and an effective vaccine is far off, preventing HIV infection by changing individual behavior is the key to stopping the AIDS epidemic in developing countries. People who have many sex partners and do not use condoms, and people who inject drugs and share unsterilized injecting equipment have the greatest risk of contracting HIV and infecting others. How quickly and extensively an HIV/AIDS epidemic spreads in a given population depends largely upon the extent to which people with many sex partners mix with people with fewer partners. A World Bank research report has, however, found that people who engage in high-risk behavior act to reduce their risk of contracting and spreading HIV when they have the knowledge and means to do so and a supportive community. The report highlights the following strategies to reduce risky behavior: providing information, lowering the costs of safer behavior, and raising the costs of risky behavior. Governments' main responsibilities in preventing the spread of HIV/AIDS are reducing the negative externalities of high-risk behavior and producing public goods. Without government action, individuals and firms will not have the incentives to do what is necessary. The need to act now and mobilizing political support are discussed.

Exploring Contextual Factors of Youth Homelessness And Sexual Risk Behaviors: A Qualitative Study.

PubMed

Santa Maria, Diane; Narendorf, Sarah C; Ha, Yoonsook; Bezette-Flores, Noel

2015-12-01

HIV disproportionately affects homeless youth, and interventions to date have had minimal success in reducing sexual risk behaviors in this population. Few qualitative studies have been conducted to provide insight into the influence of homelessness-related factors on sexual risk behaviors. A qualitative study with a quantitative component was conducted with a nonprobability sample of 64 homeless youth aged 14-24; participants were recruited from a variety of venues in Houston between October 2013 and March 2014. Thirteen focus group discussions were conducted; thematic analysis was used to identify themes related to HIV risk. Participants were predominantly black (75%), sheltered (67%) and aged 18 or older (77%). Youth discussed how the circumstances of their homelessness and the struggle to meet their immediate needs led to behaviors and experiences that put them at risk for HIV. Three themes emerged: Homeless youth frequently engage in risky sexual behavior, sometimes as a way to cope with stress; they often trade sex, either voluntarily or involuntarily, for such necessities as money or a place to sleep; and many experienced childhood sexual victimization or have been victimized since becoming homeless. Youth also described how stress, stigma and self-reliance contributed to their involvement in HIV risk behaviors. HIV prevention methods that target stress and stigma while respecting youths' self-reliance may help reduce sexual risk behaviors. Further research is needed to determine suitable behavioral change techniques to address these potentially modifiable factors. Copyright © 2015 by the Guttmacher Institute.

Analysis of Risk Compensation Behavior on Night Vision Enhancement System

NASA Astrophysics Data System (ADS)

Hiraoka, Toshihiro; Masui, Junya; Nishikawa, Seimei

Advanced driver assistance systems (ADAS) such as a forward obstacle collision warning system (FOCWS) and a night vision enhancement system (NVES) aim to decrease driver's mental workload and enhance vehicle safety by provision of useful information to support driver's perception process and judgment process. On the other hand, the risk homeostasis theory (RHT) cautions that an enhanced safety and a reduced risk would cause a risk compensation behavior such as increasing the vehicle velocity. Therefore, the present paper performed the driving simulator experiments to discuss dependence on the NVES and emergence of the risk compensation behavior. Moreover, we verified the side-effects of spontaneous behavioral adaptation derived from the presentation of the fuel-consumption meter on the risk compensation behavior.

The Use of Protective Behavioral Strategies Is Related to Reduced Risk in Heavy Drinking College Students with Poorer Mental and Physical Health

ERIC Educational Resources Information Center

LaBrie, Joseph W.; Kenney, Shannon R.; Lac, Andrew

2010-01-01

The present study examined the moderating role of health status (physical, mental, and social health) and the relationships between protective behavioral strategies utilized to reduce high-risk drinking (e.g., avoiding drinking games, setting consumption limits, or having a designated driver) and alcohol use and negative consequences in a sample…

After School: Connecting Children at Risk with Responsible Adults to Help Reduce Youth Substance Abuse and Other Health-Compromising Behaviors--An RWJF National Program. Program Results Reports

ERIC Educational Resources Information Center

Robert Wood Johnson Foundation, 2008

2008-01-01

"After School: Connecting Children at Risk With Responsible Adults to Help Reduce Youth Substance Abuse and Other Health-Compromising Behaviors (After School)" helped develop intermediary organizations in Boston, Chicago and the San Francisco Bay Area in order to create citywide systems of after-school programs. The…

The Role of Hedonic Behavior in Reducing Perceived Risk

PubMed Central

Jia, Jayson S.; Jia, Jianmin; Hsee, Christopher K.; Shiv, Baba

2016-01-01

Understanding how human populations naturally respond to and cope with risk is important for fields ranging from psychology to public health. We used geophysical and individual-level mobile-phone data (mobile-apps, telecommunications, and Web usage) of 157,358 victims of the 2013 Ya’an earthquake to diagnose the effects of the disaster and investigate how experiencing real risk (at different levels of intensity) changes behavior. Rather than limiting human activity, higher earthquake intensity resulted in graded increases in usage of communications apps (e.g., social networking, messaging), functional apps (e.g., informational tools), and hedonic apps (e.g., music, videos, games). Combining mobile data with a field survey (N = 2,000) completed 1 week after the earthquake, we use an instrumental-variable approach to show that only increases in hedonic behavior reduced perceived risk. Thus, hedonic behavior could potentially serve as a population-scale coping and recovery strategy that is often missing in risk management and policy considerations. PMID:27881710

The Role of Hedonic Behavior in Reducing Perceived Risk.

PubMed

Jia, Jayson S; Jia, Jianmin; Hsee, Christopher K; Shiv, Baba

2017-01-01

Understanding how human populations naturally respond to and cope with risk is important for fields ranging from psychology to public health. We used geophysical and individual-level mobile-phone data (mobile-apps, telecommunications, and Web usage) of 157,358 victims of the 2013 Ya'an earthquake to diagnose the effects of the disaster and investigate how experiencing real risk (at different levels of intensity) changes behavior. Rather than limiting human activity, higher earthquake intensity resulted in graded increases in usage of communications apps (e.g., social networking, messaging), functional apps (e.g., informational tools), and hedonic apps (e.g., music, videos, games). Combining mobile data with a field survey ( N = 2,000) completed 1 week after the earthquake, we use an instrumental-variable approach to show that only increases in hedonic behavior reduced perceived risk. Thus, hedonic behavior could potentially serve as a population-scale coping and recovery strategy that is often missing in risk management and policy considerations.

[Meta-analysis on the effects of health education towards HIV/AIDS high-risk behavior, knowledge, and related attitude among floating population in China].

PubMed

Chen, Lan-xin; Liang, Hao; Yang, Xiao-bo

2012-01-01

To evaluate the effects of health education on HIV/AIDS high-risk behaviors, knowledge, and attitude among floating population in China. A computerized literature searching was carried out in Chinese Biomedical Database, Chinese National Knowledge Infrastructure, Wan Fang and VIP databases to collect articles published in China between 2005 and 2010. Words as "AIDS", "Floating Population", "Intervention", "Health Education", "High-risk Behavior" were used. Type of studies would include "self-control intervention studies or studies containing sections of self-control intervention". Meta-analyses were performed to assess 8 outcomes which targeting on high-risk behavior, knowledge and attitudes of AIDS. RevMan 4.2 software was used to analyze the intervention effects for these indexes. After the interventions, the rate on awareness of "Whether condoms can reduce the HIV/AIDS infection risk" increased by 23% [rate difference (RD) 95%CI: 0.19, 0.27] and "Whether keeping monogamous sexual relationship can reduce the risk of infection" increased by 18% (RD 95%CI: 0.14, 0.23). The proportion of "Willing to use condoms in sexual life" increased by 16% (RD 95%CI: 0.11, 0.22); and "The incidence of commercial sex behaviors" reduced by 6% (RD 95%CI: -0.11, -0.02). "The Ratio of condom use during commercial sex behaviors" increased by 17% (RD 95%CI: 0.10, 0.23). and "Recent use of condoms during sex" increased by 25% (RD 95%CI: 0.15, 0.35). All the data showed significant differences (P < 0.01), respectively. After health education, great improvements were found for HIV-related sexual knowledge, attitudes, and behaviors among the floating population.

Psychological and behavioral interventions to reduce HIV risk: evidence from a randomized control trial among orphaned and vulnerable adolescents in South Africa

PubMed Central

Thurman, T. R.; Kidman, R.; Carton, T. W.; Chiroro, P.

2016-01-01

ABSTRACT Evidence-based approaches are needed to address the high levels of sexual risk behavior and associated HIV infection among orphaned and vulnerable adolescents. This study recruited adolescents from a support program for HIV-affected families and randomly assigned them by cluster to receive one of the following: (1) a structured group-based behavioral health intervention; (2) interpersonal psychotherapy group sessions; (3) both interventions; or (4) no new interventions. With 95% retention, 1014 adolescents were interviewed three times over a 22-month period. Intent-to-treat analyses, applying multivariate difference-in-difference probit regressions, were performed separately for boys and girls to assess intervention impacts on sexual risk behaviors. Exposure to a single intervention did not impact behaviors. Exposure to both interventions was associated with risk-reduction behaviors, but the outcomes varied by gender: boys reported fewer risky sexual partnerships (β = −.48, p = .05) and girls reported more consistent condom (β = 1.37, p = .02). There was no difference in the likelihood of sexual debut for either gender. Providing both psychological and behavioral interventions resulted in long-term changes in sexual behavior that were not present when either intervention was provided in isolation. Multifaceted approaches for reducing sexual risk behaviors among vulnerable adolescents hold significant promise for mitigating the HIV epidemic among this priority population. PMID:26886261

Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda.

PubMed

Bunnell, Rebecca; Ekwaru, John Paul; Solberg, Peter; Wamai, Nafuna; Bikaako-Kajura, Winnie; Were, Willy; Coutinho, Alex; Liechty, Cheryl; Madraa, Elizabeth; Rutherford, George; Mermin, Jonathan

2006-01-02

The impact of antiretroviral therapy (ART) on sexual risk behavior and HIV transmission among HIV-infected persons in Africa is unknown. To assess changes in risky sexual behavior and estimated HIV transmission from HIV-infected adults after 6 months of ART. A prospective cohort study was performed in rural Uganda. Between May 2003 and December 2004 a total of 926 HIV-infected adults were enrolled and followed in a home-based ART program that included prevention counselling, voluntary counseling and testing (VCT) for cohabitating partners and condom provision. At baseline and follow-up, participants' HIV plasma viral load and partner-specific sexual behaviors were assessed. Risky sex was defined as inconsistent or no condom use with partners of HIV-negative or unknown serostatus in the previous 3 months. The rates of risky sex were compared using a Poisson regression model and transmission risk per partner was estimated, based on established viral load-specific transmission rates. Six months after initiating ART, risky sexual behavior reduced by 70% [adjusted risk ratio, 0.3; 95% confidence interval (CI), 0.2-0.7; P = 0.0017]. Over 85% of risky sexual acts occurred within married couples. At baseline, median viral load among those reporting risky sex was 122 500 copies/ml, and at follow-up, < 50 copies/ml. Estimated risk of HIV transmission from cohort members declined by 98%, from 45.7 to 0.9 per 1000 person years. Providing ART, prevention counseling, and partner VCT was associated with reduced sexual risk behavior and estimated risk of HIV transmission among HIV-infected Ugandan adults during the first 6 months of therapy. Integrated ART and prevention programs may reduce HIV transmission in Africa.

Does Predation Risk Affect Mating Behavior? An Experimental Test in Dumpling Squid (Euprymna tasmanica)

PubMed Central

Franklin, Amanda M.; Squires, Zoe E.; Stuart-Fox, Devi

2014-01-01

Introduction One of the most important trade-offs for many animals is that between survival and reproduction. This is particularly apparent when mating increases the risk of predation, either by increasing conspicuousness, reducing mobility or inhibiting an individual's ability to detect predators. Individuals may mitigate the risk of predation by altering their reproductive behavior (e.g. increasing anti-predator responses to reduce conspicuousness). The degree to which individuals modulate their reproductive behavior in relation to predation risk is difficult to predict because both the optimal investment in current and future reproduction (due to life-history strategies) and level of predation risk may differ between the sexes and among species. Here, we investigate the effect of increased predation risk on the reproductive behavior of dumpling squid (Euprymna tasmanica). Results Females, but not males, showed a substantial increase in the number of inks (an anti-predator behavior) before mating commenced in the presence of a predator (sand flathead Platycephalus bassensis). However, predation risk did not affect copulation duration, the likelihood of mating, female anti-predator behavior during or after mating or male anti-predator behavior at any time. Conclusions Inking is a common anti-predator defense in cephalopods, thought to act like a smokescreen, decoy or distraction. Female dumpling squid are probably using this form of defense in response to the increase in predation risk prior to mating. Conversely, males were undeterred by the increase in predation risk. A lack of change in these variables may occur if the benefit of completing mating outweighs the risk of predation. Prioritizing current reproduction, even under predation risk, can occur when the chance of future reproduction is low, there is substantial energetic investment into mating, or the potential fitness payoffs of mating are high. PMID:25551378

Driver distraction: a perennial but preventable public health threat to adolescents.

PubMed

Bingham, C Raymond

2014-05-01

Although public health efforts have made some progress in reducing risk of adolescent motor vehicle crashes over the last three decades, new technologies and evolving behavior patterns have focused attention on the risk of distracted driving. For many of the same reasons that alcohol-impaired driving represents a distinct risk for adolescents, distracted driving has an elevated impact on this age group. Similarly, many of the strategies used to reduce alcohol-impaired driving among adolescents might be applied to driver distraction, including adults serving as role models with high standards of behavior. The unique challenge posed by the proliferation of new technological distractions may accelerate this risk behavior and may lend itself to innovative prevention efforts. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The Relationship between Sexual Behavior and Non-sexual Risk Behaviors among Unmarried Youth in Three Asian Cities

PubMed Central

Tu, Xiaowen; Lou, Chaohua; Gao, Ersheng; Li, Nan; Zabin, Laurie S.

2014-01-01

Background: Health risk behaviors in adolescents and youth such as smoking, alcohol, drug use, violence, suicide, and unprotected sexual behavior are issues of major public health concern. Addressing the relationship between sexual behavior and non-sexual risk behaviors will make a significant contribution to the design of effective intervention programs for this population of adolescents and unmarried youth. Methods: This cross-sectional study was conducted in three Asian cities with a common heritage of Confucian values: Hanoi, Shanghai and Taipei. Data were collected in 2006 from 17,016 youth aged 15-24 years residing in both urban and rural districts of the three settings. The relationships between sexual behavior and seven non-sexual risk behaviors among unmarried adolescents were examined using χ2 tests, logistic regression models, Cox regression models, and cluster analysis. Results: Sexual behavior was associated with seven non-sexual risk behaviors, especially with smoking, drinking, drug use and running away from home. In terms of the age at initiation of risk behaviors, smoking and drinking were usually initiated before sexual intercourse. Sexual behavior and non-sexual risk behaviors co-occurred in the high risk group in all three cities. Youth having the highest risk of sexual behavior were more likely to have the highest risk of nearly all non-sexual risk behaviors, with the exception of fighting in Hanoi, and gambling in Shanghai and Taipei. Conclusion: Sexual behavior among unmarried youth is correlated with non-sexual risk behaviors but with different patterns across the three settings. Interventions aimed at reducing unprotected sex generally focus only on the sexual behavior; however, considering the correlations found here between sexual and non-sexual risk behaviors, they should target multiple risk behaviors. PMID:22340860

The relationship between sexual behavior and nonsexual risk behaviors among unmarried youth in three Asian cities.

PubMed

Tu, Xiaowen; Lou, Chaohua; Gao, Ersheng; Li, Nan; Zabin, Laurie S

2012-03-01

Health risk behaviors in adolescents and youth, such as smoking, alcohol, drug use, violence, suicide, and unprotected sexual behavior, are issues of major public health concern. Addressing the relationship between sexual behavior and nonsexual risk behaviors will make a significant contribution to the design of effective intervention programs for this population of adolescents and unmarried youth. This cross-sectional study was conducted in three Asian cities with a common heritage of Confucian values: Hanoi, Shanghai, and Taipei. Data were collected in 2006 from 17,016 youth aged 15-24 years residing in both urban and rural districts of the three settings. The relationships between sexual behavior and seven nonsexual risk behaviors among unmarried adolescents were examined using χ(2) tests, logistic regression models, Cox regression models, and cluster analysis. Sexual behavior was associated with seven nonsexual risk behaviors, especially with smoking, drinking, drug use, and running away from home. In terms of the age at initiation of risk behaviors, smoking and drinking were usually initiated before sexual intercourse. Sexual behavior and nonsexual risk behaviors co-occurred in the high-risk group in all three cities. Youth having the highest risk of sexual behavior were more likely to have the highest risk of nearly all nonsexual risk behaviors, with the exception of fighting in Hanoi and gambling in Shanghai and Taipei. Sexual behavior among unmarried youth is correlated with nonsexual risk behaviors but with different patterns across the three settings. Interventions aimed at reducing unprotected sex generally focus only on the sexual behavior; however, considering the correlations found here between sexual and nonsexual risk behaviors, they should target multiple risk behaviors. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A randomized controlled trial of two primary school intervention strategies to prevent early onset tobacco smoking.

PubMed

Storr, Carla L; Ialongo, Nicholas S; Kellam, Sheppard G; Anthony, James C

2002-03-01

In this article, we examine the impact of two universal, grade 1 preventive interventions on the onset of tobacco smoking as assessed in early adolescence. The classroom-centered (CC) intervention was designed to reduce the risk for tobacco smoking by enhancing teachers' behavior management skills in first grade and, thereby, reducing child attention problems and aggressive and shy behavior-known risk behaviors for later substance use. The family-school partnership (FSP) intervention targeted these early risk behaviors via improvements in parent-teacher communication and parents' child behavior management strategies. A cohort of 678 urban, predominately African-American, public school students were randomly assigned to one of three Grade 1 classrooms at entrance to primary school (age 6). One classroom featured the CC intervention, a second the FSP intervention, and the third served as a control classroom. Six years later, 81% of the students completed audio computer-assisted self-interviews. Relative to controls, a modest attenuation in the risk of smoking initiation was found for students who had been assigned to either the CC or FSP intervention classrooms (26% versus 33%) (adjusted relative risk for CC/control contrast=0.57, 95% confidence interval (CI), 0.34-0.96; adjusted relative risk for FSP/control contrast=0.69, 95% CI, 0.50-0.97). Results lend support to targeting the early antecedent risk behaviors for tobacco smoking.

A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland.

PubMed

Grund, Jonathan M; Hennink, Monique M

2012-01-01

Male circumcision has been shown to reduce the risk of heterosexual transmission of HIV infection in men by up to 60% in three randomized controlled trials. Less is known, however, about sexual behavior change in men who have been circumcised and whether male circumcision's protective effect leads to riskier sexual behaviors. This study used qualitative in-depth interviews to understand men's sexual behavior after circumcision and to determine whether and how men participated in riskier sexual behaviors following male circumcision. Men in urban Swaziland, circumcised in the previous 12 months, were recruited and asked about their perceptions of sexual risk and sexual behavior post-circumcision. Results showed that following circumcision, men experience changes in both their sexual attitudes and behavior, which can be considered both protective and risky for HIV transmission. Most of them described protective changes (e.g., more responsible attitudes towards safe sex, reducing sexual temptation and partners, easier condom use). A minority, however, experienced increased sexual risk-taking, typically during a brief period of sexual experimentation shortly after circumcision. HIV counseling and counseling throughout the circumcision process is shown to be critical in influencing protective behaviors. Findings in this study confirm the existence of risk compensation following circumcision; however, this study adds important contextual insight about precisely when and why such risk-taking occurs. Nevertheless this study suggests that male circumcision scale-up as an HIV prevention strategy is likely to foster protective behavior change among men. The integration of HIV counseling with circumcision provision remains critical for effectively mitigating HIV risk behavior as male circumcision gains momentum as a viable HIV prevention tool.

The relationship of discrimination related to sexual orientation and HIV-relevant risk behaviors among men who have sex with men.

PubMed

Rogers, Andrew H; Jardin, Charles; Mayorga, Nubia A; Bakhshaie, Jafar; Leonard, Amy; Lemaire, Chad; Zvolensky, Michael J

2018-05-30

Men who have sex with men (MSM) are at high risk for contraction and transmission of Human Immunodeficiency Virus (HIV). Increased risk of infection has been linked to high risk behaviors, such as alcohol and drug use, as well as engaging in unsafe sexual behaviors. Experiences of discrimination related to sexual orientation often experienced in this population predict risky behavior outcomes, but little research has examined the mechanisms implicated in this model. The current study examined the effect of anxiety and depressive symptoms in the relationship between discrimination related to sexual orientation and high-risk behaviors of alcohol use, drug use, using sex to cope with negative emotions, frequency of sex without a condom, and frequency of sex with an HIV+ or unknown status partner. Three hundred and eighty-nine MSM were recruited to participate in a survey based study. Results indicated anxiety was maintained a significant indirect effect between discrimination related to sexual orientation and coping behaviors (using sex to cope, alcohol, substance use), but showed no significant indirect associations with risky sexual behavior. Overall, the current study provides novel empirical evidence that discrimination related to sexual orientation is associated with increased anxiety, which in turn, is associated with certain HIV risk behaviors. Importantly, it is possible that alcohol use, drug use, and using sex to cope with negative emotions may be precursors to more risky sexual behavior, such as engaging in anal sex without a condom or having sex with an HIV+ or unknown status partner. Clinically, reducing symptoms of anxiety in the context of discrimination related to sexual orientation may help reduce HIV risk behavior among MSM. Copyright © 2018. Published by Elsevier B.V.

A Multimodal Behavioral Intervention to Impact Adherence and Risk Behavior among Perinatally and Behaviorally HIV-Infected Youth: Description, Delivery, and Receptivity of Adolescent Impact

ERIC Educational Resources Information Center

Chandwani, Sulachni; Abramowitz, Susan; Koenig, Linda J.; Barnes, William; D'Angelo, Lawrence

2011-01-01

Secondary prevention programs are needed to help HIV-positive youth reduce risk behavior and improve adherence to HIV medications. This article provides an overview of Adolescent Impact, a secondary HIV prevention intervention, including its description, delivery, and receptivity among the two unique groups of participants. Adolescent Impact, a…

Adolescent Health-Risk Sexual Behaviors: Effects of a Drug Abuse Intervention

PubMed Central

Ozechowski, Timothy J.; Waldron, Holly B.; Davis, Betsy; Turner, Charles W.; Brody, Janet L.; Barrera, Manuel

2011-01-01

Adolescents who abuse substances are more likely to engage in health-risking sexual behavior (HRSB) and are at particularly high risk for HIV/AIDS. Thus, substance abuse treatment presents a prime opportunity to target HIV-risk behaviors. The present study evaluated a one-session HIV-risk intervention embedded in a controlled clinical trial for drug-abusing adolescents. The trial was conducted in New Mexico and Oregon with Hispanic and Anglo adolescents. Youths were randomly assigned to individual cognitive behavior therapy (CBT) or to an integrated behavioral and family therapy (IBFT) condition, involving individual and family sessions. The HIV-specific intervention was not associated with change. IBFT and CBT were both efficacious in reducing HIV-risk behaviors from intake to the 18-month follow-up for high-risk adolescents. For low-risk adolescents, CBT (versus IBFT) was more efficacious in suppressing HRSB. These data suggest that drug abuse treatments can have both preventative and intervention effects for adolescents, depending on their relative HIV-risk. PMID:21833690

The Days and Nights of Zoo Elephants: Using Epidemiology to Better Understand Stereotypic Behavior of African Elephants (Loxodonta africana) and Asian Elephants (Elephas maximus) in North American Zoos.

PubMed

Greco, Brian J; Meehan, Cheryl L; Hogan, Jen N; Leighty, Katherine A; Mellen, Jill; Mason, Georgia J; Mench, Joy A

2016-01-01

Stereotypic behavior is an important indicator of compromised welfare. Zoo elephants are documented to perform stereotypic behavior, but the factors that contribute to performance have not been systematically assessed. We collected behavioral data on 89 elephants (47 African [Loxodonta africana], 42 Asian [Elephas maximus]) at 39 North American zoos during the summer and winter. Elephants were videoed for a median of 12 daytime hours per season. A subset of 32 elephants (19 African, 13 Asian) was also observed live for a median of 10.5 nighttime hours. Percentages of visible behavior scans were calculated from five minute instantaneous samples. Stereotypic behavior was the second most commonly performed behavior (after feeding), making up 15.5% of observations during the daytime and 24.8% at nighttime. Negative binomial regression models fitted with generalized estimating equations were used to determine which social, housing, management, life history, and demographic variables were associated with daytime and nighttime stereotypic behavior rates. Species was a significant risk factor in both models, with Asian elephants at greater risk (daytime: p<0.001, Risk Ratio = 4.087; nighttime: p<0.001, Risk Ratio = 8.015). For both species, spending time housed separately (p<0.001, Risk Ratio = 1.009), and having experienced inter-zoo transfers (p<0.001, Risk Ratio = 1.175), increased the risk of performing higher rates of stereotypy during the day, while spending more time with juvenile elephants (p<0.001, Risk Ratio = 0.985), and engaging with zoo staff reduced this risk (p = 0.018, Risk Ratio = 0.988). At night, spending more time in environments with both indoor and outdoor areas (p = 0.013, Risk Ratio = 0.987) and in larger social groups (p = 0.039, Risk Ratio = 0.752) corresponded with reduced risk of performing higher rates of stereotypy, while having experienced inter-zoo transfers (p = 0.033, Risk Ratio = 1.115) increased this risk. Overall, our results indicate that factors related to the social environment are most influential in predicting elephant stereotypic behavior rates.

The Days and Nights of Zoo Elephants: Using Epidemiology to Better Understand Stereotypic Behavior of African Elephants (Loxodonta africana) and Asian Elephants (Elephas maximus) in North American Zoos

PubMed Central

Greco, Brian J.; Meehan, Cheryl L.; Hogan, Jen N.; Leighty, Katherine A.; Mellen, Jill; Mason, Georgia J.; Mench, Joy A.

2016-01-01

Stereotypic behavior is an important indicator of compromised welfare. Zoo elephants are documented to perform stereotypic behavior, but the factors that contribute to performance have not been systematically assessed. We collected behavioral data on 89 elephants (47 African [Loxodonta africana], 42 Asian [Elephas maximus]) at 39 North American zoos during the summer and winter. Elephants were videoed for a median of 12 daytime hours per season. A subset of 32 elephants (19 African, 13 Asian) was also observed live for a median of 10.5 nighttime hours. Percentages of visible behavior scans were calculated from five minute instantaneous samples. Stereotypic behavior was the second most commonly performed behavior (after feeding), making up 15.5% of observations during the daytime and 24.8% at nighttime. Negative binomial regression models fitted with generalized estimating equations were used to determine which social, housing, management, life history, and demographic variables were associated with daytime and nighttime stereotypic behavior rates. Species was a significant risk factor in both models, with Asian elephants at greater risk (daytime: p<0.001, Risk Ratio = 4.087; nighttime: p<0.001, Risk Ratio = 8.015). For both species, spending time housed separately (p<0.001, Risk Ratio = 1.009), and having experienced inter-zoo transfers (p<0.001, Risk Ratio = 1.175), increased the risk of performing higher rates of stereotypy during the day, while spending more time with juvenile elephants (p<0.001, Risk Ratio = 0.985), and engaging with zoo staff reduced this risk (p = 0.018, Risk Ratio = 0.988). At night, spending more time in environments with both indoor and outdoor areas (p = 0.013, Risk Ratio = 0.987) and in larger social groups (p = 0.039, Risk Ratio = 0.752) corresponded with reduced risk of performing higher rates of stereotypy, while having experienced inter-zoo transfers (p = 0.033, Risk Ratio = 1.115) increased this risk. Overall, our results indicate that factors related to the social environment are most influential in predicting elephant stereotypic behavior rates. PMID:27416071

Reducing developmental risk for emotional/behavioral problems: a randomized controlled trial examining the Tools for Getting Along curriculum.

PubMed

Daunic, Ann P; Smith, Stephen W; Garvan, Cynthia W; Barber, Brian R; Becker, Mallory K; Peters, Christine D; Taylor, Gregory G; Van Loan, Christopher L; Li, Wei; Naranjo, Arlene H

2012-04-01

Researchers have demonstrated that cognitive-behavioral intervention strategies - such as social problem solving - provided in school settings can help ameliorate the developmental risk for emotional and behavioral difficulties. In this study, we report the results of a randomized controlled trial of Tools for Getting Along (TFGA), a social problem-solving universally delivered curriculum designed to reduce the developmental risk for serious emotional or behavioral problems among upper elementary grade students. We analyzed pre-intervention and post-intervention teacher-report and student self-report data from 14 schools, 87 classrooms, and a total of 1296 students using multilevel modeling. Results (effect sizes calculated using Hedges' g) indicated that students who were taught TFGA had a more positive approach to problem solving (g=.11) and a more rational problem-solving style (g=.16). Treated students with relatively poor baseline scores benefited from TFGA on (a) problem-solving knowledge (g=1.54); (b) teacher-rated executive functioning (g=.35 for Behavior Regulation and .32 for Metacognition), and proactive aggression (g=.20); and (c) self-reported trait anger (g=.17) and anger expression (g=.21). Thus, TFGA may reduce risk for emotional and behavioral difficulties by improving students' cognitive and emotional self-regulation and increasing their pro-social choices. Copyright © 2011 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Blood Pressure, Emotional Dampening, and Risk Behavior: Implications for Hypertension Development.

PubMed

McCubbin, James A; Nathan, Aaron; Hibdon, Melissa A; Castillo, Anastasia M; Graham, Jack G; Switzer, Fred S

2018-05-07

Elevated resting blood pressure (BP) is associated with risk for hypertension and emotional dampening, including reduced responses to emotionally meaningful stimuli. Perception of threat is a critical motivator in avoidance of risky health-damaging behavior. We hypothesize that BP-associated dampening of threat appraisal may increase risk-taking behavior. We measured resting BP, perception of affect, and risk behavior in 92 healthy, women (n=49) and men (n=43) recruited from university students and staff, and members of the surrounding community. Mean age +/- standard deviation for the sample was 21.5 +/- 4.3 year. Blood pressure was measured using an automated blood pressure monitor, and risk behavior was assessed with a modified National College Health Risk Behavior Survey. We also measured recognition of affect using the Perception of Affect Task (PAT). Risk-taking behavior was positively correlated with both systolic (SBP; r(89)=.278, p=.008) and diastolic blood pressure (DBP; r(89)=.309, p<.003). Regression analysis indicated that the association between risk-taking behavior and blood pressure was not mediated by PAT scores. Results show that persons with higher resting BP levels report increased risk-taking behavior. PAT scores, while correlated with SBP, did not mediate the relationship between BP and risk. The relationship between BP and risk behavior reflects the potential involvement of CNS regulation of both BP and emotional responsivity, and its relationship to health damaging behavior and risk for hypertension.

Male Partner Risk Behaviors Are Associated With Reactive Rapid HIV Antibody Tests Among Pregnant Mexican Women: Implications for Prevention of Vertical and Sexual HIV Transmission in Concentrated HIV Epidemics.

PubMed

Rivero, Estela; Kendall, Tamil

2015-01-01

Mexico's policies on antenatal HIV testing are contradictory, and little is known about social and behavioral characteristics that increase pregnant Mexican women's risks of acquiring HIV. We analyzed the association between risk behaviors reported by pregnant women for themselves and their male partners, and women's rapid HIV antibody test results from a large national sample. Three quarters of pregnant women with a reactive test did not report risk behaviors for themselves and one third did not report risk behaviors for themselves or their male partners. In the retrospective case-control analysis, other than reporting multiple sexual partners, reactive pregnant women reported risk behaviors did not differ from nonreactive women's behaviors. However, reactive pregnant women were significantly more likely to have reported risk behaviors for male partners. Our findings support universal offer of antenatal HIV testing and suggest that HIV prevention for women should focus on reducing risk of HIV acquisition within stable relationships. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Study on Public Flood Risk Cognition and Behavioral Response Based on IEC Strategy

NASA Astrophysics Data System (ADS)

Shen, Xin; Xu, Xiaofeng; Zhou, Guilin; Pan, Shaolin; Mi, Tengfei

2017-11-01

In order to disseminate knowledge and information on flood risks in flood-prone areas, raise public awareness of flood risks and reduce possible damage to the public, a questionnaire survey was coducted among 260 residents of nine selected communities in Jiaozhou City to learn the public awareness and behavioral response to flood risks at different early warning levels. IEC key information of flood risk awareness was modified and formulated through group discussions, in-depth individual interviews and on-site observation. The awareness of residents in the project area was enhanced through the public participation, environmental management and flood management training, which plays a very important role in reducing flood losses.

Reducing Developmental Risk for Emotional/Behavioral Problems: A Randomized Controlled Trial Examining the Tools for Getting Along Curriculum

ERIC Educational Resources Information Center

Daunic, Ann P.; Smith, Stephen W.; Garvan, Cynthia W.; Barber, Brian R.; Becker, Mallory K.; Peters, Christine D.; Taylor, Gregory G.; Van Loan, Christopher L.; Li, Wei; Naranjo, Arlene H.

2012-01-01

Researchers have demonstrated that cognitive-behavioral intervention strategies--such as social problem solving--provided in school settings can help ameliorate the developmental risk for emotional and behavioral difficulties. In this study, we report the results of a randomized controlled trial of Tools for Getting Along (TFGA), a social…

The Impact of Reduced Ignition Propensity Cigarette Regulation on Smoking Behavior in a Cohort of Ontario Smokers

PubMed Central

O’Connor, Richard J.; Fix, Brian V.; Hammond, David; Giovino, Gary A.; Hyland, Andrew; Fong, Geoffrey T.; Cummings, K. Michael

2016-01-01

Introduction This study examined the degree to which legislation intended to reduce the incidence of cigarette-caused fires influenced the behaviors of a cohort of smokers in Ontario, Canada. Evaluating the effectiveness of existing cigarette fire-safety has the potential to inform the development of similar standards in other jurisdictions. Methods A random digit dialed telephone survey of adult smokers residing in the Province of Ontario was conducted between July and September of 2005, ending one month prior to the RIP regulation’s implementation date. A follow-up survey was conducted between August and November of 2006 to examine changes in engaging in fire risk behaviors, perceptions of changes to cigarettes, and behavioral changes in response to smoking reduced ignition propensity cigarettes. Of the baseline participants, 73.0% (n=435) completed the follow-up survey. Results The frequency of fire risk behaviors was similar across both surveys. At baseline, only 3.7% (95% CI: 2.20–5.76) of smokers interviewed reported that their cigarettes went out on their own ‘often’ while smoking. Following the implementation of the reduced ignition propensity legislation, this increased significantly to 14.7% (95% CI: 11.41–18.42). Discussion The results observed in this study suggest that the proportion of Ontario smokers who reported engaging in behavior such as leaving a cigarette burning unattended and smoking in bed actually declined, although these declines were not statistically significant across all measures of fire risk. As other nations look to implement RIP regulations, the Canadian experience thus far has revealed no risk compensatory behaviors that would offset the potential public health benefit of the regulations. PMID:20643872

A conceptual framework for understanding HIV risk behavior in the context of supporting fertility goals among HIV-serodiscordant couples

PubMed Central

Crankshaw, Tamaryn L.; Matthews, Lynn T.; Giddy, Janet; Kaida, Angela; Ware, Norma C.; Smit, Jennifer A.; Bangsberg, David R.

2013-01-01

Integrated reproductive health services for people living with HIV must address their fertility intentions. For HIV-serodiscordant couples who want to conceive, attempted conception confers a substantial risk of HIV transmission to the uninfected partner. Behavioral and pharmacologic strategies may reduce HIV transmission risk among HIV-serodiscordant couples who seek to conceive. In order to develop effective pharmaco-behavioral programs, it is important to understand and address the contexts surrounding reproductive decision-making; perceived periconception HIV transmission risk; and periconception risk behaviors. We present a conceptual framework to describe the dynamics involved in periconception HIV risk behaviors in a South African setting. We adapt the Information-Motivation-Behavioral Skill Model of HIV Preventative Behavior to address the structural, individual and couple-level determinants of safer conception behavior. The framework is intended to identify factors that influence periconception HIV risk behavior among serodiscordant couples, and therefore to guide design and implementation of integrated and effective HIV, reproductive health and family planning services that support reproductive decision-making. PMID:23177680

Reducing Behavioral Health Inpatient Readmissions for People With Substance Use Disorders: Do Follow-Up Services Matter?

PubMed

Reif, Sharon; Acevedo, Andrea; Garnick, Deborah W; Fullerton, Catherine A

2017-08-01

Individuals with substance use disorders are at high risk of hospital readmission. This study examined whether follow-up services received within 14 days of discharge from an inpatient hospital stay or residential detoxification reduced 90-day readmissions among Medicaid enrollees whose index admission included a substance use disorder diagnosis. Claims data were analyzed for Medicaid enrollees ages 18-64 with a substance use disorder diagnosis coded in any position for an inpatient hospital stay or residential detoxification in 2008 (N=30,439). Follow-up behavioral health services included residential, intensive outpatient, outpatient, and medication-assisted treatment (MAT). Analyses included data from ten states or fewer, based on a minimum number of index admissions and the availability of follow-up services or MAT. Survival analyses with time-varying independent variables were used to test the association of receipt of follow-up services and MAT with behavioral health readmissions. Two-thirds (67.7%) of these enrollees received no follow-up services within 14 days. Twenty-nine percent were admitted with a primary behavioral health diagnosis within 90 days of discharge. Survival analyses showed that MAT and residential treatment were associated with reduced risk of 90-day behavioral health admission. Receipt of outpatient treatment was associated with increased readmission risk, and, in only one model, receipt of intensive outpatient services was also associated with increased risk. Provision of MAT or residential treatment for substance use disorders after an inpatient or detoxification stay may help prevent readmissions. Medicaid programs should be encouraged to reduce barriers to MAT and residential treatment in order to prevent behavioral health admissions.

Pilot Test of an Integrated Sexual Risk Reduction Intervention for Women with a History of Childhood Sexual Abuse.

PubMed

Senn, Theresa E; Braksmajer, Amy; Urban, Marguerite A; Coury-Doniger, Patricia; Carey, Michael P

2017-11-01

HIV and childhood sexual abuse (CSA) are intersecting public health problems for women. We pilot tested an integrated sexual risk reduction intervention for women with a history of CSA that addressed both the consequences of CSA [based on the Traumagenic Dynamics (TD) framework] and the antecedents of sexual risk behavior (based on the Information-Motivation-Behavioral Skills [IMB] model). Women with a history of CSA who were attending a public STI clinic (n = 84) were randomly assigned to a five-session integrated TD/IMB (experimental) group intervention or to a time-matched IMB-guided sexual risk reduction (control) group intervention. Preliminary findings indicated that women in the integrated TD/IMB intervention reduced their average number of episodes of unprotected sex with a primary partner, their alcohol use, and their likelihood of being in a violent relationship, relative to women in the IMB-only group. Our findings suggest that sexual risk reduction interventions that address both the consequences of CSA and the antecedents of sexual risk behavior may be efficacious in reducing sexual risk behavior among women who were sexually abused.

How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: A study in Polish primary care.

PubMed

Szymczyk, Ireneusz; Wojtyna, Ewa; Lukas, Witold; Kępa, Joanna; Pawlikowska, Teresa

2013-11-01

Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women. A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual's CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects' self-care behavior was examined. We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most important. Different predictors of acquisition of health behavior are encountered in men and women. Our results suggest that gender-adjusted motivation models influencing the recognition process need to be considered to optimize compliance in patients with CVR.

Perceived parental monitoring and health risk behavior among public secondary school students in El Salvador.

PubMed

Springer, Andrew E; Sharma, Shreela; de Guardado, Alba Margarita; Nava, Francisco Vázquez; Kelder, Steven H

2006-12-28

Although parental monitoring has received considerable attention in studies of U.S. adolescents, few published studies have examined how parents' knowledge of their children's whereabouts may influence health risk behaviors in adolescents living in Latin America. We investigated the association between perceived parental monitoring and substance use, fighting, and sexual behaviors in rural and urban Salvadoran adolescents (n = 982). After adjusting for several sociodemographic covariates, multilevel regression analyses indicated that students reporting low parental monitoring were between 2 to 3.5 times more likely to report risk behaviors examined. The promotion of specific parenting practices such as parental monitoring may hold promise for reducing adolescent risk behaviors in El Salvador.

Validity of Self-reported Sexual Behavior Among Adolescents: Where Do We Go from Here?

PubMed

DiClemente, Ralph J

2016-01-01

Adolescents have high rates of sexually transmitted infections (STIs). Adolescents consuming alcohol and using drugs have markedly greater HIV/STI risk and are a priority population for intervention. Accurate measurement of sexual risk behavior is critical for understanding individual's risk for HIV/STI, transmission dynamics of HIV/STI, and evaluating the efficacy of interventions designed reduce HIV/STI risk. However, significant challenges to accurately measuring adolescents' self-reported sexual behavior are well-documented. Recent advances in microbiology, such as the use of less invasive specimen collection for DNA assays, can assist researchers in more accurately measuring adolescents' sexual risk behavior. However, the majority of studies of adolescents' sexual risk rely solely on self-reported behavior; therefore, methods to improve the validity of adolescents' self-reported sexual behavior are needed. In addition, integrating biologic measures to complement self-reported measures are recommended, when appropriate and feasible.

Effects of the KEEP Foster Parent Intervention on Child and Sibling Behavior Problems and Parental Stress during a Randomized Implementation Trial

PubMed Central

Price, Joseph M.; Roesch, Scott; Walsh, Natalia E.; Landsverk, John

2014-01-01

Children in foster care are at risk for externalizing behavior problems, which can in turn increase the risk of changes in foster care placement. The KEEP (Keeping Foster Parents Trained and Supported) foster parent training intervention was designed to equip foster parents with strategies for managing externalizing behavior problems. The primary goals of this investigation were to (a) examine the effectiveness of the KEEP intervention in reducing child behavior problems, as delivered by a community agency, (b) determine if the effects of the KEEP intervention generalize to more than one child in the same home, and (c) examine the effectiveness of the KEEP intervention in reducing parental stress associated with child behavior problems. The data from 335 foster and kinship families with children between the ages of 5 and 12 years were analyzed to address these objectives. Families were randomly assigned to the intervention or control condition. The results indicated that the KEEP intervention was effective in reducing child behavior problems when delivered by a community agency. These results expanded prior research on the KEEP intervention, revealing that the intervention was effective in reducing behavior problems of more than one child in the same household and in reducing parental stress levels associated with the behavioral issues of the focal child. Thus, the KEEP intervention model holds promise for reducing the behavior problems of children in foster care and reducing stress levels of foster and kinship caregivers as it is disseminated and implemented within similar child welfare settings. PMID:25418812

Kloss gibbon (Hylobates klossii) behavior facilitates the avoidance of human predation in the Peleonan forest, Siberut Island, Indonesia.

PubMed

Dooley, Helen M; Judge, Debra S

2015-03-01

Kloss gibbons (Hylobates klossii) are endemic to the Mentawai Islands in Indonesia and have been subject to human predation for more than 2000 years in the absence of any other significant predators. We investigate the behavior of Kloss gibbons that may be attributed to avoiding human predation. We observed Kloss gibbons in the Peleonan forest in the north of Siberut Island, the northernmost of the Mentawai island chain, over 18 months in 2007 and 2008, and collected data on their singing behavior, the number of individuals present during different conditions and their responses to humans. We examine behaviors that may reduce the risk of predation by humans during singing (the most conspicuous gibbon behavior), daily non-singing activities and encounters with humans. The individual risk of being stalked by hunters is reduced by singing in same-sex choruses and the risk of successful capture by hunters during singing is reduced by singing less often during daylight hours and by leaving the location of male pre-dawn singing before full light (reducing the visual signal to hunters). Groups in the Peleonan also fission during non-singing daily activity and rarely engage in play or grooming, enhancing the crypticity of their monochromatic black pelage in the canopy. We also observed a coordinated response to the presence of humans, wherein one adult individual acted as a "decoy" by approaching and distracting human observers, while other group members fled silently in multiple directions. "Decoy" behavior occurred on 31% of 96 encounters with unhabituated Kloss gibbons that detected our presence. "Decoy" individuals may put themselves at risk to increase the survival of related immatures (and adult females with infants) who have a greater risk of predation. We argue that, in combination, these behaviors are an evolved response to a long history of predation by humans. © 2014 Wiley Periodicals, Inc.

Compliance with behavioral guidelines for diet, physical activity and sedentary behaviors is related to insulin resistance among overweight and obese youth.

PubMed

Huang, Jeannie S; Gottschalk, Michael; Norman, Gregory J; Calfas, Karen J; Sallis, James F; Patrick, Kevin

2011-02-01

Overweight and obesity are established risk factors for insulin resistance in youth. A number of behavioral recommendations have been publicized with the goal of improving glycemic control. However, there is limited information about whether meeting these behavioral recommendations actually reduces insulin resistance. 92 youths 11 - 16 years with BMI ≥ 85% underwent oral glucose tolerance testing. HOMA-IR and AUCInsulin/AUCGlucose were calculated as measures of insulin resistance. Dietary and physical activity (PA) measures were performed. Assessments included whether or not participants met recommended levels of diet, PA and sedentary behaviors.62% youths met criteria for insulin resistance. 82% (75/92) met at least one behavioral recommendation. Participants who met ≥ 1 dietary, sedentary, or PA recommendations had significantly reduced insulin resistance as compared with youth who did not. This relationship remained significant in multivariate modeling of insulin resistance adjusting for age, sex, and BMI. Even relatively minor behavior change may reduce insulin resistance in youth at risk for diabetes. Our findings support the relevance of current behavioral interventions for glycemic control. Clinical Trials #NCT00412165.

Clinical Implications in the Treatment of Mania: Reducing Risk Behavior in Manic Patients

ERIC Educational Resources Information Center

Leahy, Robert L.

2005-01-01

Bipolar individuals engage in risky behavior during manic phases that contributes to their vulnerability to regret during their depressive phases. A cognitive model of risk assessment is proposed in which manic risk assessment is based on exaggeration of current and future resources, high utility for gains, low demands for information to assess…

Risky music-listening behaviors and associated health-risk behaviors.

PubMed

Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

2012-06-01

To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes, alcohol, cannabis, and hard drugs) and unsafe sexual intercourse. A total of 944 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their music-listening and traditional health-risk behaviors. Multiple logistic regression analyses were used to examine associations between music-listening and traditional health-risk behaviors. Risky MP3-player listeners used cannabis more often during the past 4 weeks. Students exposed to risky sound levels during discotheque and pop concert attendance used cannabis less often during the past 4 weeks, were more often binge drinkers, and reported inconsistent condom use during sexual intercourse. The coexistence of risky music-listening behaviors with other health-risk behaviors provides evidence in support of the integration of risky music-listening behaviors within research on and programs aimed at reducing more traditional health-risk behaviors, such as substance abuse and unsafe sexual intercourse.

Factors influencing HIV-risk behaviors among HIV-positive urban African Americans.

PubMed

Plowden, Keith O; Fletcher, Audwin; Miller, J Lawrence

2005-01-01

Urban African Americans are disproportionately affected by HIV, the virus associated with AIDS. Although incidence and mortality appear to be decreasing in some populations, they continue to remain steady among inner-city African Americans. A major concern is the number of HIV-positive individuals who continue to practice high-risk behaviors. Understanding factors that increase risks is essential for the development and implementation of effective prevention initiatives. Following a constructionist epistemology, this study used ethnography to explore social and cultural factors that influence high-risk behaviors among inner-city HIV-positive African Americans. Leininger's culture care diversity and universality theory guided the study. Individual qualitative interviews were conducted with HIV-positive African Americans in the community to explore social and cultural factors that increase HIV-risky behaviors. For this study, family/kinship, economic, and education factors played a significant role in risky behaviors. Reducing HIV disparity among African Americans is dependent on designing appropriate interventions that enhance protective factors. Clinicians providing care to HIV-positive individuals can play a key role in reducing transmission by recognizing and incorporating these factors when designing effective prevention interventions.

Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

PubMed Central

Pompili, Maurizio; Baldessarini, Ross J.; Forte, Alberto; Erbuto, Denise; Serafini, Gianluca; Fiorillo, Andrea; Amore, Mario; Girardi, Paolo

2016-01-01

Modern antipsychotic drugs are employed increasingly in the treatment of mood disorders as well as psychoses, stimulating interest in their possible contributions to altering suicidal risk. Clozapine remains the only treatment with an FDA-recognized indication for reducing suicidal risk (in schizophrenia). We carried out a systematic, computerized search for reports of studies involving antipsychotic drug treatment and suicidal behaviors. A total of 19 reports provide data with preliminary support for potential suicide risk-reducing effects of olanzapine, quetiapine, ziprasidone, aripiprazole, and asenapine in addition to clozapine, and provide some support for antipsychotic drug treatment in general. These preliminary findings encourage further testing of antipsychotics for effects on suicidal behavior, making use of explicit, pre-planned assessments of suicidal behavior. PMID:27727180

Exploring Why Young African American Women Do Not Change Condom-Use Behavior Following Participation in an STI/HIV Prevention Intervention

ERIC Educational Resources Information Center

Sales, J. M.; DiClemente, R. J.; Davis, T. P.; Sullivan, S.

2012-01-01

Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females' lack of increase in condom use…

Patterns of health care utilization among vulnerable populations in Central Texas using data from a regional health information exchange.

PubMed

Schiefelbein, Emily L; Olson, Jerome A; Moxham, Jamie D

2014-02-01

Describe patterns of health care utilization among vulnerable subgroups of an underserved population and identify populations that could benefit from interventions to reduce health care costs and improve quality of care. Health Information Exchange data focused on underserved patients was used to estimate the risk of an emergency department (ED) or inpatient (IP) visit among vulnerable patients. Approximately 20.9% of the population was vulnerable, with behavioral health being the most predominant. Homeless, disabled, and severe behavioral health patients had an increased risk of ED utilization. Behavioral health, disabled, and near elderly patients had an increased risk of IP utilization. Inpatient risk was even greater for patients with multiple vulnerabilities. Improved primary care services are needed to address both the mental and physical needs of vulnerable populations, particularly people with severe behavioral health conditions. Improved access to services may help reduce the costly burden of providing hospital-based care.

Risk perception measures' associations with behavior intentions, affect, and cognition following colon cancer screening messages.

PubMed

Dillard, Amanda J; Ferrer, Rebecca A; Ubel, Peter A; Fagerlin, Angela

2012-01-01

Risk perception is important for motivating health behavior (e.g., Janz & Becker, 1984), but different measures of the construct may change how important that relationship appears. In two studies, we examined associations between four measures of risk perception, health behavior intentions and possible behavioral determinants. Participants in these studies, who were due for colorectal cancer screening, read an online message about the importance of screening to reduce the chance of cancer. We examined bivariate and multivariate associations between risk perception measures, including absolute, comparative, and feelings-of-risk, and behavioral intentions to screen, general worry, and knowledge and attitudes related to screening. Results across the two studies were consistent, with all risk perception measures being correlated with intentions and attitudes. Multivariate analyses revealed that feelings-of-risk was most predictive of all variables, with the exception of general worry, for which comparative measures were the most predictive. Researchers interested in risk perception should assess feelings-of-risk along with more traditional measures. Those interested in influencing health behavior specifically should attempt to increase feelings of vulnerability rather than numerical risk.

Risky behavior and its effect on survival: snowshoe hare behavior under varying moonlight conditions

USGS Publications Warehouse

Gigliotti, Laura C.; Diefenbach, Duane R.

2018-01-01

Predation and predation risk can exert strong influences on the behavior of prey species. However, risk avoidance behaviors may vary among populations of the same species. We studied a population of snowshoe hares (Lepus americanus) near the southern edge of their range, in Pennsylvania. This population occupies different habitat types, experiences different environmental conditions, and are exposed to different predator species and densities than northern hare populations; therefore, they might exhibit differences in risk avoidance behaviors. We analyzed hare survival, movement rates, and habitat use under different levels of predation risk, as indexed by moonlight. Similar to previous work, we found snowshoe hare survival decreased with increased moon illumination during the winter, but we found differences in behavioral responses to increased predation risk. We found that snowshoe hares did not reduce movement rates during high‐risk nights, but instead found that hares selected areas with denser canopy cover, compared to low‐risk nights. We suggest that behavioral plasticity in response to predation risk allows populations of the same species to respond to localized conditions.

The role of a microfinance program on HIV risk behavior among Haitian women.

PubMed

Rosenberg, Molly S; Seavey, Brian K; Jules, Reginal; Kershaw, Trace S

2011-07-01

Microfinance loans targeted at vulnerable female populations have the potential to foster female economic independence, possibly leading to the negotiation of safer sexual practices and reduced HIV risk. This study assessed the relationship between experience with microfinance loans and HIV risk behavior among 192 female clients of the Haitian microfinance organization Fonkoze. Clients with longer microfinance experience were generally found to have lower indicators of HIV risk behavior and higher indicators of relationship power compared to those with shorter experience. In particular, those with longer memberships were 72% less likely to report partner infidelity, were 3.95 times more likely to use condoms with an unfaithful partner, and had higher average general power index scores compared to those with shorter experience. This study provides evidence that long-term exposure to microfinance is associated with reduced HIV risk behavior in Haitian women and that this reduction may be partly regulated by influencing relationship power. These results suggest the need to further explore the use of microfinance as a tool to prevent the spread of HIV.

Mediation of a Preventive Intervention’s Six-Year Effects on Health Risk Behaviors

PubMed Central

Soper, Ana C.; Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.

2010-01-01

Using data from a 6-year longitudinal follow-up sample of 240 youth who participated in a randomized experimental trial of a preventive intervention for divorced families with children ages 9 -12, the current study tested mechanisms by which the intervention reduced substance use and risky sexual behavior in mid to late adolescence (15–19 years old). Mechanisms tested included parental monitoring, adaptive coping, and negative errors. Parental monitoring at 6-year follow-up mediated program effects to reduce alcohol and marijuana use, polydrug use, and other drug use for those with high pre-test risk for maladjustment. In the condition that included a program for mothers only, increases in youth adaptive coping at 6-year follow-up mediated program effects on risky sexual behavior for those with high pre-test risk for maladjustment. Contrary to expectation, program participation increased negative errors and decreased adaptive coping among low risk youth in some of the analyses. Ways in which this study furthers our understanding of pathways through which evidence-based preventive interventions affect health risk behaviors are discussed. PMID:20565156

Fruit and Vegetable Dietary Behavior in Response to a Low-Intensity Dietary Intervention: The Rural Physician Cancer Prevention Project

ERIC Educational Resources Information Center

Carcaise-Edinboro, Patricia; McClish, Donna; Kracen, Amanda C.; Bowen, Deborah; Fries, Elizabeth

2008-01-01

Context: Increased fruit and vegetable intake can reduce cancer risk. Information from this study contributes to research exploring health disparities in high-risk dietary behavior. Purpose: Changes in fruit and vegetable behavior were evaluated to assess the effects of a low-intensity, physician-endorsed dietary intervention in a rural…

Effects of 2 Prevention Programs on High-Risk Behaviors Among African American Youth

PubMed Central

Flay, Brian R.; Graumlich, Sally; Segawa, Eisuke; Burns, James L.; Holliday, Michelle Y.

2008-01-01

Objective To test the efficacy of 2 programs designed to reduce high-risk behaviors among inner-city African American youth. Design Cluster randomized trial. Setting Twelve metropolitan Chicago, Ill, schools and the communities they serve, 1994 through 1998. Participants Students in grades 5 through 8 and their parents and teachers. Interventions The social development curriculum (SDC) consisted of 16 to 21 lessons per year focusing on social competence skills necessary to manage situations in which high-risk behaviors occur. The school/community intervention (SCI) consisted of SDC and school-wide climate and parent and community components. The control group received an attention-placebo health enhancement curriculum (HEC) of equal intensity to the SDC focusing on nutrition, physical activity, and general health care. Main Outcome Measures Student self-reports of violence, provocative behavior, school delinquency, substance use, and sexual behaviors (intercourse and condom use). Results For boys, the SDC and SCI significantly reduced the rate of increase in violent behavior (by 35% and 47% compared with HEC, respectively), provoking behavior (41% and 59%), school delinquency (31% and 66%), drug use (32% and 34%), and recent sexual intercourse (44% and 65%), and improved the rate of increase in condom use (95% and 165%). The SCI was significantly more effective than the SDC for a combined behavioral measure (79% improvement vs 51%). There were no significant effects for girls. Conclusions Theoretically derived social-emotional programs that are culturally sensitive, developmentally appropriate, and offered in multiple grades can reduce multiple risk behaviors for inner-city African American boys in grades 5 through 8. The lack of effects for girls deserves further research. PMID:15066879

Chronic Disease Risk Reduction with a Community-Based Lifestyle Change Programme

ERIC Educational Resources Information Center

Merrill, Ray M; Aldana, Steven G; Greenlaw, Roger L; Salberg, Audrey; Englert, Heike

2008-01-01

Objective To assess whether reduced health risks resulting from the Coronary Health Improvement Project (CHIP) persist through 18 months. Methods: The CHIP is a four-week health education course designed to help individuals reduce cardiovascular risk by improving nutrition and physical activity behaviors. Analyses were based on 211 CHIP enrollees,…

Health, health behaviors, and health dissimilarities predict divorce: results from the HUNT study.

PubMed

Torvik, Fartein Ask; Gustavson, Kristin; Røysamb, Espen; Tambs, Kristian

2015-01-01

Poor health and health behaviors are associated with divorce. This study investigates the degree to which six health indicators and health behaviors among husbands and wives are prospectively related to divorce, and whether spousal similarities in these factors are related to a reduced risk of marital dissolution. Theoretically, a reduced risk is possible, because spousal similarity can help the couple's adaptive processes. The data come from a general population sample (19,827 couples) and 15 years of follow-up data on marital dissolution. The following characteristics were investigated: Poor subjective health, obesity, heavy drinking, mental distress, lack of exercise, and smoking. Associations between these characteristics among husbands and wives and later divorce were investigated with Cox proportional hazards regression analyses. All the investigated characteristics except obesity were associated with marital dissolution. Moreover, spousal similarities in four of these characteristics (heavy drinking, mental distress, no exercise, and smoking) reduced the risk of divorce, compared to the combined main effects of husbands and wives. Nevertheless, couples concordant in these health issues still had higher risks of divorce than couples without these characteristics. Couples with similar health and health behavior are at a lower risk of divorce than are couples who are dissimilar in health. Health differences may thus be seen as vulnerabilities or stressors, supporting a health mismatch hypothesis. This study demonstrates that people who are similar to each other are more likely to stay together. Harmonizing partners' health behaviors may be a target in divorce prevention.

Predicting Behaviors to Reduce Toxic Chemical Exposures among New and Expectant Mothers: The Role of Distal Variables within the Integrative Model of Behavioral Prediction

ERIC Educational Resources Information Center

Mello, Susan; Hovick, Shelly R.

2016-01-01

There is a growing body of evidence linking childhood exposure to environmental toxins and a range of adverse health outcomes, including preterm birth, cognitive deficits, and cancer. Little is known, however, about what drives mothers to engage in health behaviors to reduce such risks. Guided by the integrative model of behavioral prediction,…

Long-term trends in fire behavior and changes in population at risk

EPA Science Inventory

Long-term trends in fire behavior and changes in population at risk Rappold AG, Peterson GC, US EPA Matt Jolly, USFS Air pollution regulations and technological advances have successfully reduced emissions of air pollutants from many anthropogenic sources in recent decades. Duri...

Evaluation of an HIV risk reduction intervention among African-American homosexual and bisexual men.

PubMed

Peterson, J L; Coates, T J; Catania, J; Hauck, W W; Acree, M; Daigle, D; Hillard, B; Middleton, L; Hearst, N

1996-03-01

To provide the first data which evaluates an HIV risk reduction intervention designed to reduce HIV high-risk sexual behavior in African-American homosexual and bisexual men. Participants (n = 318) were recruited from bars, bathhouses, and erotic bookstores, and through homosexual African-American organizations, street out-reach, media advertisements, and personal referrals of individuals aware of the study. Participants were randomized into a single or triple session experimental group or a wait-list control group. Both experimental interventions included AIDS risk education, cognitive-behavioral self-management training, assertion training, and attempts to develop self-identity and social support. Data collection involved assessments of self-reported changes in sexual behavior at 12- and 18-month follow-up. Participants in the triple session intervention greatly reduced their frequency of unprotected anal intercourse (from 46 to 20%) at the 12-month follow-up evaluation and (from 45% to 20%) at the 18-month follow-up evaluation. However, levels of risky behavior for the control group remained constant (from 26 to 23% and from 24 to 18%) at 12- and 18-month follow-up evaluations, respectively. In addition, levels of risky behavior for the single session intervention decreased only slightly (from 47 to 38% and from 50 to 38%) at the 12- and 18-month follow-up evaluations, respectively. Results were interpreted to demonstrate the superiority of a triple session over a single session intervention in reducing risky sexual behavior in this cohort.

Maternal intraguild predation risk affects offspring anti-predator behavior and learning in mites.

PubMed

Seiter, Michael; Schausberger, Peter

2015-10-09

Predation risk is a strong selective force shaping prey morphology, life history and behavior. Anti-predator behaviors may be innate, learned or both but little is known about the transgenerational behavioral effects of maternally experienced predation risk. We examined intraguild predation (IGP) risk-induced maternal effects on offspring anti-predator behavior, including learning, in the predatory mite Phytoseiulus persimilis. We exposed predatory mite mothers during egg production to presence or absence of the IG predator Amblyseius andersoni and assessed whether maternal stress affects the anti-predator behavior, including larval learning ability, of their offspring as protonymphs. Protonymphs emerging from stressed or unstressed mothers, and having experienced IGP risk as larvae or not, were subjected to choice situations with and without IG predator traces. Predator-experienced protonymphs from stressed mothers were the least active and acted the boldest in site choice towards predator cues. We argue that the attenuated response of the protonymphs to predator traces alone represents optimized risk management because no immediate risk existed. Such behavioral adjustment could reduce the inherent fitness costs of anti-predator behaviors. Overall, our study suggests that P. persimilis mothers experiencing IGP risk may prime their offspring to behave more optimally in IGP environments.

Maternal intraguild predation risk affects offspring anti-predator behavior and learning in mites

PubMed Central

Seiter, Michael; Schausberger, Peter

2015-01-01

Predation risk is a strong selective force shaping prey morphology, life history and behavior. Anti-predator behaviors may be innate, learned or both but little is known about the transgenerational behavioral effects of maternally experienced predation risk. We examined intraguild predation (IGP) risk-induced maternal effects on offspring anti-predator behavior, including learning, in the predatory mite Phytoseiulus persimilis. We exposed predatory mite mothers during egg production to presence or absence of the IG predator Amblyseius andersoni and assessed whether maternal stress affects the anti-predator behavior, including larval learning ability, of their offspring as protonymphs. Protonymphs emerging from stressed or unstressed mothers, and having experienced IGP risk as larvae or not, were subjected to choice situations with and without IG predator traces. Predator-experienced protonymphs from stressed mothers were the least active and acted the boldest in site choice towards predator cues. We argue that the attenuated response of the protonymphs to predator traces alone represents optimized risk management because no immediate risk existed. Such behavioral adjustment could reduce the inherent fitness costs of anti-predator behaviors. Overall, our study suggests that P. persimilis mothers experiencing IGP risk may prime their offspring to behave more optimally in IGP environments. PMID:26449645

Pathways towards risk: syndemic conditions mediate the effect of adversity on HIV risk behaviors among young men who have sex with men (YMSM).

PubMed

Herrick, Amy; Stall, Ron; Egan, James; Schrager, Sheree; Kipke, Michele

2014-10-01

Research shows that young men who have sex with men (YMSM) engage in higher rates of health risk behaviors and experience higher rates of negative health outcomes than their peers. The purpose of this study is to determine if the effects of adversity on HIV risk are mediated by syndemics (co-occurring health problems). Participants were 470 ethnically diverse YMSM ages 18 to 24 recruited between 2005 and 2006 and surveyed every 6 months for 24 months. Regression analyses examined the impact of adversity on syndemics (emotional distress, substance use, and problematic alcohol use) and the effects of both adversity and syndemics on HIV risk behaviors over time. Gay-related discrimination and victimization-among other adversity variables-were significantly associated with syndemics and condomless sex (CS). Syndemics mediated the effects of adversity on CS in all models. Adverse events impact HIV risk taking among YMSM through syndemics. These findings suggest that prevention programs aimed at reducing adversity may reduce both the synergistic effect of multiple psychosocial health problems and HIV risk taking.

Life Is Precious: Views of Adolescents and Their Mothers on Methods to Reduce Suicidal Behavior in Latinas

ERIC Educational Resources Information Center

Humensky, Jennifer L.; Gil, Rosa M.; Mazzula, Silvia; Diaz, Samantha; Lewis-Fernández, Roberto

2017-01-01

Life is Precious (LIP) was developed to help reduce suicidal behavior in Latina adolescents. As part of an external evaluation of the LIP program, we conducted focus groups with adolescent participants and mothers to learn whether participants and families believe that the activities of LIP address risks for suicidal behavior. Four focus groups…

Brief Intervention for Truant Youth Sexual Risk Behavior and Marijuana Use

PubMed Central

Dembo, Richard; Briones-Robinson, Rhissa; Barrett, Kimberly; Ungaro, Rocio; Winters, Ken C.; Belenko, Steven; Karas, Lora M.; Gulledge, Laura; Wareham, Jennifer

2013-01-01

Substance use and sexual risk behaviors are common among adolescents. Although attention has focused primarily on alcohol use, less is known about the relationship between marijuana use and sexual risk behavior among high-risk youth. Since truant youth often experience problems in school, troubled family situations, and other psychosocial problems, they represent an important group of high-risk youth to study. Previous research suggests that truant youth are at considerable risk of continuing their troubled behavior in school and entering the juvenile justice system. It is also likely that truant youth are involved in marijuana use and sexual risk behavior at a higher rate, than the general youth population. Involving them in effective intervention services could reduce these risk behaviors. The current study presents interim findings from a NIDA-funded experimental, brief intervention (BI) study involving truant youths and their parents/guardians. Longitudinal data were analyzed to study: (1) the relationships between the youths’ marijuana use and engaging in sexual risk behavior over time, and (2) the effects of a substance use BI on their marijuana use and sexual risk behavior. Analyses examined a growth model for parallel processes in marijuana use and sexual risk behavior, and an assessment of the effect of the intervention on linear and quadratic trends, and on subgroups of youth differing in their sexual risk behavior and marijuana use. Implications of the results for future research and service delivery are considered. PMID:25400493

77 FR 2072 - Proposed Collection; Comment Request; Prevalence, Incidence, Epidemiology and Molecular Variants...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-13

... Request; Prevalence, Incidence, Epidemiology and Molecular Variants of HIV in Blood Donors in Brazil... Collection: Title: Prevalence, Incidence, Epidemiology and Molecular Variants of HIV in Blood Donors in... behavioral risk behaviors for HIV infection among donors are critical steps to assessing and reducing risk of...

AIDS susceptibility in a migrant population: perception and behavior.

PubMed

McBride, D C; Weatherby, N L; Inciardi, J A; Gillespie, S A

1999-01-01

Within the framework of the Health Belief Model, this paper examines correlates of perception of AIDS susceptibility among 846 drug-using migrant farm workers and their sex partners. Significant but relatively small differences by ethnicity and gender were found. The data showed a consistent significant statistical relationship between frequency of drug use, high-risk sexual behavior, and perception of AIDS susceptibility. Perception of AIDS susceptibility was significantly related to a subsequent reduction in sexual risk behaviors. Consistent with the Health Belief Model, the data suggest that increasing perception of AIDS susceptibility may be an important motivator in reducing high-risk behaviors.

Feminine ideology and sexual assault: are more traditional college women at greater risk?

PubMed

Wigderson, Sara; Katz, Jennifer

2015-05-01

Previous research has not conclusively determined whether traditional femininity increases women's risk for sexual assault. Certain femininity beliefs, such as valuing deference, may increase risk for sexual assault by discouraging sexual refusal assertiveness (SRA). Other femininity beliefs, such as valuing purity, may promote self-protective behaviors. College women (N = 254) provided self-report data on these beliefs, risk and protective behaviors, and sexual assault experiences. Traditional femininity was not directly associated with experiencing sexual assault. However, specific traditional beliefs were related to behaviors directly associated with risk. High SRA and sexual abstinence simultaneously reduced the odds for sexual assault. © The Author(s) 2015.

The Association between Childhood Maltreatment Experiences and the Onset of Maltreatment Perpetration in Young Adulthood Controlling for Proximal and Distal Risk Factors

PubMed Central

Ben-David, Vered; Jonson-Reid, Melissa; Drake, Brett; Kohl, Patricia L.

2015-01-01

The evidence for association between child maltreatment victimization and later maltreatment perpetration is both scant and mixed. The objective of the present study was to assess the association between childhood maltreatment experiences and later perpetration of maltreatment in young adulthood controlling for proximal young adult functioning, prior youth risk behaviors, and childhood poverty. The study included 6935 low-income children with (n=4470) or without (n=2465) maltreatment reports prior to age 18 followed from ages 1.5 through11 years through early adulthood (ages 18-26). Administrative data from multiple regional and statewide agencies captured reports of maltreatment, family poverty and characteristics, system contact for health, behavioral risks and mental health in adolescence, and concurrent adult functioning (crime, mental health and poverty). After controlling for proximal adult functioning, repeated instances of neglect or mixed type maltreatment remained associated with young adult perpetration. Females and subjects with adolescent history of runaway, violent behaviors or non-violent delinquency also had higher risk. Greater caregiver education remained associated with reduced risk. The study concludes that prevention of recurrent neglect and mixed forms of maltreatment may reduce risk of maltreatment for future generations. Intervening to increase parental education and decrease adolescent risk behaviors may offer additional benefit. PMID:25682732

Change in smoking, diet, and walking for exercise in Blacks.

PubMed

Berg, Carla J; Thomas, Janet L; An, Lawrence C; Guo, Hongfei; Collins, Tracie; Okuyemi, Kolawole S; Ahluwalia, Jasjit S

2012-04-01

Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers (≤10 cigarettes per day ≥25 days/month) enrolled in a 2 × 2 factorial study (placebo vs. nicotine gum, health education vs. motivational interviewing). Reducing cigarette consumption (p = .02) and quitting smoking (p < .01), as well as receiving the nicotine gum (p = .04), was associated with increased FV intake, after controlling for baseline FV intake. Compared with those who did not reduce their smoking, both reducers (p < .001) and quitters (p < .001) were more likely to walk for exercise at follow-up, after controlling for baseline walking status (p = .01). Thus, addressing one health risk behavior may prompt other positive health behaviors, which may argue for developing interventions targeting multiple health risk behaviors.

Change in Smoking, Diet, and Walking for Exercise in Blacks

PubMed Central

Berg, Carla J.; Thomas, Janet L.; An, Lawrence C.; Guo, Hongfei; Collins, Tracie; Okuyemi, Kolawole S.; Ahluwalia, Jasjit S.

2013-01-01

Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers (≤10 cigarettes per day ≥25 days/month) enrolled in a 2 × 2 factorial study (placebo vs. nicotine gum, health education vs. motivational interviewing). Reducing cigarette consumption (p = .02) and quitting smoking (p < .01), as well as receiving the nicotine gum (p = .04), was associated with increased FV intake, after controlling for baseline FV intake. Compared with those who did not reduce their smoking, both reducers (p < .001) and quitters (p < .001) were more likely to walk for exercise at follow-up, after controlling for baseline walking status (p = .01). Thus, addressing one health risk behavior may prompt other positive health behaviors, which may argue for developing interventions targeting multiple health risk behaviors. PMID:22330092

The Risky Business of Dopamine Agonists in Parkinson Disease and Impulse Control Disorders

PubMed Central

Claassen, Daniel O.; van den Wildenberg, Wery P.M.; Ridderinkhof, K. Richard; Jessup, Charles K.; Harrison, Madaline B.; Wooten, G. Frederick; Wylie, Scott A.

2011-01-01

Risk-taking behavior is characterized by pursuit of reward in spite of potential negative consequences. Dopamine neurotransmission along the mesocorticolimbic pathway is a potential modulator of risk behavior. In patients with Parkinson's Disease (PD), impulse control disorder (ICD) can result from dopaminergic medication use, particularly Dopamine Agonists (DAA). Behaviors associated with ICD include hypersexuality as well as compulsive gambling, shopping, and eating, and are potentially linked to alterations to risk processing. Using the Balloon Analogue Risk task, we assessed the role of agonist therapy on risk-taking behavior in PD patients with (n=22) and without (n=19) active ICD symptoms. Patients performed the task both ‘on’ and ‘off’ DAA. DAA increased risk-taking in PD patients with active ICD symptoms, but did not affect risk behavior of PD controls. DAA dose was also important in explaining risk behavior. Both groups similarly reduced their risk-taking in high compared to low risk conditions and following the occurrence of a negative consequence, suggesting that ICD patients do not necessarily differ in their ability to process and adjust to some aspects of negative consequences. Our findings suggest dopaminergic augmentation of risk-taking behavior as a potential contributing mechanism for the emergence of ICD in PD patients. PMID:21604834

Fall prevention and monitoring of assisted living patients: an exploratory study of physician perspectives.

PubMed

Nyrop, Kirsten A; Zimmerman, Sheryl; Sloane, Philip D; Bangdiwala, Srikant

2012-06-01

Explore physician perspectives on their involvement in fall prevention and monitoring for residential care/assisted living (RC/AL) residents. Exploratory cross-sectional study; mailed questionnaire. Four RC/AL communities, North Carolina. Primary physicians for RC/AL residents. Past Behavior and future Intentions of physicians with regard to (1) fall risk assessment and (2) collaboration with RC/AL staff to reduce falls and fall risks among RC/AL residents were explored using Theory of Planned Behavior (TPB) constructs. Predictor variables examined (1) physicians' views on their own responsibilities (Attitude), (2) their views of expectations from important referent groups (Subjective Norms), and (3) perceived constraints on engaging in fall prevention and monitoring (Perceived Behavioral Control). Physicians reported conducting fall risk assessments of 47% of RC/AL patients and collaborating with RC/AL staff to reduce fall risks for 36% of RC/AL patients (Behavior). These proportions increased to 75% and 62%, respectively, for future Intentions. TPB-based models explained approximately 60% of the variance in self-reported Behavior and Intentions. Physician's involvement in fall prevention and monitoring was significantly associated (P < .05) with their perceptions of barriers and facilitators-ease, time, reimbursement, and expertise. This study provides first data on physician beliefs regarding their involvement in fall risk assessment of RC/AL patients and collaboration with RC/AL staff to reduce fall risks of individual patients. Challenges to physician involvement identified in our study are not unique or specific to the RC/AL setting, and instead relate to clinical practice and reimbursement constraints in general. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Violence exposure and health related risk among African American adolescent female detainees: A strategy for reducing recidivism

PubMed Central

Woodson, Kamilah M.; Hives, Courtney; Sanders-Phillips, Kathy

2010-01-01

Juvenile crime and violent victimization continue to be significant social problems (Fitzpatrick, Piko, Wright, & LaGory, 2005); in that, adolescents, females in particular, are likely to participate in health related risk behaviors as result of having been victimized or exposed to a violent environment. Specifically, abuse, neglect, sexual molestation, poverty, and witnessing violence are well known risk factors for the development of trauma-related psychopathology and poor outcomes relative to delinquency, drug and alcohol abuse, and HIV risk behaviors (Steiner, Garcia, & Matthews, 1997). HIV infection is a common public health concern disproportionally affecting adolescent African American female detainees. This unique population has a serious history of violence exposure, which subsequently tends to lead to engaging in risky sexual behaviors, mental health problems, and abusing substances. Also, as a result of little to no intervention, this population is recidivating at an alarming rate, a problem that may further exacerbate the expression of health-related risk behaviors among African American adolescent female detainees. The authors briefly describe a pilot program to be implemented in the juvenile justice system that is based on the Model of Accumulated Risk (Garbarino, 1996), Bronfenbrenner’s Ecological Model (1994), and the Positive Youth Justice Model (Butts, Bazemore, & Meroe, 2009). The program proposes to reduce risky sexual behaviors, teach alternatives to abusing substances, treat mental health concerns, and reduce the rate of recidivism through “positive youth development”, PYD (Butts, Bazemore, & Meroe, 2009). Tying elements of wraparound services and reeducation together, this program addresses salient concerns that may have an impact on an adolescent detainees’ success following their release from prison in a holistic manner. PMID:21373205

Blockade of dopamine D1-family receptors attenuates the mania-like hyperactive, risk-preferring, and high motivation behavioral profile of mice with low dopamine transporter levels.

PubMed

Milienne-Petiot, Morgane; Groenink, Lucianne; Minassian, Arpi; Young, Jared W

2017-10-01

Patients with bipolar disorder mania exhibit poor cognition, impulsivity, risk-taking, and goal-directed activity that negatively impact their quality of life. To date, existing treatments for bipolar disorder do not adequately remediate cognitive dysfunction. Reducing dopamine transporter expression recreates many bipolar disorder mania-relevant behaviors (i.e. hyperactivity and risk-taking). The current study investigated whether dopamine D 1 -family receptor blockade would attenuate the risk-taking, hypermotivation, and hyperactivity of dopamine transporter knockdown mice. Dopamine transporter knockdown and wild-type littermate mice were tested in mouse versions of the Iowa Gambling Task (risk-taking), Progressive Ratio Breakpoint Test (effortful motivation), and Behavioral Pattern Monitor (activity). Prior to testing, the mice were treated with the dopamine D 1 -family receptor antagonist SCH 23390 hydrochloride (0.03, 0.1, or 0.3 mg/kg), or vehicle. Dopamine transporter knockdown mice exhibited hyperactivity and hyperexploration, hypermotivation, and risk-taking preference compared with wild-type littermates. SCH 23390 hydrochloride treatment decreased premature responding in dopamine transporter knockdown mice and attenuated their hypermotivation. SCH 23390 hydrochloride flattened the safe/risk preference, while reducing activity and exploratory levels of both genotypes similarly. Dopamine transporter knockdown mice exhibited mania-relevant behavior compared to wild-type mice. Systemic dopamine D 1 -family receptor antagonism attenuated these behaviors in dopamine transporter knockdown, but not all effects were specific to only the knockdown mice. The normalization of behavior via blockade of dopamine D 1 -family receptors supports the hypothesis that D 1 and/or D 5 receptors could contribute to the mania-relevant behaviors of dopamine transporter knockdown mice.

The influence of parental monitoring and parent-adolescent communication on Bahamian adolescent risk involvement: A three-year longitudinal examination

PubMed Central

Wang, Bo; Stanton, Bonita; Li, Xiaoming; Cottrell, Lesley; Deveaux, Lynette; Kaljee, Linda

2014-01-01

The literature suggests that parental monitoring can best be conceptualized and measured through the domains of parental knowledge, youth disclosure, parental solicitation, and parental control. Using longitudinal data on 913 grade-six Bahamian students followed over a period of three years, we examined the unique and independent roles of these domains of parental monitoring and parent–adolescent communication in relation to adolescent involvement in delinquency, substance use, and sexual risk behaviors. The results obtained with mixed-effects models indicate that parental knowledge, youth disclosure, and parental control are negatively associated with both delinquency and substance use. Open parent—adolescent communication was associated with decreased sexual risk behavior, whereas problematic parent–adolescent communication was associated with increased sexual risk behavior. The results obtained with path models indicate that youth disclosure is a significant longitudinal predictor of reduced adolescent delinquency and that parental control during early adolescence predicted reduced substance use in middle adolescence. The findings suggest that parental knowledge, youth disclosure and parental control differ in their impacts on substance use, delinquency and sexual risk behaviors. Problematic parent–adolescent communication is consistently associated with increases in all three types of adolescent risk behaviors. Future parental monitoring interventions should focus on enhancing parents’ interpersonal communication skills and emphasize the differences in and importance of the unique components of parental monitoring. PMID:24161101

The influence of parental monitoring and parent-adolescent communication on Bahamian adolescent risk involvement: a three-year longitudinal examination.

PubMed

Wang, Bo; Stanton, Bonita; Li, Xiaoming; Cottrell, Lesley; Deveaux, Lynette; Kaljee, Linda

2013-11-01

The literature suggests that parental monitoring can best be conceptualized and measured through the domains of parental knowledge, youth disclosure, parental solicitation, and parental control. Using longitudinal data on 913 grade-six Bahamian students followed over a period of three years, we examined the unique and independent roles of these domains of parental monitoring and parent-adolescent communication in relation to adolescent involvement in delinquency, substance use, and sexual risk behaviors. The results obtained with mixed-effects models indicate that parental knowledge, youth disclosure, and parental control are negatively associated with both delinquency and substance use. Open parent-adolescent communication was associated with decreased sexual risk behavior, whereas problematic parent-adolescent communication was associated with increased sexual risk behavior. The results obtained with path models indicate that youth disclosure is a significant longitudinal predictor of reduced adolescent delinquency and that parental control during early adolescence predicted reduced substance use in middle adolescence. The findings suggest that parental knowledge, youth disclosure and parental control differ in their impacts on substance use, delinquency and sexual risk behaviors. Problematic parent-adolescent communication is consistently associated with increases in all three types of adolescent risk behaviors. Future parental monitoring interventions should focus on enhancing parents' interpersonal communication skills and emphasize the differences in and importance of the unique components of parental monitoring. Copyright © 2013. Published by Elsevier Ltd.

Childhood experiences and psychosocial influences on HIV risk among adolescent Latinas in southern California.

PubMed

Newcomb, Michael D; Locke, Thomas F; Goodyear, Rodney K

2003-08-01

This study determined how adverse childhood experiences influenced risky sexual behavior in a community sample of Latina adolescents in Los Angeles (N = 904) within a modified ecodevelopmental perspective. Psychosocial, sociocultural, and environmental mediators of the relations between childhood experiences and risky sexual behavior were tested. Many direct and mediated paths were revealed using structural equation modeling. Childhood maltreatment was associated with risk sexual practices, including more partners, less condom use, more frequent intercourse, and less HIV testing. Drug use and general self-efficacy mediated several relationships. Reducing childhood maltreatment reduced HIV risk and improved psychosocial functioning. Many factors tested did not influence HIV risk. Much of what is known about HIV risk among other populations may not apply to young Latina women.

The Efficacy of Behavioral Interventions in Reducing HIV Risk Behaviors and Incident Sexually Transmitted Diseases in Heterosexual African Americans

PubMed Central

Darbes, Lynae; Crepaz, Nicole; Lyles, Cynthia; Kennedy, Gail; Rutherford, George

2009-01-01

Objective To conduct a meta-analytic review of HIV interventions for heterosexual African Americans to determine the overall efficacy in reducing HIV-risk sex behaviors and incident sexually transmitted diseases (STD) and identify intervention characteristics associated with efficacy. Methods Comprehensive searches included electronic databases from 1988 to 2005, handsearches of journals, reference lists of articles, and contacts with researchers. Thirty-eight randomized controlled trials met the selection criteria. Random-effects models were used to aggregate data. Results Interventions significantly reduced unprotected sex (OR = 0.75, 95% CI = 0.67, 0.84, 35 trials, N = 14,682) and marginally significantly decreased incident STD (OR = 0.88, 95% CI = 0.72, 1.07, 10 trials, n = 10,944). Intervention characteristics associated with efficacy include: (1) culturally tailored, (2) aiming to influence social norms in promoting safe sex behaviour, (3) utilizing peer education, (4) providing skills training on correct use of condoms and communication skills needed for negotiating safer sex, and (5) multiple sessions and opportunities to practice learned skills. Conclusion Interventions targeting heterosexual African Americans are efficacious in reducing HIV-risk sex behaviors. Efficacious intervention components identified in this review should be incorporated into the development of future interventions and further evaluated for effectiveness. PMID:18525264

Impact of an Educational Text Message Intervention on Adolescents' Knowledge and High-Risk Behaviors.

PubMed

Hickman, Nichole Erin; Schaar, Gina

2018-03-01

Health care providers need to develop improved methods of educating adolescents. This study was developed to evaluate adolescents' responses to and satisfaction with an educational text message intervention to promote healthy behaviors, reduce the incidence of unhealthy behaviors, and prevent high-risk behaviors. Adolescent participants received weekly text messages regarding high-risk sexual behaviors, healthy dietary habits, exercise, drug, or alcohol use, and social issues. Results indicate adolescents learned something new, made a behavioral change, and overall liked the delivery of educational information via text message. This indicates long-term continuation of a text message intervention is a viable means to deliver adolescent health information, thereby improving an adolescent's current and future health status.

The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.

PubMed

Chin, Helen B; Sipe, Theresa Ann; Elder, Randy; Mercer, Shawna L; Chattopadhyay, Sajal K; Jacob, Verughese; Wethington, Holly R; Kirby, Doug; Elliston, Donna B; Griffith, Matt; Chuke, Stella O; Briss, Susan C; Ericksen, Irene; Galbraith, Jennifer S; Herbst, Jeffrey H; Johnson, Robert L; Kraft, Joan M; Noar, Seth M; Romero, Lisa M; Santelli, John

2012-03-01

Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identified 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. Meta-analyses were conducted for each strategy on the seven key outcomes identified by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent findings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. Based on these findings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the effectiveness of group-based abstinence education. Published by Elsevier Inc.

Evaluation of an HIV prevention intervention for African Americans and Hispanics: findings from the VOICES/VOCES Community-based Organization Behavioral Outcomes Project.

PubMed

Fisher, Holly H; Patel-Larson, A; Green, K; Shapatava, E; Uhl, G; Kalayil, E J; Moore, A; Williams, W; Chen, B

2011-11-01

There is limited knowledge about whether the delivery of evidence-based, HIV prevention interventions in 'real world' settings will produce outcomes similar to efficacy trial outcomes. In this study, we describe longitudinal changes in sexual risk outcomes among African American and Hispanic participants in the Video Opportunities for Innovative Condom Education and Safer Sex (VOICES/VOCES) program at four CDC-funded agencies. VOICES/VOCES was delivered to 922 high-risk individuals in a variety of community settings such as substance abuse treatment centers, housing complex centers, private residences, shelters, clinics, and colleges. Significant risk reductions were consistently observed at 30- and 120-days post-intervention for all outcome measures (e.g., unprotected sex, self-reported STD infection). Risk reductions were strongest for African American participants, although Hispanic participants also reported reducing their risky behaviors. These results suggest that, over a decade after the first diffusion of VOICES/VOCES across the U.S. by CDC, this intervention remains an effective tool for reducing HIV risk behaviors among high-risk African American and Hispanic individuals.

Digital media and sexually transmitted infections.

PubMed

Gilliam, Melissa; Chor, Julie; Hill, Brandon

2014-10-01

Digital media, including the Internet, social networking sites, text messaging, and mobile applications, are ubiquitous among adolescents and young adults. These platforms enable users to obtain important information on a multitude of health topics, they may facilitate risk-taking behaviors, and they can be key components of health interventions. The purpose of this article is to review the recent literature on digital media and sexually transmitted infections, discussing their role in potentiating and reducing risk. This review demonstrates adolescents' use of digital media to gather information on health topics and discusses significant privacy concerns regarding using media to explore sexual health information. Although several studies demonstrate an association between social media and increased sexual risk-taking behaviors, this relationship is not fully understood. Digital media-based interventions are increasingly being developed to either reduce risk or improve management of sexually transmitted infections. As greater numbers of adolescents use digital media, the potential for these platforms to influence sexual risk-taking behaviors is significant. Additional research is needed to better understand the impact of digital media on sexually transmitted infection risk and to develop social media-based interventions to improve sexually transmitted infection outcomes.

Effects of Prenatal Cocaine Exposure on Early Sexual Behavior: Gender Difference in Externalizing Behavior as a Mediator

PubMed Central

Min, Meeyoung O.; Minnes, Sonia; Lang, Adelaide; Yoon, Susan; Singer, Lynn T.

2015-01-01

Background Prenatal cocaine exposure (PCE) is associated with increased risk for externalizing behavior problems; childhood externalizing behavior problems are linked with subsequent early sexual behavior. The present study examined the effects of PCE on early sexual initiation (sexual intercourse prior to age 15) and whether externalizing behavior in preadolescence mediated the relationship. Methods Three hundred fifty-four (180 PCE and 174 non-cocaine exposed; 192 girls, 142 boys), primarily African-American, low socioeconomic status, 15-year old adolescents participated in a prospective longitudinal study. Adolescents’ sexual behavior was assessed at 15 years using the Youth Risk Behavior Surveillance System. Externalizing behavior was assessed at 12 years using the Youth Self-Report. Results Logistic regression models indicated that adolescents with PCE (n=69, 38%) were 2.2 times more likely (95% CI= 1.2 – 4.1, p < .01) to engage in early sexual intercourse than non-exposed peers (n=49, 28%) controlling for covariates. This relationship was fully mediated by self-reported externalizing behavior in girls but not in boys, suggesting childhood externalizing behavior as a gender moderated mediator. Blood lead level during preschool years was also related to a greater likelihood of early sexual intercourse (OR=2.6, 95% CI=1.4 – 4.7, p < .002). Greater parental monitoring decreased the likelihood of early sexual intercourse, while violence exposure increased the risk. Conclusions PCE is related to early sexual intercourse, and externalizing behavior problems mediate PCE effects in female adolescents. Interventions targeting externalizing behavior may reduce early sexual initiation and thereby reduce HIV risk behaviors and early, unplanned pregnancy in girls with PCE. PMID:26088698

Effects of prenatal cocaine exposure on early sexual behavior: Gender difference in externalizing behavior as a mediator.

PubMed

Min, Meeyoung O; Minnes, Sonia; Lang, Adelaide; Yoon, Susan; Singer, Lynn T

2015-08-01

Prenatal cocaine exposure (PCE) is associated with increased risk for externalizing behavior problems; childhood externalizing behavior problems are linked with subsequent early sexual behavior. The present study examined the effects of PCE on early sexual initiation (sexual intercourse prior to age 15) and whether externalizing behavior in preadolescence mediated the relationship. Three hundred fifty-four (180 PCE and 174 non-cocaine exposed; 192 girls, 142 boys), primarily African-American, low socioeconomic status, 15-year-old adolescents participated in a prospective longitudinal study. Adolescents' sexual behavior was assessed at 15 years using the Youth Risk Behavior Surveillance System. Externalizing behavior was assessed at 12 years using the Youth Self-Report. Logistic regression models indicated that adolescents with PCE (n=69, 38%) were 2.2 times more likely (95% CI=1.2-4.1, p<.01) to engage in early sexual intercourse than non-exposed peers (n=49, 28%) controlling for covariates. This relationship was fully mediated by self-reported externalizing behavior in girls but not in boys, suggesting childhood externalizing behavior as a gender moderated mediator. Blood lead level during preschool years was also related to a greater likelihood of early sexual intercourse (OR=2.6, 95% CI=1.4-4.7, p<.002). Greater parental monitoring decreased the likelihood of early sexual intercourse, while violence exposure increased the risk. PCE is related to early sexual intercourse, and externalizing behavior problems mediate PCE effects in female adolescents. Interventions targeting externalizing behavior may reduce early sexual initiation and thereby reduce HIV risk behaviors and early, unplanned pregnancy in girls with PCE. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Patterns of health risk behaviors for chronic disease: a comparison between adolescent and adult American Indians living on or near reservations in Montana.

PubMed

Nelson, D E; Moon, R W; Holtzman, D; Smith, P; Siegel, P Z

1997-07-01

To compare the chronic disease health risk behavior patterns of adolescents and adults among American Indians living on or near reservations in Montana. We analyzed data from the 1993 Youth Risk Behavior Survey of American Indians in Grades 9-12 living on or near Montana reservations. Risk factors included tobacco use, low physical activity, attempted weight loss, and low consumption of fruits, vegetables, and green salad. Similar data were analyzed from a 1994 Behavioral Risk Factor Survey of American Indian adults living on or near reservations in Montana. The prevalence of most adolescent health risk behaviors was high, especially cigarette smoking (45% for males, 57% for females), smokeless tobacco use (44% for males, 30% for females), and infrequent consumption of salad or vegetables (59-76%). With the exception of daily cigarette smoking and inadequate fruit consumption among adolescents of both genders and physical inactivity among adolescent males, the prevalence of chronic disease health risk behaviors among adolescents was similar to or higher than the prevalence of the same risk behaviors among adults. Many health risk behaviors for chronic diseases are common by the time this group of American Indians in Montana has reached adolescence. Possible reasons may include modeling of familial behaviors, peer pressure, advertising, or age cohort effects. If these risk behavior patterns continue into adulthood, morbidity and mortality from chronic diseases are likely to remain high. Substantial efforts are needed to prevent or reduce health risk behaviors among adolescents and adults in this population.

Personal Genomic Testing for Cancer Risk: Results From the Impact of Personal Genomics Study.

PubMed

Gray, Stacy W; Gollust, Sarah E; Carere, Deanna Alexis; Chen, Clara A; Cronin, Angel; Kalia, Sarah S; Rana, Huma Q; Ruffin, Mack T; Wang, Catharine; Roberts, J Scott; Green, Robert C

2017-02-20

Purpose Significant concerns exist regarding the potential for unwarranted behavior changes and the overuse of health care resources in response to direct-to-consumer personal genomic testing (PGT). However, little is known about customers' behaviors after PGT. Methods Longitudinal surveys were given to new customers of 23andMe (Mountain View, CA) and Pathway Genomics (San Diego, CA). Survey data were linked to individual-level PGT results through a secure data transfer process. Results Of the 1,042 customers who completed baseline and 6-month surveys (response rate, 71.2%), 762 had complete cancer-related data and were analyzed. Most customers reported that learning about their genetic risk of cancers was a motivation for testing (colorectal, 88%; prostate, 95%; breast, 94%). No customers tested positive for pathogenic mutations in highly penetrant cancer susceptibility genes. A minority of individuals received elevated single nucleotide polymorphism-based PGT cancer risk estimates (colorectal, 24%; prostate, 24%; breast, 12%). At 6 months, customers who received elevated PGT cancer risk estimates were not significantly more likely to change their diet, exercise, or advanced planning behaviors or engage in cancer screening, compared with individuals at average or reduced risk. Men who received elevated PGT prostate cancer risk estimates changed their vitamin and supplement use more than those at average or reduced risk (22% v 7.6%, respectively; adjusted odds ratio, 3.41; 95% CI, 1.44 to 8.18). Predictors of 6-month behavior include baseline behavior (exercise, vitamin or supplement use, and screening), worse health status (diet and vitamin or supplement use), and older age (advanced planning, screening). Conclusion Most adults receiving elevated direct-to-consumer PGT single nucleotide polymorphism-based cancer risk estimates did not significantly change their diet, exercise, advanced care planning, or cancer screening behaviors.

Personal Genomic Testing for Cancer Risk: Results From the Impact of Personal Genomics Study

PubMed Central

Gollust, Sarah E.; Carere, Deanna Alexis; Chen, Clara A.; Cronin, Angel; Kalia, Sarah S.; Rana, Huma Q.; Ruffin, Mack T.; Wang, Catharine; Roberts, J. Scott; Green, Robert C.

2017-01-01

Purpose Significant concerns exist regarding the potential for unwarranted behavior changes and the overuse of health care resources in response to direct-to-consumer personal genomic testing (PGT). However, little is known about customers’ behaviors after PGT. Methods Longitudinal surveys were given to new customers of 23andMe (Mountain View, CA) and Pathway Genomics (San Diego, CA). Survey data were linked to individual-level PGT results through a secure data transfer process. Results Of the 1,042 customers who completed baseline and 6-month surveys (response rate, 71.2%), 762 had complete cancer-related data and were analyzed. Most customers reported that learning about their genetic risk of cancers was a motivation for testing (colorectal, 88%; prostate, 95%; breast, 94%). No customers tested positive for pathogenic mutations in highly penetrant cancer susceptibility genes. A minority of individuals received elevated single nucleotide polymorphism-based PGT cancer risk estimates (colorectal, 24%; prostate, 24%; breast, 12%). At 6 months, customers who received elevated PGT cancer risk estimates were not significantly more likely to change their diet, exercise, or advanced planning behaviors or engage in cancer screening, compared with individuals at average or reduced risk. Men who received elevated PGT prostate cancer risk estimates changed their vitamin and supplement use more than those at average or reduced risk (22% v 7.6%, respectively; adjusted odds ratio, 3.41; 95% CI, 1.44 to 8.18). Predictors of 6-month behavior include baseline behavior (exercise, vitamin or supplement use, and screening), worse health status (diet and vitamin or supplement use), and older age (advanced planning, screening). Conclusion Most adults receiving elevated direct-to-consumer PGT single nucleotide polymorphism-based cancer risk estimates did not significantly change their diet, exercise, advanced care planning, or cancer screening behaviors. PMID:27937091

Toddlers with Early Behavioral Problems at Higher Family Demographic Risk Benefit the Most from Maternal Emotion Talk.

PubMed

Brophy-Herb, Holly E; Bocknek, Erika London; Vallotton, Claire D; Stansbury, Kathy E; Senehi, Neda; Dalimonte-Merckling, Danielle; Lee, Young-Eun

2015-09-01

To test the hypothesis that toddlers at highest risk for behavioral problems from the most economically vulnerable families will benefit most from maternal talk about emotions. This study included 89 toddlers and mothers from low-income families. Behavioral problems were rated at 2 time points by masters-level trained Early Head Start home visiting specialists. Maternal emotion talk was coded from a wordless book-sharing task. Coding focused on mothers' emotion bridging, which included labeling emotions, explaining the context of emotions, noting the behavioral cues of emotions, and linking emotions to toddlers' own experiences. Maternal demographic risk reflected a composite score of 5 risk factors. A significant 3-way interaction between Time 1 toddler behavior problems, maternal emotion talk, and maternal demographic risk (p = .001) and examination of slope difference tests revealed that when maternal demographic risk was greater, more maternal emotion talk buffered associations between earlier and later behavior problems. Greater demographic risk and lower maternal emotion talk intensified Time 1 behavior problems as a predictor of Time 2 behavior problems. The model explained 54% of the variance in toddlers' Time 2 behavior problems. Analyses controlled for maternal warmth to better examine the unique contributions of emotion bridging to toddlers' behaviors. Toddlers at highest risk, those with more early behavioral problems from higher demographic-risk families, benefit the most from mothers' emotion talk. Informing parents about the use of emotion talk may be a cost-effective, simple strategy to support at-risk toddlers' social-emotional development and reduce behavioral problems.

Go Grrrls: A Randomized Controlled Trial of a Gender-Specific Intervention to Reduce Sexual Risk Factors in Middle School Females.

PubMed

LeCroy, Craig Winston; McCullough Cosgrove, Jenny; Cotter, Katie; Fordney, Marie

2018-04-01

Adolescent females continue to face health consequences associated with risky sexual behaviors such as unintended pregnancies and sexually transmitted diseases. The purpose of this study was to investigate the efficacy of a gender-specific intervention targeted to early adolescent females. This study used an intent to treat randomized clinical trial comparing a broad-based female empowerment curriculum with a dose-matched science and technology female leadership curriculum. The sample ( N = 801) was recruited from schools and was implemented in community-based settings mostly in an after school context. Assessments were conducted at baseline, postintervention, 6-, and 18-month follow-up time periods. Both groups in the study obtained good implementation and engagement. The average attendance rate was 81% of program sessions. There were significant differences between the two groups favoring the intervention group on measures of sexually transmitted disease knowledge and condom technical skills. On a measure of condom self-efficacy, there was a significant trend. At the postassessment, there was a significant difference on the intentions to reduce sexual risk behaviors. Both the intervention and control groups made gains on the self-assertive behavior scale. Gender-specific programs for early adolescent females can help reduce indicators that are related to sexual risk reduction. More long-term follow-up is needed to assess impact on sexual behaviors. Efforts directed at a younger population of females should continue to be researched for potential in reducing sexual risks.

Developmental Assets: Profile of Youth in a Juvenile Justice Facility

ERIC Educational Resources Information Center

Chew, Weslee; Osseck, Jenna; Raygor, Desiree; Eldridge-Houser, Jennifer; Cox, Carol

2010-01-01

Background: Possessing high numbers of developmental assets greatly reduces the likelihood of a young person engaging in health-risk behaviors. Since youth in the juvenile justice system seem to exhibit many high-risk behaviors, the purpose of this study was to assess the presence of external, internal, and social context areas of developmental…

Cardiovascular Risk Factors and Behavioral Contracting in Exercise Programs.

ERIC Educational Resources Information Center

Neale, Anne Victoria; And Others

The use of behavioral contracting in exercise programs has been shown to be effective in increasing the frequency of exercise activity and in reducing dropout rates. A study was undertaken to examine the impact of three cardiovascular risk factors (poor physical fitness, obesity, and smoking) on both client willingness to sign a behavioral…

Reducing sexual risk behaviors: secondary analyses from a randomized controlled trial of a brief web-based alcohol intervention for underage, heavy episodic drinking college women.

PubMed

Bountress, Kaitlin E; Metzger, Isha W; Maples-Keller, Jessica L; Gilmore, Amanda K

2017-01-01

Alcohol use and sexual risk behaviors (SRBs) are significant problems on college campuses. College women are at particularly high risk for negative consequences associated with sexually transmitted infections (STIs) and unwanted pregnancy. The current study ( n = 160) examined the effect of a brief, web-based alcohol intervention ( n = 53) for college women on reducing SRBs compared to an assessment only control ( n = 107) with a randomized controlled trial. Outcome measures included condom use assertiveness and number of vaginal sex partners and data were collected at baseline and three-month follow-up. Regression analyses revealed that the alcohol intervention was associated with higher levels of condom use assertiveness at a three-month follow-up. Additionally, more alcohol use was associated with less condom use assertiveness for those with more significant sexual assault histories. These findings suggest that alcohol interventions may impact college women's beliefs but not behavior, and future interventions should more explicitly target both alcohol and sexual risk to decrease risky behaviors.

Reducing sexual risk behaviors: secondary analyses from a randomized controlled trial of a brief web-based alcohol intervention for underage, heavy episodic drinking college women

PubMed Central

Bountress, Kaitlin E.; Metzger, Isha W.; Maples-Keller, Jessica L.; Gilmore, Amanda K.

2017-01-01

Background Alcohol use and sexual risk behaviors (SRBs) are significant problems on college campuses. College women are at particularly high risk for negative consequences associated with sexually transmitted infections (STIs) and unwanted pregnancy. Methods The current study (n = 160) examined the effect of a brief, web-based alcohol intervention (n = 53) for college women on reducing SRBs compared to an assessment only control (n = 107) with a randomized controlled trial. Outcome measures included condom use assertiveness and number of vaginal sex partners and data were collected at baseline and three-month follow-up. Results Regression analyses revealed that the alcohol intervention was associated with higher levels of condom use assertiveness at a three-month follow-up. Additionally, more alcohol use was associated with less condom use assertiveness for those with more significant sexual assault histories. Conclusions These findings suggest that alcohol interventions may impact college women’s beliefs but not behavior, and future interventions should more explicitly target both alcohol and sexual risk to decrease risky behaviors. PMID:28428737

Long-term effects of self-control on alcohol use and sexual behavior among urban minority young women.

PubMed

Griffin, Kenneth W; Scheier, Lawrence M; Acevedo, Bianca; Grenard, Jerry L; Botvin, Gilbert J

2012-01-01

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors.

Long-Term Effects of Self-Control on Alcohol Use and Sexual Behavior among Urban Minority Young Women

PubMed Central

Griffin, Kenneth W.; Scheier, Lawrence M.; Acevedo, Bianca; Grenard, Jerry L.; Botvin, Gilbert J.

2011-01-01

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors. PMID:22470274

Lifestyle and Risk of Premature Sexual Activity in a High School Population of Seventh-Day Adventists: Valuegenesis 1989.

ERIC Educational Resources Information Center

Weinbender, Miriam L. M.; Rossignol, Annette MacKay

1996-01-01

Evaluated Adventist lifestyle as a modification of popular American culture which reduces the risk of early sexual activity in adolescents and thus also reduces the risk for both STDs and teen pregnancy. Data analysis demonstrated a wide variety of behaviors were associated with premature sexual activity, including previously reported high-risk…

Sleep, health behaviors, and behavioral interventions: Reducing the risk of cardiovascular disease in adults

PubMed Central

Kaar, Jill L; Luberto, Christina M; Campbell, Kirsti A; Huffman, Jeff C

2017-01-01

Numerous health behaviors, including physical activity, diet, smoking, and sleep, play a major role in preventing the development and progression of cardiovascular disease (CVD). Among these behaviors, sleep may play a pivotal role, yet it has been studied somewhat less than other behaviors and there have been few well-designed sleep intervention studies targeting CVD. Furthermore, despite the fact that these behaviors are often interrelated, interventions tend to focus on changing one health behavior rather than concurrently intervening on multiple behaviors. Psychological constructs from depression to positive affect may also have a major effect on these health behaviors and ultimately on CVD. In this review, we summarize the existing literature on the impact of sleep and other cardiac health behaviors on CVD onset and prognosis. We also describe interventions that may promote these behaviors, from established interventions such as motivational interviewing and cognitive behavioral therapy, to more novel approaches focused on mindfulness and other positive psychological constructs. Finally, we outline population-health-level care management approaches for patients with psychiatric conditions (e.g., depression) that may impact cardiac health, and discuss their potential utility in improving mental health, promoting health behaviors, and reducing CVD-related risk. Much work is still needed to better understand how sleep and other health behaviors may uniquely contribute to CVD risk, and additional high-quality studies of interventions designed to modify cardiac health behaviors are required to improve cardiovascular health in individuals and the population at large. PMID:28603586

Are Family Meals as Good for Youth as We Think They Are? A Review of the Literature on Family Meals as They Pertain to Adolescent Risk Prevention

ERIC Educational Resources Information Center

Skeer, Margie R.; Ballard, Erica L.

2013-01-01

Regular family meals have been shown to reduce adolescents' engagement in various risk behaviors. In this article, we comprehensively examine the literature to review the association between family meals and eight adolescent risk outcomes: alcohol, tobacco, marijuana and other drugs; aggressive and/or violent behaviors; poor school performance;…

Optimistic Bias, Risk Factors, and Development of High Blood Pressure and Obesity among African American Adolescents in Mississippi (USA)

PubMed Central

White, Monique S.; Addison, Clifton C.; Campbell Jenkins, Brenda W.; Bland, Vanessa; Clark, Adrianne; Antoine LaVigne, Donna

2017-01-01

Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and obesity in a school district. We examined the relationship between individual health risk practices and optimistic bias on health outcomes; 433 African American high school students were administered a survey and had their obesity and blood pressure measured by the school nurse. Canonical correlational analyses were used to examine relationships between health risk practices and descriptive statistics for optimistic bias and health outcomes. Engaging in moderate exercise for at least 30 min in the last 7 days and lower blood pressure was the only statistically significant relationship. Two-thirds of the students did not perceive themselves to be at risk of developing cardiovascular disease with males at greater risk than females, despite the presence of clinical risk factors for hypertension and obesity. Reducing health optimistic bias is an effective way of motivating young people to adopt more positive behaviors using educational institutions to implement intervention programs that promote positive health behavior as a way to reduce health disparities. PMID:28230728

Optimistic Bias, Risk Factors, and Development of High Blood Pressure and Obesity among African American Adolescents in Mississippi (USA).

PubMed

White, Monique S; Addison, Clifton C; Jenkins, Brenda W Campbell; Bland, Vanessa; Clark, Adrianne; LaVigne, Donna Antoine

2017-02-20

Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and obesity in a school district. We examined the relationship between individual health risk practices and optimistic bias on health outcomes; 433 African American high school students were administered a survey and had their obesity and blood pressure measured by the school nurse. Canonical correlational analyses were used to examine relationships between health risk practices and descriptive statistics for optimistic bias and health outcomes. Engaging in moderate exercise for at least 30 min in the last 7 days and lower blood pressure was the only statistically significant relationship. Two-thirds of the students did not perceive themselves to be at risk of developing cardiovascular disease with males at greater risk than females, despite the presence of clinical risk factors for hypertension and obesity. Reducing health optimistic bias is an effective way of motivating young people to adopt more positive behaviors using educational institutions to implement intervention programs that promote positive health behavior as a way to reduce health disparities.

The Interaction of Sexual Identity With Sexual Behavior and Its Influence on HIV Risk Among Latino Men: Results of a Community Survey in Northern San Diego County, California

PubMed Central

Zellner, Jennifer A.; Sañudo, Fernando; Fernández-Cerdeño, Araceli; Sipan, Carol L.; Hovell, Melbourne F.; Carrillo, Héctor

2009-01-01

Objectives. We examined the sexual behavior, sexual identities, and HIV risk factors of a community sample of Latino men to inform efforts to reduce Latinos' HIV risk. Methods. In 2005 and 2006, 680 Latino men in San Diego County, California, in randomly selected, targeted community venues, completed an anonymous, self-administered survey. Results. Most (92.3%) respondents self-identified as heterosexual, with 2.2%, 4.9%, and 0.6% self-identifying as bisexual, gay, or other orientation, respectively. Overall, 4.8% of heterosexually identified men had a lifetime history of anal intercourse with other men. Compared with behaviorally heterosexual men, heterosexually identified men who had sex with both men and women were more likely to have had a sexually transmitted infection, to have unprotected sexual intercourse with female partners, and to report having sex while under the influence of alcohol or other drugs. Bisexually identified men who had sex with men and women did not differ from behaviorally heterosexual men in these risk factors. Conclusions. Latino men who have a heterosexual identity and bisexual practices are at greater risk of HIV infection, and efforts to reduce HIV risk among Latinos should target this group. PMID:19008512

Health risks, correlates, and interventions to reduce sedentary behavior in young people.

PubMed

Salmon, Jo; Tremblay, Mark S; Marshall, Simon J; Hume, Clare

2011-08-01

Opportunities for young people to be sedentary have increased during leisure time, study time, and transportation time. This review paper focuses on sedentary behaviors among young people aged 2-18 years and includes evidence of the relationship between sedentary behavior and health risk indicators, an overview of public health recommendations, the prevalence of key sedentary behaviors, evidence of correlates of sedentary behavior and the effectiveness of interventions to reduce sedentary behaviors. Although this is a narrative style review and not systematic, where possible, findings from relevant review papers were summarized and a search of more recent literature was performed using computer-based databases such as PubMed, Google Scholar, ERIC, PsycINFO, Social Science Index, SportDiscus, and Health Reference Center - Academic. Young people spend 2-4 hours per day in screen-based behaviors and 5-10 hours per day sedentary. Ethnicity, sociodemographic status, having a TV set in the bedroom, and parental behavior appear to be the most consistent correlates of TV viewing time; however, few recent studies aiming to reduce TV viewing or sedentary time among young people have been successful. A growing body of evidence supports the development of public health recommendations to limit the time spent in screen-based behaviors. More research is needed to examine the prospective and experimental evidence of associations between overall sedentary time and health, determinants of sedentary behaviors other than screen-based behaviors, and interventions to reduce overall sedentary time or even alternative sedentary behaviors, such as transport- or education-related sitting time. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Does heightening risk appraisals change people's intentions and behavior? A meta-analysis of experimental studies.

PubMed

Sheeran, Paschal; Harris, Peter R; Epton, Tracy

2014-03-01

Several theories construe risk appraisals as key determinants of decisions and actions, and this idea has been supported in correlational studies. However, correlational data cannot answer the question, "Does heightening risk appraisals change people's intentions and behavior?" The present review meta-analyzed experimental evidence in order to address this issue. We identified 4 elements of risk appraisal-risk perception, anticipatory emotion, anticipated emotion, and perceived severity-and located experiments that (a) engendered a statistically significant increase in risk appraisal among treatment compared to control participants and (b) measured subsequent intention or behavior. Heightening risk appraisals had effects of d+ = .31 (k = 217) and d+ = .23 (k = 93) on intention and behavior, respectively. There was evidence that the elements of risk appraisal combined to influence outcomes. For instance, heightening risk perceptions had larger effects on outcomes when anticipatory emotions or perceived severity was also increased. Crucially, risk appraisal effects were augmented by coping appraisals: Risk appraisals had larger effects on outcomes when response efficacy and self-efficacy were enhanced or when response costs were reduced. The largest effect sizes were observed when risk appraisals, response efficacy, and self-efficacy were simultaneously heightened (d+ = .98 and .45, for intention and behavior, respectively). These findings indicate that heightening risk appraisals changes intentions and behavior. However, the direct effects of risk appraisals were generally small. Exploiting synergies among the elements of risk appraisal, and between risk appraisals and coping appraisals, should make for more effective behavior change interventions.

Evaluation of a Digital Behavioral Counseling Program for Reducing Risk Factors for Chronic Disease in a Workforce.

PubMed

Wilson, Mark G; Castro Sweet, Cynthia M; Edge, Michael D; Madero, Erica N; McGuire, Megan; Pilsmaker, Megan; Carpenter, Dan; Kirschner, Scott

2017-08-01

To evaluate a digitally delivered, intensive behavioral counseling program for a workforce at risk for obesity-related chronic disease. Employees were offered a digital health program modeled after the diabetes prevention program (DPP). Annual workforce health assessments were used to examine changes in chronic disease risk factors between participants (n = 634) relative to a matched comparison group (n = 1268). Overall, employees were gaining an average of 3.5 pounds annually before program inception. Program engagement was positive; 83% completed the majority of the curriculum and 31% lost at least 5% of their starting weight. Compared with non-participating peers, participants demonstrated reduced weight, improved fasting blood glucose, and improved nutritional intake after a year. The digital health program was effective for engaging employees in health behavior change. Digital options facilitate widespread implementation.

"Nudges" to Prevent Behavioral Risk Factors Associated With Major Depressive Disorder.

PubMed

Woodend, Ashleigh; Schölmerich, Vera; Denktaş, Semiha

2015-11-01

Major depressive disorder-colloquially called "depression"-is a primary global cause of disability. Current preventive interventions, such as problem-solving therapy, are effective but also expensive. "Nudges" are easy and cheap interventions for altering behavior. We have explored how nudging can reduce three behavioral risk factors of depression: low levels of physical activity, inappropriate coping mechanisms, and inadequate maintenance of social ties. These nudges use cognitive biases associated with these behavioral risks, such as valuing the present more than the future, following the herd or the norm, making different choices in light of equivalent conditions, and deciding on the basis of salience or attachment to status quo.

The Empowering Role of Mobile Apps in Behavior Change Interventions: The Gray Matters Randomized Controlled Trial.

PubMed

Hartin, Phillip J; Nugent, Chris D; McClean, Sally I; Cleland, Ian; Tschanz, JoAnn T; Clark, Christine J; Norton, Maria C

2016-08-02

Health education and behavior change programs targeting specific risk factors have demonstrated their effectiveness in reducing the development of future diseases. Alzheimer disease (AD) shares many of the same risk factors, most of which can be addressed via behavior change. It is therefore theorized that a behavior change intervention targeting these risk factors would likely result in favorable rates of AD prevention. The objective of this study was to reduce the future risk of developing AD, while in the short term promoting vascular health, through behavior change. The study was an interventional randomized controlled trial consisting of subjects who were randomly assigned into either treatment (n=102) or control group (n=42). Outcome measures included various blood-based biomarkers, anthropometric measures, and behaviors related to AD risk. The treatment group was provided with a bespoke "Gray Matters" mobile phone app designed to encourage and facilitate behavior change. The app presented evidence-based educational material relating to AD risk and prevention strategies, facilitated self-reporting of behaviors across 6 behavioral domains, and presented feedback on the user's performance, calculated from reported behaviors against recommended guidelines. This paper explores the rationale for a mobile phone-led intervention and details the app's effect on behavior change and subsequent clinical outcomes. Via the app, the average participant submitted 7.3 (SD 3.2) behavioral logs/day (n=122,719). Analysis of these logs against primary outcome measures revealed that participants who improved their high-density lipoprotein cholesterol levels during the study duration answered a statistically significant higher number of questions per day (mean 8.30, SD 2.29) than those with no improvement (mean 6.52, SD 3.612), t97.74=-3.051, P=.003. Participants who decreased their body mass index (BMI) performed significantly better in attaining their recommended daily goals (mean 56.21 SD 30.4%) than those who increased their BMI (mean 40.12 SD 29.1%), t80 = -2.449, P=.017. In total, 69.2% (n=18) of those who achieved a mean performance percentage of 60% or higher, across all domains, reduced their BMI during the study, whereas 60.7% (n=34) who did not, increased their BMI. One-way analysis of variance of systolic blood pressure category changes showed a significant correlation between reported efforts to reduce stress and category change as a whole, P=.035. An exit survey highlighted that respondents (n=83) reported that the app motivated them to perform physical activity (85.4%) and make healthier food choices (87.5%). In this study, the ubiquitous nature of the mobile phone excelled as a delivery platform for the intervention, enabling the dissemination of educational intervention material while simultaneously monitoring and encouraging positive behavior change, resulting in desirable clinical effects. Sustained effort to maintain the achieved behaviors is expected to mitigate future AD risk. ClinicalTrails.gov NCT02290912; https://clinicaltrials.gov/ct2/show/NCT02290912 (Archived by WebCite at http://www.webcitation.org/6ictUEwnm).

The Empowering Role of Mobile Apps in Behavior Change Interventions: The Gray Matters Randomized Controlled Trial

PubMed Central

Nugent, Chris D; McClean, Sally I; Cleland, Ian; Tschanz, JoAnn T; Clark, Christine J; Norton, Maria C

2016-01-01

Background Health education and behavior change programs targeting specific risk factors have demonstrated their effectiveness in reducing the development of future diseases. Alzheimer disease (AD) shares many of the same risk factors, most of which can be addressed via behavior change. It is therefore theorized that a behavior change intervention targeting these risk factors would likely result in favorable rates of AD prevention. Objective The objective of this study was to reduce the future risk of developing AD, while in the short term promoting vascular health, through behavior change. Methods The study was an interventional randomized controlled trial consisting of subjects who were randomly assigned into either treatment (n=102) or control group (n=42). Outcome measures included various blood-based biomarkers, anthropometric measures, and behaviors related to AD risk. The treatment group was provided with a bespoke “Gray Matters” mobile phone app designed to encourage and facilitate behavior change. The app presented evidence-based educational material relating to AD risk and prevention strategies, facilitated self-reporting of behaviors across 6 behavioral domains, and presented feedback on the user’s performance, calculated from reported behaviors against recommended guidelines. Results This paper explores the rationale for a mobile phone–led intervention and details the app’s effect on behavior change and subsequent clinical outcomes. Via the app, the average participant submitted 7.3 (SD 3.2) behavioral logs/day (n=122,719). Analysis of these logs against primary outcome measures revealed that participants who improved their high-density lipoprotein cholesterol levels during the study duration answered a statistically significant higher number of questions per day (mean 8.30, SD 2.29) than those with no improvement (mean 6.52, SD 3.612), t97.74=−3.051, P=.003. Participants who decreased their body mass index (BMI) performed significantly better in attaining their recommended daily goals (mean 56.21 SD 30.4%) than those who increased their BMI (mean 40.12 SD 29.1%), t80 = −2.449, P=.017. In total, 69.2% (n=18) of those who achieved a mean performance percentage of 60% or higher, across all domains, reduced their BMI during the study, whereas 60.7% (n=34) who did not, increased their BMI. One-way analysis of variance of systolic blood pressure category changes showed a significant correlation between reported efforts to reduce stress and category change as a whole, P=.035. An exit survey highlighted that respondents (n=83) reported that the app motivated them to perform physical activity (85.4%) and make healthier food choices (87.5%). Conclusions In this study, the ubiquitous nature of the mobile phone excelled as a delivery platform for the intervention, enabling the dissemination of educational intervention material while simultaneously monitoring and encouraging positive behavior change, resulting in desirable clinical effects. Sustained effort to maintain the achieved behaviors is expected to mitigate future AD risk. Trial Registration ClinicalTrails.gov NCT02290912; https://clinicaltrials.gov/ct2/show/NCT02290912 (Archived by WebCite at http://www.webcitation.org/6ictUEwnm) PMID:27485822

Are family meals as good for youth as we think they are? A review of the literature on family meals as they pertain to adolescent risk prevention.

PubMed

Skeer, Margie R; Ballard, Erica L

2013-07-01

Regular family meals have been shown to reduce adolescents' engagement in various risk behaviors. In this article, we comprehensively examine the literature to review the association between family meals and eight adolescent risk outcomes: alcohol, tobacco, marijuana and other drugs; aggressive and/or violent behaviors; poor school performance; sexual behavior; mental health problems; and disordered eating patterns. The majority of the studies reviewed found associations in the relationship between family meals and adolescents' risk profiles. More specifically, studies reporting significant associations found that adolescents who frequently ate meals with their family and/or parents were less likely to engage in risk behaviors when compared to peers who never or rarely ate meals with their families. Additionally, the influence of family meal frequency on youth risk outcomes appears to be dependent on gender, with family meals being a protective factor for females and males differently, depending on the outcome examined. However, the studies available about family meals and adolescent risk only examined the effect of family meal frequency, and not other components of family meals that contribute to the protective effect, and, thus, hinder the understanding of the mechanisms unique to family meals' protective characteristics. Regardless of these limitations, the studies examined indicate that family meals may be protective and, therefore, have practical implications for parents, clinicians, and organizations looking to reduce adolescent risk behaviors. However, further examination is needed to better understand the mechanisms that contribute to the protective effect afforded by family meal frequency on adolescents.

Study designs for identifying risk compensation behavior among users of biomedical HIV prevention technologies: balancing methodological rigor and research ethics.

PubMed

Underhill, Kristen

2013-10-01

The growing evidence base for biomedical HIV prevention interventions - such as oral pre-exposure prophylaxis, microbicides, male circumcision, treatment as prevention, and eventually prevention vaccines - has given rise to concerns about the ways in which users of these biomedical products may adjust their HIV risk behaviors based on the perception that they are prevented from infection. Known as risk compensation, this behavioral adjustment draws on the theory of "risk homeostasis," which has previously been applied to phenomena as diverse as Lyme disease vaccination, insurance mandates, and automobile safety. Little rigorous evidence exists to answer risk compensation concerns in the biomedical HIV prevention literature, in part because the field has not systematically evaluated the study designs available for testing these behaviors. The goals of this Commentary are to explain the origins of risk compensation behavior in risk homeostasis theory, to reframe risk compensation as a testable response to the perception of reduced risk, and to assess the methodological rigor and ethical justification of study designs aiming to isolate risk compensation responses. Although the most rigorous methodological designs for assessing risk compensation behavior may be unavailable due to ethical flaws, several strategies can help investigators identify potential risk compensation behavior during Phase II, Phase III, and Phase IV testing of new technologies. Where concerns arise regarding risk compensation behavior, empirical evidence about the incidence, types, and extent of these behavioral changes can illuminate opportunities to better support the users of new HIV prevention strategies. This Commentary concludes by suggesting a new way to conceptualize risk compensation behavior in the HIV prevention context. Copyright © 2013 Elsevier Ltd. All rights reserved.

Study designs for identifying risk compensation behavior among users of biomedical HIV prevention technologies: Balancing methodological rigor and research ethics

PubMed Central

Underhill, Kristen

2014-01-01

The growing evidence base for biomedical HIV prevention interventions – such as oral pre-exposure prophylaxis, microbicides, male circumcision, treatment as prevention, and eventually prevention vaccines – has given rise to concerns about the ways in which users of these biomedical products may adjust their HIV risk behaviors based on the perception that they are prevented from infection. Known as risk compensation, this behavioral adjustment draws on the theory of “risk homeostasis,” which has previously been applied to phenomena as diverse as Lyme disease vaccination, insurance mandates, and automobile safety. Little rigorous evidence exists to answer risk compensation concerns in the biomedical HIV prevention literature, in part because the field has not systematically evaluated the study designs available for testing these behaviors. The goals of this Commentary are to explain the origins of risk compensation behavior in risk homeostasis theory, to reframe risk compensation as a testable response to the perception of reduced risk, and to assess the methodological rigor and ethical justification of study designs aiming to isolate risk compensation responses. Although the most rigorous methodological designs for assessing risk compensation behavior may be unavailable due to ethical flaws, several strategies can help investigators identify potential risk compensation behavior during Phase II, Phase III, and Phase IV testing of new technologies. Where concerns arise regarding risk compensation behavior, empirical evidence about the incidence, types, and extent of these behavioral changes can illuminate opportunities to better support the users of new HIV prevention strategies. This Commentary concludes by suggesting a new way to conceptualize risk compensation behavior in the HIV prevention context. PMID:23597916

Familia Adelante: A Multi-Risk Prevention Intervention for Latino Families

PubMed Central

Cervantes, Richard; Goldbach, Jeremy; Santos, Susana M.

2011-01-01

A comprehensive approach for providing behavioral health services to youth is becoming increasingly emphasized (IOM, 2009). Latino youth are at increased risk for substance abuse, mental health concerns, unsafe sexual practices and HIV (Prado et al., 2006), and these outcomes have been empirically connected to individual, family and community-based stress (IOM, 2009). Despite this knowledge, there is a lack of evidence-based approaches that target these negative outcomes by reducing stress in Latino families in a culturally relevant manner (Cervantes, Kappos, Duenas & Arellano, 2003). The current study examined the use of research-based strategies for reducing multiple risk behaviors in a predominantly Mexican American sample of families. Through a modular approach, participants engaged in a psycho-educational curriculum to enhance communication and psychosocial coping, increase substance abuse and HIV knowledge and perception of harm, and improve school behavior. Over 12 sessions, the curriculum aimed to achieve these outcomes through an overall decrease in family and community-based stress by focusing on acculturative stress. Findings indicate that communication and perception of substance use harm were significantly enhanced, while social norms regarding sexual behavior, HIV anxiety and past use of marijuana and other illegal drugs were significantly reduced. While many of measures were reliable (α > .80), further changes are necessary to improve the accuracy of future studies. Despite these limitations, Familia Adelante improves many areas of participant’s family life, and points toward the feasibility of multi-risk reduction behavioral health prevention approaches. PMID:21822979

Stress mediates the relationship between past drug addiction and current risky sexual behavior among low income women

PubMed Central

Wu, Z. Helen; Tennen, Howard; Hosain, Monawar; Coman, Emil; Cullum, Jerry; Berenson, Abbey B.

2014-01-01

This study examined the role of stress as a mediator of the relationship between prior drug addiction and current high risk sexual behavior. Eight hundred twenty women aged 18 to 30 years, who received care at community-based family planning clinics were interviewed using the Composite International Diagnostic Interview and the Sexual Risk Behavior Assessment Schedule. They also completed the brief version of the Self-Control Scale as a measure of problem-solving strategies, and measures of recent stressful events, daily hassles, and ongoing chronic stress. Regardless of addiction history, stress exposure during the previous 12 months was associated with risky sexual behavior during the previous 12 months. Structural equation modeling revealed that 12-month stress levels mediated the relationship between past drug addiction and 12-month high risk sexual behaviors, as well as the negative relationship between problem-solving strategies and high risk sexual behaviors. Problem-solving strategies did not moderate the relationship between drug addiction and high risk sexual behaviors. These findings suggest that stress management training may help reduce risky behavior among young, low-income women PMID:24985341

HIV Education and Sexual Risk Behaviors Among Young Men Who Have Sex with Men

PubMed Central

Beyrer, Chris; Arrington-Sanders, Renata

2018-01-01

Abstract Purpose: Men who have sex with men (MSM) have nearly 80 times the lifetime risk of human immunodeficiency virus (HIV) relative to men who have sex with women only (MSW), and young MSM (YMSM) accounted for 95% of estimated HIV diagnoses among adolescents between 13 and 24 years in 2015. We aimed to evaluate HIV education and sexual risk behaviors among YMSM relative to young MSW (YMSW) and to evaluate the relationship between HIV education and YMSM sexual risk behaviors. Methods: We used Youth Risk Behavior Surveillance System data from 13 states that collected information on sex of sexual contacts and on HIV education in 2011 and/or 2013. We assessed HIV education, number of sexual partners ever and in the past three months, and condom use at last sex in logistic regression analyses controlling for age, race/ethnicity, state, and year. Results: YMSM were less likely to report school-based HIV education and more likely to report sexual risk behaviors relative to YMSW. HIV education was associated with reduced sexual risk behaviors among all students and with significant additional reductions in sexual risk behaviors among YMSM. Conclusion: There is a need for HIV education programs to reach YMSM, who are at increased risk of HIV. PMID:29297755

HIV Education and Sexual Risk Behaviors Among Young Men Who Have Sex with Men.

PubMed

Raifman, Julia; Beyrer, Chris; Arrington-Sanders, Renata

Men who have sex with men (MSM) have nearly 80 times the lifetime risk of human immunodeficiency virus (HIV) relative to men who have sex with women only (MSW), and young MSM (YMSM) accounted for 95% of estimated HIV diagnoses among adolescents between 13 and 24 years in 2015. We aimed to evaluate HIV education and sexual risk behaviors among YMSM relative to young MSW (YMSW) and to evaluate the relationship between HIV education and YMSM sexual risk behaviors. We used Youth Risk Behavior Surveillance System data from 13 states that collected information on sex of sexual contacts and on HIV education in 2011 and/or 2013. We assessed HIV education, number of sexual partners ever and in the past three months, and condom use at last sex in logistic regression analyses controlling for age, race/ethnicity, state, and year. YMSM were less likely to report school-based HIV education and more likely to report sexual risk behaviors relative to YMSW. HIV education was associated with reduced sexual risk behaviors among all students and with significant additional reductions in sexual risk behaviors among YMSM. There is a need for HIV education programs to reach YMSM, who are at increased risk of HIV.

Using the Information-Motivation Behavioral Model to Predict Sexual Behavior among Underserved Minority Youth

ERIC Educational Resources Information Center

Bazargan, Mohsen; Stein, Judith A.; Bazargan-Hejazi, Shahrzad; Hindman, David W.

2010-01-01

Background: Testing, refining, and tailoring theoretical approaches that are hypothesized to reduce sexual risk behaviors among adolescent subpopulations is an important task. Relatively little is known about the relationship between components of the information-motivation-behavior (IMB) model and sexual behaviors among underage minority youth.…

A Randomized Controlled Trial of Familias Unidas for Hispanic Adolescents With Behavior Problems

PubMed Central

Pantin, Hilda; Prado, Guillermo; Lopez, Barbara; Huang, Shi; Tapia, Maria I.; Schwartz, Seth J.; Sabillon, Eduardo; Brown, C. Hendricks; Branchini, Jennifer

2009-01-01

Objective To evaluate the efficacy of Familias Unidas, a Hispanic-specific, parent-centered intervention, in preventing/reducing adolescent substance use, unsafe sexual behavior, and externalizing disorders. Methods A total of 213 8th grade Hispanic adolescents with behavior problems and their primary caregivers were assigned randomly to one of two conditions: Familias Unidas or Community Control. Participants were assessed at baseline and at 6, 18, and 30 months post baseline. Results Results showed that, relative to a Community Control condition, Familias Unidas was efficacious in preventing or reducing externalizing disorders, preventing and reducing substance use, and in reducing unsafe sexual behavior. The effects of Familias Unidas on these outcomes were partially mediated by improvements in family functioning. Conclusions These findings suggest that parent-centered intervention is an efficacious strategy for preventing/reducing specific health risk behaviors in Hispanic adolescents with behavior problems. PMID:19834053

Fat-related dietary behaviors of adult Puerto Ricans, with and without diabetes, in New York City.

PubMed

Melnik, Thomas A; Spence, Maureen M; Hosler, Akiko S

2006-09-01

To assess the fat-related dietary behaviors of adult Puerto Ricans with and without diagnosed diabetes, living in New York City. A random-digit-dialing telephone survey was conducted following Behavioral Risk Factor Surveillance System procedures. Dietary behavior was assessed using a brief Fat-Related Diet Habits Questionnaire, in which higher scores indicated higher fat intake. A total of 1,304 adult Puerto Ricans living in New York City were interviewed. Diabetes status was assessed using standard Behavioral Risk Factor Surveillance System questions. Weighted analyses using SUDAAN software for complex surveys were done, and t tests were used to assess differences in mean fat-related dietary score by sociodemographic and health characteristics. Age-adjusted least-squared means were used to compare scores between those with and without diabetes. Linear regression was used to model characteristics associated with fat-related dietary score. Fat-related dietary score was lower among those with diabetes and varied by population and health characteristics. Age-adjusted scores were significantly lower for those with diabetes who were younger, less educated, obese, or physically active. In the regression model, family history, weight, and exercise interacted with diabetes status. Those with diabetes were significantly more likely to modify meat consumption practices (eg, remove skin or trim fat) to reduce fat compared with those without diabetes. New York City Puerto Ricans with diabetes are somewhat more likely to engage in behaviors to reduce fat compared with those without diabetes. Targeted, culturally sensitive nutrition education and counseling emphasizing lower-fat food choices and other fat-reducing behaviors can help reduce risk and control diabetes. Education messages should be tailored to the individual's diabetes status and other health and sociodemographic characteristics.

The Combined Effects of Alcohol, Caffeine and Expectancies on Subjective Experience, Impulsivity and Risk-Taking

PubMed Central

Heinz, Adrienne J.; de Wit, Harriet; Lilje, Todd C.; Kassel, Jon D.

2013-01-01

Caffeinated alcoholic beverage (CAB) consumption is a rapidly growing phenomenon among young adults and is associated with a variety of health-risk behaviors. The current study examined whether either caffeinated alcohol or the expectation of receiving caffeinated alcohol altered affective, cognitive and behavioral outcomes hypothesized to contribute to risk behavior. Young adult social drinkers (N=146) participated in a single session where they received alcohol (peak Breath Alcohol Content = .088 g/dL, SD = .019; equivalent to about 4 standard drinks) and were randomly assigned to one of four further conditions 1) no caffeine, no caffeine expectancy, 2) caffeine and caffeine expectancy, 3) no caffeine but caffeine expectancy, 4) caffeine but no caffeine expectancy. Participants’ habitual CAB consumption was positively correlated with measures of impulsivity and risky behavior, independently of study drugs. Administration of caffeine (mean dose = 220 mg, SD = 38; equivalent to about 2.75 Red Bulls) in the study reduced subjective ratings of intoxication and reversed the decrease in desire to continue drinking, regardless of expectancy. Caffeine also reduced the effect of alcohol on inhibitory reaction time (faster incorrect responses). Participants not expecting caffeine were less attentive after alcohol, whereas participants expecting caffeine were not, regardless of caffeine administration. Alcohol decreased response accuracy in all participants except those who both expected and received caffeine. Findings suggest that CABs may elevate risk for continued drinking by reducing perceived intoxication, and by maintaining the desire to continue drinking. Simply expecting to consume caffeine may reduce the effects of alcohol on inattention, and either expecting or consuming caffeine may protect against other alcohol-related performance decrements. Caffeine, when combined with alcohol, has both beneficial and detrimental effects on mechanisms known to contribute to risky behavior. PMID:23750693

Gender and racial/ethnic disparities in the impact of HIV prevention programming in substance abuse treatment.

PubMed

Cao, Dingcai; Marsh, Jeanne C; Shin, Hee-Choon

2008-01-01

The objective of the study was to evaluate the capacity of HIV prevention programs offered in substance abuse treatment to reduce HIV-related risk behavior for women and men and for Black, Latino, and White groups. Prospective data was collected at intake, discharage, and 12 months post-treatment from 1992 to 1997 for the National Treatment Improvement Evaluation Study with a sample consisting of 3,142 clients from 59 service delivery units: 972 females, 1,870 males, 1,812 Blacks, 486 Latinos, and 844 Whites. Study findings show that receipt of HIV prevention programming as part of substance abuse treatment services resulted in reductions in HIV-related risk behavior for the sample overall and for women as well as men. However, although Blacks received more prevention services than Latinos and Whites, the significant positive effect of HIV services on reduced HIVrisk behavior held only for Whites. Racial/ethnic disparities exist in the capacity for HIV prevention programming offered as part of substance abuse treatment to reduce HIV-risk behavior. The findings highlight the need for the development of culturally competent service delivery strategies to enhance the impact of these services for all groups.

Middle Eastern Energy Security: Synchronizing Domestic and Foreign Policy

DTIC Science & Technology

2009-05-18

Reversing profligacy is largely an undertaking to change consumer behavior that will reduce demand and therefore dependence on oil. It will have the...transportation technology and associated goods and services. One of the most powerful catalysts for change in America is consumer behavior . As such...and reducing consumption run the risk of failure because changing consumer behavior and long-standing cultural norms will face stiff resistance in the

Long-Term Effects of the Communities That Care Trial on Substance Use, Antisocial Behavior, and Violence Through Age 21 Years.

PubMed

Oesterle, Sabrina; Kuklinski, Margaret R; Hawkins, J David; Skinner, Martie L; Guttmannova, Katarina; Rhew, Isaac C

2018-05-01

To evaluate whether the effects of the Communities That Care (CTC) prevention system, implemented in early adolescence to promote positive youth development and reduce health-risking behavior, endured through age 21 years. We analyzed 9 waves of prospective data collected between 2004 and 2014 from a panel of 4407 participants (grade 5 through age 21 years) in the community-randomized trial of the CTC system in Colorado, Illinois, Kansas, Maine, Oregon, Utah, and Washington State. We used multilevel models to evaluate intervention effects on sustained abstinence, lifetime incidence, and prevalence of past-year substance use, antisocial behavior, and violence. The CTC system increased the likelihood of sustained abstinence from gateway drug use by 49% and antisocial behavior by 18%, and reduced lifetime incidence of violence by 11% through age 21 years. In male participants, the CTC system also increased the likelihood of sustained abstinence from tobacco use by 30% and marijuana use by 24%, and reduced lifetime incidence of inhalant use by 18%. No intervention effects were found on past-year prevalence of these behaviors. Implementation of the CTC prevention system in adolescence reduced lifetime incidence of health-risking behaviors into young adulthood. Clinicaltrials.gov identifier: NCT01088542.

Emotional Intelligence: An Untapped Resource for Alcohol and Other Drug Related Prevention among Adolescents and Adults

PubMed Central

Coelho, Ken Russell

2012-01-01

Alcohol and Other Drug abuse in adolescents and adults continues to be a major public health problem in the United States. Care in intervention programs aimed at high risk populations identified occurs after the maladaptive behavioral delinquency has occurred, and only then is an individual afforded the opportunity to join an intervention program. The focus of this paper is to illustrate and highlight the value of prevention programs which emphasize altering maladaptive behavior before the behavior becomes problematic. Emotional Intelligence is not only an indicator of alcohol and other drug abuse, but is linked to emotional competence, social and emotional learning, the development of healthy and life promoting behavior, and has been proven to reduce some of the risk factors associated with alcohol and other drug abuse in adolescents and adults. This paper seeks to recognize the significance of Emotional Intelligence as a desirable health promoting attribute and to establish the importance of its conceptual use in a prevention based model for reducing associated high risk behaviors. PMID:22570777

The Association Between Suicidal Behavior, Attentional Control, and Frontal Asymmetry

PubMed Central

Thompson, Catherine; Ong, Elsie Li Chen

2018-01-01

It can be difficult to identify those at risk of suicide because suicidal thoughts are often internalized and not shared with others. Yet to prevent suicide attempts it is crucial to identify suicidal thoughts and actions at an early stage. Past studies have suggested that deficits in attentional control are associated with suicide, with the argument that individuals are unable to inhibit negative thoughts and direct resources away from negative information. The current study aimed to investigate the association of suicidal behavior with neurological and behavioral markers, measuring attentional bias and inhibition in two Stroop tasks. Fifty-four participants responded to the color of color words in a standard Stroop task and the color of positive, negative, and neutral words in an emotional Stroop task. Electroencephalographic (EEG) activity was recorded from frontal areas during each task and at resting. Participants were separated into a low-risk and high-risk group according to their self-reported suicidal behavior. Participants in the high-risk group showed slower response times in the color Stroop and reduced accuracy to incongruent trials, but faster response times in the emotional Stroop task. Response times to the word “suicide” were significantly slower for the high-risk group. This indicates an attentional bias toward specific negative stimuli and difficulties inhibiting information for those with high levels of suicidal behavior. In the emotional Stroop task the high-risk group showed reduced activity in leftward frontal areas, suggesting limitations in the ability to regulate emotional processing via the left frontal regions. The findings support the argument that deficits in attentional control are related to suicidal behavior. The research also suggests that under certain conditions frontal asymmetry may be associated with suicidal behavior. PMID:29593586

Information sources, awareness and preventive health behaviors in a population at risk of Arsenic exposure: The role of gender and social networks

PubMed Central

Távora, Renata; Nakano, Eduardo Yoshio; Castilhos, Zuleica Carmen

2017-01-01

The population of Paracatu is at risk of Arsenic (As) exposure associated with long-term exploration of the largest open pit gold mine in Brazil. As part of the interdisciplinary research “The Paracatu project: Arsenic environmental contamination and human health risks assessment in Paracatu-MG”, carried out between 2011 and 2013, we used data disaggregated by gender to identify the sources of As-related information being accessed by inhabitants of Paracatu and to examine if access to these sources was correlated to awareness of As health effects and adoption of behaviors to reduce risk of As exposure. Semi-structured, face-to-face interviews were carried out with 460 participants (294 women and 166 men) to collect data on respondent’s socio-demographic characteristics, use of mass media and social communication networks as sources of information on As issues, the trustworthiness of these information sources, awareness of As health effects, and adoption of behaviors to reduce As exposure. For both men and women, interpersonal communication was used and trusted more frequently than mass media to obtain information on As. Discussion of As issues occurred preferentially among individuals of the same gender and was associated with awareness of As health risks. There are marked differences in variables correlated with the adoption of behaviors to reduce the risk of As exposure between men and women. Discussing As issues with women was associated with adoption of risk-reduction practices for both genders. In contrast, men who discuss As issues with other men were less likely to adopt As exposure prevention behaviors. Finally, adoption was associated with awareness of As health effects for women, but this was not the case for men. Policy implications for decision makers, practitioners and researchers are discussed, based on concrete examples of how gender-specific approaches can effectively guide the formulation and implementation of health promotion campaigns and programs. PMID:29016663

Reducing Risk through a Supplementary Reading Intervention: A Case Study of First- and Second-Grade Urban Students

ERIC Educational Resources Information Center

Council, Morris R., III; Cartledge, Gwendolyn; Green, DeLayna; Barber, Mariah; Gardner, Ralph, III

2016-01-01

This descriptive study examined whether a computer-based, repeated reading intervention (i.e., Reading Relevant and Culturally Engaging Stories) is associated with improved reading and social behavior for three primary-aged urban black girls who each showed both academic and behavioral risk. The Reading Relevant and Culturally Engaging Stories…

Artificial neural network modeling using clinical and knowledge independent variables predicts salt intake reduction behavior

PubMed Central

Isma’eel, Hussain A.; Sakr, George E.; Almedawar, Mohamad M.; Fathallah, Jihan; Garabedian, Torkom; Eddine, Savo Bou Zein

2015-01-01

Background High dietary salt intake is directly linked to hypertension and cardiovascular diseases (CVDs). Predicting behaviors regarding salt intake habits is vital to guide interventions and increase their effectiveness. We aim to compare the accuracy of an artificial neural network (ANN) based tool that predicts behavior from key knowledge questions along with clinical data in a high cardiovascular risk cohort relative to the least square models (LSM) method. Methods We collected knowledge, attitude and behavior data on 115 patients. A behavior score was calculated to classify patients’ behavior towards reducing salt intake. Accuracy comparison between ANN and regression analysis was calculated using the bootstrap technique with 200 iterations. Results Starting from a 69-item questionnaire, a reduced model was developed and included eight knowledge items found to result in the highest accuracy of 62% CI (58-67%). The best prediction accuracy in the full and reduced models was attained by ANN at 66% and 62%, respectively, compared to full and reduced LSM at 40% and 34%, respectively. The average relative increase in accuracy over all in the full and reduced models is 82% and 102%, respectively. Conclusions Using ANN modeling, we can predict salt reduction behaviors with 66% accuracy. The statistical model has been implemented in an online calculator and can be used in clinics to estimate the patient’s behavior. This will help implementation in future research to further prove clinical utility of this tool to guide therapeutic salt reduction interventions in high cardiovascular risk individuals. PMID:26090333

Risk-taking behaviors and impulsivity among veterans with and without PTSD and mild TBI.

PubMed

James, Lisa M; Strom, Thad Q; Leskela, Jennie

2014-04-01

Military personnel commonly experience post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI), both of which are associated with premature mortality. The present study examined two factors that may play a role in premature mortality--impulsivity and risk-taking behaviors--in a sample of 234 veterans screening positive for PTSD, mTBI, PTSD + mTBI, and controls. Analyses of variance demonstrated that veterans with PTSD, regardless of mTBI status, reported engaging in more frequent risky behaviors and reported a greater tendency to engage in impulsive behaviors when in a negative affective state. They also reported more premilitary delinquent behaviors and more suicide-related behaviors than controls. The present study highlights associations between impulsivity, risk-taking behaviors, and PTSD, and suggests continuity across the lifespan in terms of a predisposition to engage in impulsive and/or risky behaviors. Thorough evaluation of impulsivity and potentially risky behaviors is important in clinical settings to guide interventions and reduce the mortality and public health impact of high-risk behaviors in veterans. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Risky Sex in High-Risk Adolescents: Associations with Alcohol Use, Marijuana Use, and Co-Occurring Use.

PubMed

Gillman, Arielle S; Yeater, Elizabeth A; Feldstein Ewing, Sarah W; Kong, Alberta S; Bryan, Angela D

2018-04-01

Risky sexual behavior and substance use appear to be interconnected behaviors among adolescents, but data are scarce regarding the extent to which sexual risk behavior is associated with high levels of marijuana and alcohol use, both separately and in combination. 301 adolescents were recruited from a short-term detention facility, and substance use and risky sexual behavior were assessed. We found that adolescents who frequently used marijuana, but not alcohol, reported significantly less risky sex as well as greater intentions to use condoms than either adolescents who frequently used alcohol, but not marijuana, or adolescents who frequently used both substances. Substance use status as a predictor of future risky sexual behavior followed a similar pattern. When designing interventions to reduce substance use in the context of risky sex, it might be especially effective to target efforts toward reducing harm associated with alcohol use, either alone or in combination with marijuana use.

Integrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study.

PubMed

Shrestha, Roman; Altice, Frederick L; Karki, Pramila; Copenhaver, Michael M

2018-03-26

This study reports the feasibility, acceptability, and preliminary efficacy of the bio-behavioral community-friendly health recovery program-an integrated, HIV prevention intervention to improve pre-exposure prophylaxis (PrEP) adherence and HIV-risk reduction behaviors among high-risk people who use drugs. We used a within-subjects, pretest-posttest follow-up design to recruit participants, who were HIV-uninfected, methadone-maintained and reported HIV-risk behaviors and had initiated PrEP (n = 40; males: 55%). Participants were assessed at baseline (T 0 ), immediately post-intervention (4 weeks: T 4 ) and 4 weeks post-intervention (T 8 ). Immediately after completing the four weekly intervention groups, participants underwent a post-intervention assessment including in-depth qualitative interviews. Feasibility was high, assessed by participant willingness to enroll (90.1%) and retention (95%). Results showed that participants were highly satisfied and perceived the intervention as valuable and acceptable [mean: 81.3 (range 0-100)]. Significant enhancements in self-reported PrEP adherence [F(2,74) = 7.500, p = 0.001] and PrEP-related knowledge [F(2,74) = 3.828, p = 0.026] were observed. Drug-related (e.g., injection of drugs, sharing of injection equipment) and sex-related (e.g., number of sexual partners, condomless sex) risk behaviors were reduced, while information, motivation, and behavioral skills (IMB) constructs increased. The results support feasibility and high acceptability and support further examination of the efficacy of this combination bio-behavioral intervention in a prospective clinical trial.

Borderline Personality Disorder Diagnostic Criteria as Risk Factors for Suicidal Behavior Through the Lens of the Interpersonal Theory of Suicide.

PubMed

Rogers, Megan L; Joiner, Thomas E

2016-01-01

Borderline personality disorder diagnostic criteria, particularly affective dysregulation and behavioral dysregulation, are avenues through which suicide risk is conferred, though pathways are not well understood. The interpersonal theory of suicide may help elucidate these associations. The current study examined indirect relationships between affective and behavioral dysregulation and suicidal ideation through perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide. 169 outpatients completed measures prior to their intake assessment. Perceived burdensomeness accounted for the relationship between affective dysregulation and suicidal ideation. The acquired capability did not explain the association between behavioral dysregulation and suicide attempt history. Affective and behavioral dysregulation may be key targets in treatment for reducing suicide risk.

Integrating Household Risk Mitigation Behavior in Flood Risk Analysis: An Agent-Based Model Approach.

PubMed

Haer, Toon; Botzen, W J Wouter; de Moel, Hans; Aerts, Jeroen C J H

2017-10-01

Recent studies showed that climate change and socioeconomic trends are expected to increase flood risks in many regions. However, in these studies, human behavior is commonly assumed to be constant, which neglects interaction and feedback loops between human and environmental systems. This neglect of human adaptation leads to a misrepresentation of flood risk. This article presents an agent-based model that incorporates human decision making in flood risk analysis. In particular, household investments in loss-reducing measures are examined under three economic decision models: (1) expected utility theory, which is the traditional economic model of rational agents; (2) prospect theory, which takes account of bounded rationality; and (3) a prospect theory model, which accounts for changing risk perceptions and social interactions through a process of Bayesian updating. We show that neglecting human behavior in flood risk assessment studies can result in a considerable misestimation of future flood risk, which is in our case study an overestimation of a factor two. Furthermore, we show how behavior models can support flood risk analysis under different behavioral assumptions, illustrating the need to include the dynamic adaptive human behavior of, for instance, households, insurers, and governments. The method presented here provides a solid basis for exploring human behavior and the resulting flood risk with respect to low-probability/high-impact risks. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

Randomized Clinical Trial of Brief Risk Reduction Counseling for Sexually Transmitted Infection Clinic Patients in Cape Town, South Africa

PubMed Central

Cain, Demetria; Eaton, Lisa; Jooste, Sean; Simbayi, Leickness C.

2011-01-01

Objectives. We examined the effects of a brief counseling intervention designed to reduce HIV risk behaviors and sexually transmitted infections (STIs) among patients receiving STI services in Cape Town, South Africa. Methods. After randomization to either a 60-minute risk reduction counseling session or a 20-minute HIV–STI educational session, patients completed computerized sexual behavior assessments. More than 85% of the participants were retained at the 12-month follow-up. Results. There were 24% fewer incident STIs and significant reductions in unprotected vaginal and anal intercourse among participants who received risk reduction counseling relative to members of the control condition. Moderator analyses showed shorter lived outcomes for heavy alcohol drinkers than for lighter drinkers. The results were not moderated by gender. Conclusions. Brief single-session HIV prevention counseling delivered to STI clinic patients has the potential to reduce HIV infections. Counseling should be enhanced for heavier drinkers, and sustained outcomes will require relapse prevention techniques. Disseminating effective, brief, and feasible behavioral interventions to those at highest risk for HIV infection should remain a public health priority. PMID:21778486

Effectiveness of personalized and interactive health risk calculators: a randomized trial.

PubMed

Harle, Christopher A; Downs, Julie S; Padman, Rema

2012-01-01

Risk calculators are popular websites that provide individualized disease risk assessments to the public. Little is known about their effect on risk perceptions and health behavior. This study sought to test whether risk calculator features-namely, personalized estimates of one's disease risk and feedback about the effects of risk-mitigating behaviors-improve risk perceptions and motivate healthy behavior. A web-based experimental study using simple randomization was conducted to compare the effects of 3 prediabetes risk communication websites. Setting The study was conducted in the context of ongoing health promotion activities sponsored by a university's human resources office. Patients Participants were adult university employees. Intervention The control website presented nonindividualized risk information. The personalized noninteractive website presented individualized risk calculations. The personalized interactive website presented individualized risk calculations and feedback about the effects of hypothetical risk-mitigating behaviors. Measurements Pre- and postintervention risk perceptions were measured in absolute and relative terms. Health behavior was measured by assessing participant interest in follow-up preventive health services. On average, risk perceptions decreased by 2%. There was no general effect of personalization or interactivity in aligning subjective risk perceptions with objective risk calculations or in increasing healthy behaviors. However, participants who previously overestimated their risk reduced their perceptions by 16%. This was a significantly larger change than the 2% increase by participants who underestimated their risk. Limitations Results may not generalize to different populations, different diseases, or longer-term outcomes. Compared to nonpersonalized information, individualized risk calculators had little positive effect on prediabetes risk perception accuracy or health behavior. Risk perception accuracy was improved in people who receive relatively "good news" about risk rather than "bad news."

Cognitive-Behavioral Therapy for PTSD and Depression Symptoms Reduces Risk for Future Intimate Partner Violence among Interpersonal Trauma Survivors

PubMed Central

Iverson, Katherine M.; Gradus, Jaimie L.; Resick, Patricia A.; Suvak, Michael K.; Smith, Kamala F.; Monson, Candice M.

2010-01-01

Objective Women who develop symptoms of posttraumatic stress disorder (PTSD) and depression subsequent to interpersonal trauma are at heightened risk for future intimate partner violence (IPV) victimization. Cognitive-behavioral therapy (CBT) is effective in reducing PTSD and depression symptoms, yet limited research has investigated the effectiveness of cognitive-behavior therapy in reducing risk for future IPV among interpersonal trauma survivors. Method This study examined the effect of CBT for PTSD and depressive symptoms on the risk of future IPV victimization in a sample of women survivors of interpersonal violence. The current sample included 150 women diagnosed with PTSD secondary to an array of interpersonal traumatic events who were participating in a randomized clinical trial of different forms of cognitive processing therapy for the treatment of PTSD. Participants were assessed at nine time points as part of the larger trial: pre-treatment, six times during treatment, post-treatment, and at 6-month follow-up. Results As hypothesized, reductions in both PTSD and depressive symptoms during treatment were associated with a decreased likelihood of IPV victimization at a 6-month follow-up even after controlling for recent IPV (i.e., IPV from a current partner within the year prior to beginning the study) and prior interpersonal traumas. Conclusions These findings highlight the importance of identifying and treating PTSD and depressive symptoms among interpersonal trauma survivors as a method for reducing risk for future IPV. PMID:21341889

The Effects of Positive Behavior Interventions and Support on Changing the Behavior of Red Zone Students

ERIC Educational Resources Information Center

Robinson, Fredrick

2012-01-01

In order to improve culture, safety, and climate, numerous schools nationwide are implementing Positive Behavior Interventions and Support (PBIS). The purpose of this study was to examine the effectiveness of the Positive Behavior Interventions and Support (PBIS) model for reducing high-risk behaviors of students identified as red zone. The…

Effects of behavioral and morphological plasticity on risk of predation in a Neotropical tadpole

USGS Publications Warehouse

McIntyre, P.B.; Baldwin, S.; Flecker, A.S.

2004-01-01

Predator-induced phenotypic plasticity is widespread among aquatic animals, however the relative contributions of behavioral and morphological shifts to reducing risk of predation remain uncertain. We tested the phenotypic plasticity of a Neotropical tadpole (Rana palmipes) in response to chemical cues from predatory Belostoma water bugs, and how phenotype affects risk of predation. Behavior, morphology, and pigmentation all were plastic, resulting in a predator-induced phenotype with lower activity, deeper tail fin and muscle, and darker pigmentation. Tadpoles in the predator cue treatment also grew more rapidly, possibly as a result of the nutrient subsidy from feeding the caged predator. For comparison to phenotypes induced in the experiment, we quantified the phenotype of tadpoles from a natural pool. Wildcaught tadpoles did not match either experimentally induced phenotype; their morphology was more similar to that produced in the control treatment, but their low swimming activity was similar to that induced by predator cues. Exposure of tadpoles from both experimental treatments and the natural pool to a free-ranging predator confirmed that predator-induced phenotypic plasticity reduces risk of predation. Risk of predation was comparable among wild-caught and predator-induced tadpoles, indicating that behavioral shifts can substantially alleviate risk in tadpoles that lack the typical suite of predator-induced morphological traits. The morphology observed in wild-caught tadpoles is associated with rapid growth and high competition in other tadpole species, suggesting that tadpoles may profitably combine a morphology suited to competition for food with behaviors that minimize risk of predation. ?? Springer-Verlag 2004.

Evaluation of a Digital Behavioral Counseling Program for Reducing Risk Factors for Chronic Disease in a Workforce

PubMed Central

Wilson, Mark G.; Castro Sweet, Cynthia M.; Edge, Michael D.; Madero, Erica N.; McGuire, Megan; Pilsmaker, Megan; Carpenter, Dan; Kirschner, Scott

2017-01-01

Objective: To evaluate a digitally delivered, intensive behavioral counseling program for a workforce at risk for obesity-related chronic disease. Methods: Employees were offered a digital health program modeled after the diabetes prevention program (DPP). Annual workforce health assessments were used to examine changes in chronic disease risk factors between participants (n = 634) relative to a matched comparison group (n = 1268). Results: Overall, employees were gaining an average of 3.5 pounds annually before program inception. Program engagement was positive; 83% completed the majority of the curriculum and 31% lost at least 5% of their starting weight. Compared with non-participating peers, participants demonstrated reduced weight, improved fasting blood glucose, and improved nutritional intake after a year. Conclusions: The digital health program was effective for engaging employees in health behavior change. Digital options facilitate widespread implementation. PMID:28650899

Potential Mediating Pathways through Which Sports Participation Relates to Reduced Risk of Suicidal Ideation

ERIC Educational Resources Information Center

Taliaferro, Lindsay A.; Rienzo, Barbara A.; Miller, M. David; Pigg, R. Morgan; Dodd, Virginia J.

2010-01-01

Suicide ranks as the third leading cause of death for American youth. Researchers examining sport participation and suicidal behavior have regularly found inverse relationships. This study represents the first effort to test a model depicting potential mechanisms through which sport participation relates to reduced risk of suicidal ideation. The…

Insight into the Earthquake Risk Information Seeking Behavior of the Victims: Evidence from Songyuan, China

PubMed Central

Li, Shasha; Zhai, Guofang; Zhou, Shutian; Fan, Chenjing; Wu, Yunqing; Ren, Chongqiang

2017-01-01

Efficient risk communication is a vital way to reduce the vulnerability of individuals when facing emergency risks, especially regarding earthquakes. Efficient risk communication aims at improving the supply of risk information and fulfilling the need for risk information by individuals. Therefore, an investigation into individual-level information seeking behavior within earthquake risk contexts is very important for improved earthquake risk communication. However, at present there are very few studies that have explored the behavior of individuals seeking earthquake risk information. Under the guidance of the Risk Information Seeking and Processing model as well as relevant practical findings using the structural equation model, this study attempts to explore the main determinants of an individual’s earthquake risk information seeking behavior, and to validate the mediator effect of information need during the seeking process. A questionnaire-based survey of 918 valid respondents in Songyuan, China, who had been hit by a small earthquake swarm, was used to provide practical evidence for this study. Results indicated that information need played a noteworthy role in the earthquake risk information seeking process, and was detected both as an immediate predictor and as a mediator. Informational subjective norms drive the seeking behavior on earthquake risk information through both direct and indirect approaches. Perceived information gathering capacity, negative affective responses and risk perception have an indirect effect on earthquake risk information seeking behavior via information need. The implications for theory and practice regarding risk communication are discussed and concluded. PMID:28272359

Insight into the Earthquake Risk Information Seeking Behavior of the Victims: Evidence from Songyuan, China.

PubMed

Li, Shasha; Zhai, Guofang; Zhou, Shutian; Fan, Chenjing; Wu, Yunqing; Ren, Chongqiang

2017-03-07

Efficient risk communication is a vital way to reduce the vulnerability of individuals when facing emergency risks, especially regarding earthquakes. Efficient risk communication aims at improving the supply of risk information and fulfilling the need for risk information by individuals. Therefore, an investigation into individual-level information seeking behavior within earthquake risk contexts is very important for improved earthquake risk communication. However, at present there are very few studies that have explored the behavior of individuals seeking earthquake risk information. Under the guidance of the Risk Information Seeking and Processing model as well as relevant practical findings using the structural equation model, this study attempts to explore the main determinants of an individual's earthquake risk information seeking behavior, and to validate the mediator effect of information need during the seeking process. A questionnaire-based survey of 918 valid respondents in Songyuan, China, who had been hit by a small earthquake swarm, was used to provide practical evidence for this study. Results indicated that information need played a noteworthy role in the earthquake risk information seeking process, and was detected both as an immediate predictor and as a mediator. Informational subjective norms drive the seeking behavior on earthquake risk information through both direct and indirect approaches. Perceived information gathering capacity, negative affective responses and risk perception have an indirect effect on earthquake risk information seeking behavior via information need. The implications for theory and practice regarding risk communication are discussed and concluded.

“Nudges” to Prevent Behavioral Risk Factors Associated With Major Depressive Disorder

PubMed Central

Schölmerich, Vera; Denktaş, Semiha

2015-01-01

Major depressive disorder—colloquially called “depression”—is a primary global cause of disability. Current preventive interventions, such as problem-solving therapy, are effective but also expensive. “Nudges” are easy and cheap interventions for altering behavior. We have explored how nudging can reduce three behavioral risk factors of depression: low levels of physical activity, inappropriate coping mechanisms, and inadequate maintenance of social ties. These nudges use cognitive biases associated with these behavioral risks, such as valuing the present more than the future, following the herd or the norm, making different choices in light of equivalent conditions, and deciding on the basis of salience or attachment to status quo. PMID:26378823

Health-protective effects of attachment among African American girls in psychiatric care.

PubMed

Emerson, Erin; Donenberg, Geri R; Wilson, Helen W

2012-02-01

African American girls in psychiatric care are at increased risk for HIV and sexually transmitted infection (STI) through sexual risk taking. Adolescent sexual behavior often reflects peer norms and behavior. Secure attachment patterns with mothers and peers might lessen the effects of negative peer influences and reduce sexual risk taking among African American girls. This study examined the relationships among mother-daughter and peer attachment, peer norms, and sexual-risk behaviors in African American girls seeking outpatient psychiatric care. A group of 12-16-year-old African American girls (N = 262; M age = 14.45 years) reported on their attachment to their mothers and peers, peer risk-taking and dating behaviors, peer pressure, and sexual-risk behaviors (e.g., number of partners, high-risk partners, and condom use). Structural equation modeling examined whether peer attachment and peer norms mediated the relationship between mother attachment and sexual risk. Findings supported peer norms, but not peer attachment, as a mediator of mother attachment and girls' sexual-risk behaviors. Findings revealed important family and peer factors for African American girls in psychiatric care. HIV prevention programs may be strengthened by improving mother-daughter relationships, addressing the importance of peer relationships, and emphasizing how secure mother-daughter relationships can temper the impact of peer norms.

Cognitive Behavioral Therapy Reduces Suicidal Ideation in Schizophrenia: Results from a Randomized Controlled Trial

ERIC Educational Resources Information Center

Bateman, Katy; Hansen, Lars; Turkington, Douglas; Kingdon, David

2007-01-01

Patients with schizophrenia are at high risk of suicide. Cognitive behavior therapy (CBT) has been shown to reduce symptoms in schizophrenia. This study examines whether CBT also changes the level of suicidal ideation in patients with schizophrenia compared to a control group. Ninety ambulatory patients with symptoms of schizophrenia resistant to…

Community and School Practices to Reduce Delinquent Behavior: Intervening on the School-to-Prison Pipeline

ERIC Educational Resources Information Center

Shippen, Margaret E.; Patterson, DaShaunda; Green, Kemeche L.; Smitherman, Tracy

2012-01-01

Youth at risk for school failure need community and school supports to reduce the likelihood of developing delinquent behavior. This article provides an overview of community and school approaches aimed at intervening on the school-to-prison pipeline. Community and school efforts are emerging that take into account empirical evidence demonstrating…

Cumulative effects of mothers' risk and promotive factors on daughters' disruptive behavior.

PubMed

van der Molen, Elsa; Hipwell, Alison E; Vermeiren, Robert; Loeber, Rolf

2012-07-01

Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N = 2043). Maternal risk and promotive factors were operative at different time points in girls' development. Maternal warmth explained variance in girls' disruptive behavior, even after controlling for maternal risk factors and relevant child and neighborhood factors. In addition, findings supported the cumulative hypothesis that the number of risk factors increased the chance on girls' disruptive behavior disorder (DBD), while the number of promotive factors decreased this probability. Daughters of mothers with a history of Conduct Disorder (CD) were exposed to more risk factors and fewer promotive factors compared to daughters of mothers without prior CD. The identification of malleable maternal factors that can serve as targets for intervention has important implications for intergenerational intervention. Cumulative effects show that the focus of prevention efforts should not be on single factors, but on multiple factors associated with girls' disruptive behavior.

Cumulative Effects of Mothers’ Risk and Promotive Factors on Daughters’ Disruptive Behavior

PubMed Central

Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

2012-01-01

Little is known about the ways in which the accumulation of maternal factors increases or reduces risk for girls’ disruptive behavior during preadolescence. In the current study, maternal risk and promotive factors and the severity of girls’ disruptive behavior were assessed annually among girls’ ages 7–12 in an urban community sample (N=2043). Maternal risk and promotive factors were operative at different time points in girls’ development. Maternal warmth explained variance in girls’ disruptive behavior, even after controlling for maternal risk factors and relevant child and neighborhood factors. In addition, findings supported the cumulative hypothesis that the number of risk factors increased the chance on girls’ disruptive behavior disorder (DBD), while the number of promotive factors decreased this probability. Daughters of mothers with a history of Conduct Disorder (CD) were exposed to more risk factors and fewer promotive factors compared to daughters of mothers without prior CD. The identification of malleable maternal factors that can serve as targets for intervention has important implications for intergenerational intervention. Cumulative effects show that the focus of prevention efforts should not be on single factors, but on multiple factors associated with girls’ disruptive behavior. PMID:22127641

Perception of partner sexual history: Effects on safe-sex intentions.

PubMed

Cornelius, Talea; Kershaw, Trace

2017-07-01

Sexual intercourse is a dyadic activity, and intentions to engage in safe sex vary across partners. Because pregnant and newly parenting adolescents and young adults are at high risk for sexually transmitted infections (STIs), it is important to understand sexual decision-making in this population. This cross-sectional study examined how participants' own risk behavior and their partners' risk behavior influence perceptions of partner risk, and the impact of risk perceptions on condom use intentions and monogamy intentions in 296 pregnant adolescent and young adult couples (MAgeFemale = 18.71 years; MAgeMale = 21.33 years). Participants' behavior and their partners' behavior both related to increased perceptions of partner risk. Male participants' perceptions were more strongly influenced by female partners' behavior than participants' own behavior. Perceiving a partner as having a history of more risk behaviors trended toward a negative relationship with condom use intentions and monogamy intentions. For females, more previous sex partners related negatively to condom use intentions and positively to monogamy intentions. Having a male partner with more previous sex partners related positively to condom use intentions and monogamy intentions. Perceptions of partner risk did not significantly relate to condom use intentions and monogamy intentions, however, trends suggest that risk perception could reflect similarity bias and ongoing risk engagement. Differences in partner perception by gender suggest that females may communicate more openly about risks. Interventions to reduce STI transmission in couples should work to interrupt trajectories of risky behavior and enhance risk communication. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

[Risk behaviours and Chlamydia trachomatis prevalence in prisoners by length of stay in prison].

PubMed

Lopez-Corbeto, Evelin; Humet, Victoria; Leal, M Jesús; Teixidó, Nuria; Quiroga, Teresa; Casabona, Jordi

2014-11-18

Young prisoners have high-risk behaviors and socio-economic insecurity that increases vulnerability for Chlamydia trachomatis (CT) acquisition. Monitoring its prevalence will help to reduce infection rates. Cross-sectional study from a convenience sample of prisoners aged 18-25 years. Urine samples were obtained to determine CT. A standardized and anonymous questionnaire was used to collect the study variables. The overall CT prevalence was 11%, significantly higher in those with less than one year in prison, who also presented higher frequencies in risk behaviors, while these were reduced in those who had been imprisoned for more than a year. The prevalence values obtained give an idea of the concentration of the population vulnerable to this disease in prisons and underscore the need to continue programs for the prevention and control of sexual transmitted infections (STIs). Being imprisoned longer decreased risk behaviors; therefore, it is important to screen for STIs upon admission because they are more likely to be infected and it would be thus possible to influence at that time in sex education because, at that time, risk behaviors occur more commonly, which are most likely done when they were free. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Reducing Child Problem Behaviors and Improving Teacher-Child Interactions and Relationships: A Randomized Controlled Trial of Best in Class

ERIC Educational Resources Information Center

Sutherland, Kevin S.; Conroy, Maureen A.; Algina, James; Ladwig, Crystal; Jesse, Gabriel; Gyure, Maria

2018-01-01

Research has consistently linked early problem behavior with later adjustment problems, including antisocial behavior, learning problems and risk for the development of emotional/behavioral disorders (EBDs). Researchers have focused upon developing effective intervention programs for young children who arrive in preschool exhibiting chronic…

Trans-Situational Interventions: Generalization of Behavior Support across School and Home Environments.

ERIC Educational Resources Information Center

Harvey, Mark T.; Lewis-Palmer, Teri; Horner, Robert H.; Sugai, George

2003-01-01

Individualized trans-situational interventions (TSIs) were implemented with three middle-school students at risk for school failure. Problem behaviors in school were reduced and linked to problem behavior reduction in the home when concurrent behavior support was established in the home and at school. (Contains references.) (Author/CR)

Antipredator behavior promotes diversification of feeding strategies.

PubMed

Ledón-Rettig, Cris C; Pfennig, David W

2012-07-01

Animals often facultatively engage in less risky behavior when predators are present. Few studies, however, have investigated whether, or how, such predator-mediated behavior promotes diversification. Here, we ask whether tadpoles of the spadefoot toad Scaphiopus couchii have a diminished ability to utilize a potentially valuable resource--anostracan fairy shrimp--because of behavioral responses to predation risk imposed by carnivorous tadpoles of the genus Spea. Observations of a congener of Sc. couchii that occurs in allopatry with Spea, coupled with an ancestral character state reconstruction, revealed that Sc. couchii's ancestors likely consumed shrimp. By experimentally manipulating the presence of Spea carnivore-morph tadpoles in microcosms, we found that Sc. couchii reduce feeding and avoid areas where both Spea carnivores and shrimp occur. We hypothesize that the recurrent expression of such behaviors in sympatric populations of Sc. couchii led to the evolutionary fixation of a detritivorous feeding strategy, which is associated with a reduced risk of predation from Spea carnivores. Generally, predator-mediated behavior might play a key role in promoting diversification of feeding strategies.

Behavioral Health and Performance Element: Tools and Technologies

NASA Technical Reports Server (NTRS)

Leveton, Lauren B.

2009-01-01

This slide presentation reviews the research into the Behavioral Health and Performance (BHP) of the Human Research Program. The program element goal is to identify, characterize and prevent or reduce behavioral health and performance risks associated with space travel, exploration, and return to terrestrial life. To accomplish this goal the program focuses on applied research that is designed to yield deliverables that reduce risk. There are several different elements that are of particular interest: Behavioral Medicine, Sleep, and team composition, and team work. In order to assure success for NASA missions the Human Research Program develops and validate the standards for each of the areas of interest. There is discussion of the impact on BHP while astronauts are on Long Duration Missions. The effort in this research is to create tools to meet the BHP concerns, these prospective tools are reviewed.

Was Bob Seger Right? Relation Between Boredom in Leisure and [Risky] Sex.

PubMed

Miller, Jacqueline A; Caldwell, Linda L; Weybright, Elizabeth H; Smith, Edward A; Vergnani, Tania; Wegner, Lisa

2014-01-16

This article examines the association between boredom in leisure and risky sexual behaviors among South African youth (N = 1695) using longitudinal data. We hypothesized that youth who were higher on boredom in leisure at the end of ninth grade would be more likely to report engaging in risky sexual behaviors at the beginning of tenth grade. Chi-square results indicate youth, especially male youth who experience high levels of leisure boredom in ninth grade, are more likely to engage in risky sexual behaviors in tenth grade. These findings have implications for prevention programs that aim to delay sexual initiation, reduce sexual risk behaviors, and decrease the transmission of HIV and AIDS. The findings support the need for additional research on how the reduction of leisure boredom may be a potential target for reducing sexual risk among youth.

Was Bob Seger Right? Relation Between Boredom in Leisure and [Risky] Sex

PubMed Central

MILLER, JACQUELINE A.; CALDWELL, LINDA L.; WEYBRIGHT, ELIZABETH H.; SMITH, EDWARD A.; VERGNANI, TANIA; WEGNER, LISA

2015-01-01

This article examines the association between boredom in leisure and risky sexual behaviors among South African youth (N = 1695) using longitudinal data. We hypothesized that youth who were higher on boredom in leisure at the end of ninth grade would be more likely to report engaging in risky sexual behaviors at the beginning of tenth grade. Chi-square results indicate youth, especially male youth who experience high levels of leisure boredom in ninth grade, are more likely to engage in risky sexual behaviors in tenth grade. These findings have implications for prevention programs that aim to delay sexual initiation, reduce sexual risk behaviors, and decrease the transmission of HIV and AIDS. The findings support the need for additional research on how the reduction of leisure boredom may be a potential target for reducing sexual risk among youth. PMID:25684832

Limitations of self-care in reducing the risk of lymphedema: supportive-educative systems.

PubMed

Armer, Jane M; Brooks, Constance W; Stewart, Bob R

2011-01-01

The purpose of this study was to examine patient perceptions of limitations related to self-care measures to reduce lymphedema risk following breast cancer surgery. Secondary analysis of survey data from a companion study to a study piloting a behavioral-educational intervention was conducted to examine the specific limitations in performing lymphedema risk-reduction self-care measures. Findings suggest a more comprehensive approach is needed if patients are to engage in self-care actions to reduce lymphedema risk. Understanding the concepts of self-care and personal support interventions that include motivational interviewing can help nurses design supportive-educative care systems that assist patients in overcoming limitations in the estimative, transitional, and productive phases of self-care necessary to reduce lymphedema risk.

Reducing Risk of Noise-Induced Hearing Loss in Collegiate Music Ensembles Using Ambient Technology.

PubMed

Powell, Jason; Chesky, Kris

2017-09-01

Student musicians are at risk for noise-induced hearing loss (NIHL) as they develop skills and perform during instructional activities. Studies using longitudinal dosimeter data show that pedagogical procedures and instructor behaviors are highly predictive of NIHL risk, thus implying the need for innovative approaches to increase instructor competency in managing instructional activities without interfering with artistic and academic freedom. Ambient information systems, an emerging trend in human-computer interaction that infuses psychological behavioral theories into technologies, can help construct informative risk-regulating systems. The purpose of this study was to determine the effects of introducing an ambient information system into the ensemble setting. The system used two ambient displays and a counterbalanced within-subjects treatment study design with six jazz ensemble instructors to determine if the system could induce a behavior change that alters trends in measures resulting from dosimeter data. This study assessed efficacy using time series analysis to determine changes in eight statistical measures of behavior over a 9-wk period. Analysis showed that the system was effective, as all instructors showed changes in a combination of measures. This study is in an important step in developing non-interfering technology to reduce NIHL among academic musicians.

Selecting Strategies to Reduce High-Risk Unsafe Work Behaviors Using the Safety Behavior Sampling Technique and Bayesian Network Analysis.

PubMed

Ghasemi, Fakhradin; Kalatpour, Omid; Moghimbeigi, Abbas; Mohammadfam, Iraj

2017-03-04

High-risk unsafe behaviors (HRUBs) have been known as the main cause of occupational accidents. Considering the financial and societal costs of accidents and the limitations of available resources, there is an urgent need for managing unsafe behaviors at workplaces. The aim of the present study was to find strategies for decreasing the rate of HRUBs using an integrated approach of safety behavior sampling technique and Bayesian networks analysis. A cross-sectional study. The Bayesian network was constructed using a focus group approach. The required data was collected using the safety behavior sampling, and the parameters of the network were estimated using Expectation-Maximization algorithm. Using sensitivity analysis and belief updating, it was determined that which factors had the highest influences on unsafe behavior. Based on BN analyses, safety training was the most important factor influencing employees' behavior at the workplace. High quality safety training courses can reduce the rate of HRUBs about 10%. Moreover, the rate of HRUBs increased by decreasing the age of employees. The rate of HRUBs was higher in the afternoon and last days of a week. Among the investigated variables, training was the most important factor affecting safety behavior of employees. By holding high quality safety training courses, companies would be able to reduce the rate of HRUBs significantly.

Parsing protection and risk for problem behavior versus pro-social behavior among US and Chinese adolescents.

PubMed

Jessor, Richard; Turbin, Mark S

2014-07-01

This study investigates the different roles played by protective factors and risk factors-and by particular protective and risk factors-when the concern is with accounting for adolescent problem behavior than when the concern is with accounting for adolescent pro-social behavior. The protective and risk factor literature on adolescent problem behavior reveals considerable conceptual and operational ambiguity; an aim of the present study was to advance understanding in this domain of inquiry by providing a systematic conceptualization of protection and risk and of their measurement. Within the systematic framework of Problem Behavior Theory, four protective and four risk factors are assessed in a cross-national study of both problem behavior and pro-social behavior involving large adolescent samples in China (N = 1,368) and the US (N = 1,087), in grades 9, 10, and 11; females 56 %, US; 50 %, China. The findings reveal quite different roles for protection and risk, and for particular protective and risk factors, when the outcome criterion is problem behavior than when it is pro-social behavior. The protective factor, Controls Protection, which engages rule and regulations and sanctions in the adolescent's ecology, emerges as most important in influencing problem behavior, but it plays a relatively minor role in relationship to pro-social behavior. By contrast, Models Protection, the presence of pro-social models in the adolescent's ecology, and Support Protection, the presence of interest and care in that same ecology, have no significant relationship to problem behavior variation, but they are both the major predictors of variation in pro-social behavior. The findings are robust across the samples from the two very diverse societies. These results suggest that greater attention be given to protection in problem behavior research and that a more nuanced perspective is needed about the roles that particular protective and risk factors play in reducing problem behavior and in promoting pro-social behavior.

Do behavioral scientists really understand HIV-related sexual risk behavior? A systematic review of longitudinal and experimental studies predicting sexual behavior.

PubMed

Huebner, David M; Perry, Nicholas S

2015-10-01

Behavioral interventions to reduce sexual risk behavior depend on strong health behavior theory. By identifying the psychosocial variables that lead causally to sexual risk, theories provide interventionists with a guide for how to change behavior. However, empirical research is critical to determining whether a particular theory adequately explains sexual risk behavior. A large body of cross-sectional evidence, which has been reviewed elsewhere, supports the notion that certain theory-based constructs (e.g., self-efficacy) are correlates of sexual behavior. However, given the limitations of inferring causality from correlational research, it is essential that we review the evidence from more methodologically rigorous studies (i.e., longitudinal and experimental designs). This systematic review identified 44 longitudinal studies in which investigators attempted to predict sexual risk from psychosocial variables over time. We also found 134 experimental studies (i.e., randomized controlled trials of HIV interventions), but of these only 9 (6.7 %) report the results of mediation analyses that might provide evidence for the validity of health behavior theories in predicting sexual behavior. Results show little convergent support across both types of studies for most traditional, theoretical predictors of sexual behavior. This suggests that the field must expand the body of empirical work that utilizes the most rigorous study designs to test our theoretical assumptions. The inconsistent results of existing research would indicate that current theoretical models of sexual risk behavior are inadequate, and may require expansion or adaptation.

Preventing and De-escalating Aggressive Behavior Among Adult Psychiatric Patients: A Systematic Review of the Evidence.

PubMed

Gaynes, Bradley N; Brown, Carrie L; Lux, Linda J; Brownley, Kimberly A; Van Dorn, Richard A; Edlund, Mark J; Coker-Schwimmer, Emmanuel; Weber, Rachel Palmieri; Sheitman, Brian; Zarzar, Theodore; Viswanathan, Meera; Lohr, Kathleen N

2017-08-01

The project goal was to compare the effectiveness of strategies to prevent and de-escalate aggressive behaviors among psychiatric patients in acute care settings, including interventions for reducing use of seclusion and restraint. Relevant databases were systematically reviewed for comparative studies of violence prevention and de-escalation strategies involving adult psychiatric patients in acute care settings. Studies (trials and cohort studies) were required to report on aggression or seclusion or restraint outcomes. Both risk of bias, an indicator of quality of individual studies, and strength of evidence (SOE) for each outcome were independently assessed by two study personnel. Seventeen primary studies met inclusion criteria. Evidence was limited for benefits and harms; information about characteristics that might modify the interventions' effectiveness, such as race or ethnicity, was especially limited. All but one study had a medium or high risk of bias and thus presented worrisome limitations. For prevention, risk assessment reduced both aggression and use of seclusion and restraint (low SOE), and multimodal interventions reduced the use of seclusion and restraint (low SOE). SOE for all other interventions, whether aimed at preventing or de-escalating aggression, and for modifying characteristics was insufficient. Available evidence about strategies for preventing and de-escalating aggressive behavior among psychiatric patients is very limited. Two preventive strategies, risk assessment and multimodal interventions consistent with the Six Core Strategies principles, may effectively lower aggressive behavior and use of seclusion and restraint, but more research is needed on how best to prevent and de-escalate aggressive behavior in acute care settings.

Sexual Pleasure and Sexual Risk among Women who Use Methamphetamine: A Mixed Methods Study

PubMed Central

Lorvick, Jennifer; Bourgois, Philippe; Wenger, Lynn D.; Arreola, Sonya G.; Lutnick, Alexandra; Wechsberg, Wendee M.; Kral, Alex H.

2012-01-01

Background The intersection of drug use, sexual pleasure and sexual risk behavior is rarely explored when it comes to poor women who use drugs. This paper explores the relationship between sexual behavior and methamphetamine use in a community-based sample of women, exploring not only risk, but also desire, pleasure and the challenges of overcoming trauma. Methods Quantitative data were collected using standard epidemiological methods (N=322) for community-based studies. In addition, using purposive sampling, qualitative data were collected among a subset of participants (n=34). Data were integrated for mixed methods analysis. Results While many participants reported sexual risk behavior (unprotected vaginal or anal intercourse) in the quantitative survey, sexual risk was not the central narrative pertaining to sexual behavior and methamphetamine use in qualitative findings. Rather, desire, pleasure and disinhibition arose as central themes. Women described feelings of power and agency related to sexual behavior while high on methamphetamine. Findings were mixed on whether methamphetamine use increased sexual risk behavior. Conclusion The use of mixed methods afforded important insights into the sexual behavior and priorities of methamphetamine-using women. Efforts to reduce sexual risk should recognize and valorize the positive aspects of methamphetamine use for some women, building on positive feelings of power and agency as an approach to harm minimization. PMID:22954501

Risk compensation and vaccination: can getting vaccinated cause people to engage in risky behaviors?

PubMed

Brewer, Noel T; Cuite, Cara L; Herrington, James E; Weinstein, Neil D

2007-08-01

Some believe that vaccinating young women against human papillomavirus (HPV) will increase their risky behavior. In more formal terms, vaccination lowers risk perception, and people compensate for their lower perceived risk by reducing other preventive behaviors. We test several predictions from the risk compensation hypothesis in the context of vaccination behavior. We obtained a random sample of adults (N=705), interviewing them by phone just as the Lyme disease vaccine first became available to the public and again 18 months later. Analyses controlled for age, sex, education, and race. Vaccinated respondents were less likely to continue engaging in two of five protective behaviors after vaccination. The frequency of these protective behaviors did not dip below that among the unvaccinated respondents. We found some evidence of regression (protective behaviors dropping, after vaccination, to levels reported by the unvaccinated cohort). However, we did not find disinhibition (exceeding the risk taking of the unvaccinated cohort), the greater threat to public health. Although we will not know for several years what effect HPV vaccination has on other behaviors, if any, data on other vaccinations can offer critically important information in the interim.

An emotion regulation intervention to reduce risk behaviors among at-risk early adolescents

PubMed Central

Houck, Christopher D.; Hadley, Wendy; Barker, David; Brown, Larry K.; Hancock, Evan; Almy, Brandon

2015-01-01

This study aimed to evaluate an intervention designed to enhance early adolescents’ emotion regulation skill use and to decrease risk behaviors. Adolescents 12 to 14 years old (N = 420; 53% male) with mental health symptoms were referred for participation in either an Emotion Regulation (ER) or Health Promotion (HP) intervention consisting of twelve after-school sessions. Participants completed baseline and follow-up questionnaires on laptop computers. Using a generalized analysis of covariance controlling for baseline scores, participants in the ER intervention were less likely to be sexually active and engage in other risk behaviors, such as fighting, at the conclusion of the program. Additionally, participants in the ER intervention reported greater use of emotion regulation strategies and more favorable attitudes toward abstinence. Interventions directly targeting emotion regulation may be useful in addressing health risk behaviors of adolescents with mental health symptoms. PMID:26297499

Work stress and health risk behavior.

PubMed

Siegrist, Johannes; Rödel, Andreas

2006-12-01

This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

Social responsibility, substance use, and sexual risk behavior in men who have sex with men.

PubMed

Martin, Aaron M; Benotsch, Eric G; Cejka, Anna; Luckman, Diana

2014-01-01

Considerable public health literature focuses on relationships between problematic human characteristics (e.g., psychopathology) and unhealthy behaviors. A recent movement termed positive psychology emphasizes the advantages of assessing relationships between human strengths (e.g., altruism) and beneficial health behaviors. The present study assessed social responsibility, an orientation to help or protect others even when there is nothing to be gained as an individual, and its relationship to HIV-relevant behaviors. In our sample of 350 men who have sex with men (MSM), social responsibility was negatively correlated with substance use and HIV risk behaviors. Men who had been tested for HIV and knew their HIV status-a behavior that helps men protect their partners but does not protect themselves from the virus-also scored higher in social responsibility. Interventions designed to reduce HIV risk behavior in MSM may benefit from efforts to promote human strengths.

HIV status disclosure, depressive symptoms, and sexual risk behavior among HIV-positive young men who have sex with men

PubMed Central

Cook, Stephanie H.; Valera, Pamela

2015-01-01

The rate of HIV infection among young men who have sex with men (YMSM) is increasing in the United States, and targeted research is needed to inform interventions aimed at reducing HIV transmission in this population. This study aims to understand the association between HIV status disclosure and sexual risk behavior among HIV-positive YMSM. A particular focus is given to depressive symptoms and their potential role in explaining the association between HIV disclosure and sexual risk behavior. In a sample of 991 YMSM receiving care at 20 clinics across the United States, Univariate and multivariate analyses were conducted to explore these associations. Approximately one-half (52.4 %) of participants reported disclosing to their current sexual/romantic partner. Disclosure to family members was negatively associated with sexual risk behavior. Also, depressive symptoms were positively associated with sexual risk behavior. We discuss the implications of our findings for future research and intervention. PMID:25773478

Maternal medical risks during pregnancy and childhood externalizing behavior.

PubMed

Jackson, Dylan B; Vaughn, Michael G

2018-04-25

Research has indicated that maternal health during the prenatal period and at delivery carries far reaching significance for the development of offspring. Even so, the role of the accumulation of maternal medical risks during pregnancy in the development of externalizing behavior during childhood has generally been overlooked. The present study investigates whether the accumulation of maternal medical risks during the prenatal period is positively associated with childhood externalizing behavior, and whether this association is stronger among male offspring. We examined a large, nationally representative sample of children who participated in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Information concerning maternal medical history, including the presence of a number of medical risks during pregnancy, was obtained through hospital records. A subsample of children with both parent and teacher reports of externalizing behavior during kindergarten was employed in the present study. A greater number of maternal medical risks during pregnancy increased the odds of childhood externalizing behavior across settings, but only among male offspring. The predicted probability of persistent externalizing behavior among males increased from .084 in the absence of maternal medical risks during pregnancy to .241 in the presence of three or more maternal medical risks during pregnancy. Our findings suggest that maternal medical risks during the prenatal period can have far-reaching consequences for the behavioral development of male offspring. Treatment of medical risks among expectant mothers may have the added benefit of reducing the likelihood of childhood externalizing behavior among male progeny. Copyright © 2018 Elsevier Ltd. All rights reserved.

Pathways Linking Childhood Maltreatment and Adolescent Sexual Risk Behaviors: The Role of Attachment Security

PubMed Central

Thibodeau, Marie-Ève; Lavoie, Francine; Hébert, Martine; Blais, Martin

2017-01-01

Previous research has shown an association between child maltreatment (sexual abuse, physical abuse, neglect or witnessing interparental violence) and adolescent sexual risk behaviors. The mechanisms explaining this association are not well understood but attachment theory could provide further insight into them. This study examined the relationships between child maltreatment and sexual risk behaviors and investigated anxious and avoidant attachment as mediators. The sample comprised 1,900 sexually active adolescents (13 to 17 years old; 60.8% girls) attending Quebec high schools. The results of path analyses indicated that neglect was associated with a higher number of sexual partners, casual sexual behavior, and being younger at first intercourse. Anxious attachment mediated the relation between neglect and number of sexual partners, whereas avoidant attachment explained the relation between neglect and number of sexual partners, casual sexual behavior, and age at first intercourse (for boys only). Sexual abuse was directly associated with all three sexual risk behaviors. Neither anxious attachment nor avoidant attachment mediated these associations. Youth with a history of neglect and sexual abuse represent a vulnerable population that is likely to engage in sexual risk behaviors. Interventions designed to induce a positive change in attachment security may reduce sexual risk behaviors among victims of neglect. PMID:28467103

Predictors of sexual risk behaviors among newly homeless youth: a longitudinal study.

PubMed

Solorio, M Rosa; Rosenthal, Doreen; Milburn, Norweeta G; Weiss, Robert E; Batterham, Philip J; Gandara, Marla; Rotheram-Borus, Mary Jane

2008-04-01

To longitudinally examine the association between newly homeless youth individual factors (sociodemographic characteristics, depression, substance use), and structural factors, such as living situation (family, institution, nonfamily), with sexual risk behaviors. A cohort of newly homeless youth from Los Angeles County (N = 261; aged 12-20 years) was interviewed at baseline, 3, 6, 12, 18, and 24 months. At each assessment youth were asked about symptoms of depression (using the Brief Symptom Inventory), substance use, living situation, and sexual risk behaviors (number of sexual partners and condom use). Random effects models were used to determine the effects of predictors on the number of sexual partners and on condom use over time, by gender. At baseline, 77% of youth had been sexually active, increasing to 85% of youth at 24 months of follow-up. For predictors of multiple sexual partners, among male youth, these included living in nonfamily settings and using drugs; among females, living situation was not predictive of having multiple sexual partners but drug use was. For condom use, among females, living in a nonfamily setting and drug use decreased the odds of always using condoms; for males, no factors were found to be predictive of condom use. Living with nonfamily members and drug use appear to be the most salient in explaining sexual risk among newly homeless youth. Our findings indicate that interventions aimed at reducing sexual risk behaviors, and thereby reducing sexually transmitted diseases and HIV among newly homeless youth, need to help youth in finding housing associated with supervision and social support (family and institutional settings) as well as aim to reduce drug use.

Relationships between direct predation and risk effects.

PubMed

Creel, Scott; Christianson, David

2008-04-01

Risk effects arise when prey alter their behavior in response to predators, and these responses carry costs. Empirical studies have found that risk effects can be large. Nonetheless, studies of predation in vertebrate conservation and management usually consider only direct predation. Given the ubiquity and strength of behavioral responses to predators by vertebrate prey, it is not safe to assume that risk effects on dynamics can be ignored. Risk effects can be larger than direct effects. Risk effects can exist even when the direct rate of predation is zero. Risk effects and direct effects do not necessarily change in parallel. When risk effects reduce reproduction rather than survival, they are easily mistaken for limitation by food supply.

Effects of providing personalized feedback of child's obesity risk on mothers' food choices using a virtual reality buffet.

PubMed

McBride, C M; Persky, S; Wagner, L K; Faith, M S; Ward, D S

2013-10-01

Providing personalized genetic-risk feedback of a child's susceptibility to adult-onset health conditions is a topic of considerable debate. Family health history (FHH), specifically parental overweight/obesity status, is a useful assessment for evaluating a child's genetic and environmental risk of becoming obese. It is unclear whether such risk information may influence parents' efforts to reduce their child's risk of obesity. To evaluate whether telling mothers the magnitude of their child's risk of becoming obese based on personal FHH influenced food choices for their young child from a virtual reality-based buffet restaurant. Overweight/obese mothers of a child aged 4-5 years who met eligibility criteria (N=221) were randomly assigned to one of three experimental arms, which emphasized different health information: arm 1, food safety control (Control); arm 2, behavioral-risk information (BRI) alone or arm 3, behavioral-risk information plus personal FHH-based risk assessment (BRI+FHH). Mothers donned a head-mounted display to be immersed in a virtual restaurant buffet, where they selected virtual food and beverages as a lunch for their child. Mothers who were randomized to BRI+FHH filled the index child's plate with an average of 45 fewer calories than those in the Control arm (P<0.05); those in the BRI arm filled the plate with 35 fewer calories than the Control arm, a non-significant difference. Calorie restriction was greatest among mothers in the BRI+FHH arm who received the weaker-risk message (that is, only one overweight parent). The influence of communicating a child's inherited risk of obesity on mothers' feeding practices may vary by the risk level conveyed. High-risk messages may best be coupled with strategies to increase mother's perceptions that efforts can be undertaken to reduce risk and build requisite behavioral skills to reduce risk.

Long term effects of community-based STI screening and mass media HIV prevention messages on sexual risk behaviors of African American adolescents.

PubMed

Sznitman, Sharon; Stanton, Bonita F; Vanable, Peter A; Carey, Michael P; Valois, Robert F; Brown, Larry K; DiClemente, Ralph; Hennessy, Michael; Salazar, Laura F; Romer, Daniel

2011-11-01

We examined the long-term effects of two interventions designed to reduce sexual risk behavior among African American adolescents. African American adolescents (N = 1383, ages 14-17) were recruited from community-based organizations over a period of 16 months in two northeastern and two southeastern mid-sized U.S. cities with high rates of sexually transmitted infection (STI). Participants were screened for three STIs (gonorrhea, chlamydia, and trichomoniasis) and completed an audio computer-assisted attitude, intention, and behavior self-interview. Youth who tested positive for an STI (8.3%) received treatment and risk reduction counseling. In addition, television and radio HIV-prevention messages were delivered during the recruitment period and 18 months of follow-up in one randomly selected city in each region. Analyses determined effects of the media program for those receiving a positive versus negative STI test result on number of sexual partners and occurrence of unprotected sex. Adolescents who tested STI-positive reduced their number of vaginal sex partners and the probability of unprotected sex over the first 6 months. However, in the absence of the mass media program, adolescents returned to their previously high levels of sexual risk behavior after 6 months. Adolescents who tested STI-positive and received the mass media program showed more stable reductions in unprotected sex. Community-based STI treatment and counseling can achieve significant, but short-lived reductions in sexual risk behavior among STI-positive youth. A culturally sensitive mass media program has the potential to achieve more stable reductions in sexual risk behavior and can help to optimize the effects of community-based STI screening.

Neurocognitive and psychiatric dimensions of hot, but not cool, impulsivity predict HIV sexual risk behaviors among drug users in protracted abstinence.

PubMed

Wilson, Michael J; Vassileva, Jasmin

2016-03-01

Impulsivity is an important risk factor for HIV risky drug and sexual behaviors. Research identifies hot (i.e. affectively-mediated, reward-based) and cool (motoric, attentional, independent of context) neurocognitive and psychiatric dimensions of impulsivity, though the impact of specific drugs of abuse on these varieties of impulsivity remains an open question. The present study examined the associations of neurocognitive and psychiatric varieties of hot and cool impulsivity with measures of lifetime and recent sexual risk behaviors among users of different classes of drugs. The study sample was comprised of drug users in protracted (> 1 year) abstinence: heroin mono-dependent (n = 61), amphetamine mono-dependent (n = 44), and polysubstance dependent (n = 73). Hot impulsivity was operationalized via neurocognitive tasks of reward-based decision-making and symptoms of psychopathy. Cool impulsivity was operationalized via neurocognitive tasks of response inhibition and symptoms of attention deficit/hyperactivity disorder (ADHD). Hot impulsivity was associated with sexual risk behaviors among heroin and amphetamine users in protracted abstinence, whereas cool impulsivity was not associated with sexual risk behaviors among any drug-using group. Neurocognitive hot impulsivity was associated with recent (past 30-day) sexual risk behaviors, whereas psychopathy was associated with sexual risk behaviors during more remote time-periods (past 6 month and lifetime) and mediated the association between heroin dependence and past 6-month sexual risk behaviors. Assessments and interventions aimed at reducing sexual risk behaviors among drug users should focus on hot neurocognitive and psychiatric dimensions of impulsivity, such as decision-making and psychopathy. Cool dimensions of impulsivity such as response inhibition and ADHD were not related to sexual risk behaviors among drug users in protracted abstinence.

Neurocognitive and psychiatric dimensions of “hot” impulsivity, but not “cool” impulsivity, predict HIV sexual risk behaviors among drug users in protracted abstinence

PubMed Central

Wilson, Michael J.; Vassileva, Jasmin

2016-01-01

Background Impulsivity is an important risk factor for HIV risky drug and sexual behaviors. Research identifies “hot” (i.e., affectively-mediated, reward-based) and “cool” (motoric, attentional, independent of context) neurocognitive and psychiatric dimensions of impulsivity, though the impact of specific drugs of abuse on these varieties of impulsivity remains an open question. Objectives The present study examined the associations of neurocognitive and psychiatric varieties of “hot” and “cool” impulsivity with measures of lifetime and recent sexual risk behaviors among users of different classes of drugs. Methods The study sample was comprised drug users in protracted (>1yr) abstinence: heroin monodependent (n=61), amphetamine monodependent (n=44), and polysubstance dependent (n= 73). “Hot” impulsivity was operationalized via neurocognitive tasks of reward-based decision-making and symptoms of psychopathy. “Cool” impulsivity was operationalized via neurocognitive tasks of response inhibition and symptoms of ADHD. Results “Hot” impulsivity was associated with sexual risk behaviors among heroin and amphetamine users in protracted abstinence, whereas “cool” impulsivity was not associated with sexual risk behaviors among any drug-using group. Neurocognitive “hot” impulsivity was associated with recent (past 30-day) sexual risk behaviors, whereas psychopathy was associated with sexual risk behaviors during more remote time-periods (past 6 month and lifetime) and mediated the association between heroin dependence and past 6-month sexual risk behaviors. Conclusion Assessments and interventions aimed at reducing sexual risk behaviors among drug users should focus on “hot” neurocognitive and psychiatric dimensions of impulsivity, such as decision-making and psychopathy. “Cool” dimensions of impulsivity such as response inhibition and ADHD were not related to sexual risk behaviors among drug users in protracted abstinence. PMID:26837332

How to reduce the latent social risk of disease: the determinants of vaccination against rabies in Taiwan.

PubMed

Ku-Yuan, Lee; Li-Chi, Lan; Jiun-Hao, Wang; Chen-Ling, Fang; Kun-Sun, Shiao

2014-06-04

To control the latent social risk of disease, the government usually spreads accurate information and attempts to improve the public's attitude toward adopting prevention. However, these methods with the Knowledge, Attitudes, and Practices (KAP) model do not always work. Therefore, we used the theory of planned behavior (TPB) to understand dog owners' behavior and distinguished the knowledge effect as objective knowledge (OK) and subjective knowledge (SK). A total of 310 dog owners completed a questionnaire based on our model. We employed structural equation modeling to verify the structural relationships and found three main results. First, our model was fit, and each path was significant. People with better attitudes, stronger subjective norms, and more perceptive behavioral control have stronger behavioral intention. Second, perceived behavioral control, not attitude, was the best predictive index in this model. Finally, on perceived behavioral control, subjective knowledge showed more influence than objective knowledge. We successfully extended TPB to explain the behavioral intention of dog owners and presented more workable recommendations. To reduce the latent social risk of disease, the government should not only address dog owners' attitudes, but also their subjective norms and perceptive behavioral control. Indeed, perceptive behavioral control and SK showed the most influence in this model. It is implied that the self-efficacy of dog owners is the most important factor in such a behavior. Therefore, the government should focus on enhancing dog owners' self-efficacy first while devoted to prevention activities.

How to Reduce the Latent Social Risk of Disease: The Determinants of Vaccination against Rabies in Taiwan

PubMed Central

Ku-Yuan, Lee; Li-Chi, Lan; Jiun-Hao, Wang; Chen-Ling, Fang; Kun-Sun, Shiao

2014-01-01

To control the latent social risk of disease, the government usually spreads accurate information and attempts to improve the public’s attitude toward adopting prevention. However, these methods with the Knowledge, Attitudes, and Practices (KAP) model do not always work. Therefore, we used the theory of planned behavior (TPB) to understand dog owners’ behavior and distinguished the knowledge effect as objective knowledge (OK) and subjective knowledge (SK). A total of 310 dog owners completed a questionnaire based on our model. We employed structural equation modeling to verify the structural relationships and found three main results. First, our model was fit, and each path was significant. People with better attitudes, stronger subjective norms, and more perceptive behavioral control have stronger behavioral intention. Second, perceived behavioral control, not attitude, was the best predictive index in this model. Finally, on perceived behavioral control, subjective knowledge showed more influence than objective knowledge. We successfully extended TPB to explain the behavioral intention of dog owners and presented more workable recommendations. To reduce the latent social risk of disease, the government should not only address dog owners’ attitudes, but also their subjective norms and perceptive behavioral control. Indeed, perceptive behavioral control and SK showed the most influence in this model. It is implied that the self-efficacy of dog owners is the most important factor in such a behavior. Therefore, the government should focus on enhancing dog owners’ self-efficacy first while devoted to prevention activities. PMID:24901413

Reducing Supervisee Anxiety: A Cognitive-Behavioral Approach.

ERIC Educational Resources Information Center

Dodge, Jacqueline

1982-01-01

Presents an anxiety management approach which suggests supervisors of counselors-in-training can help supervisees resolve approval and performance anxiety through rational-emotive and cognitive-behavior therapies. Stresses cognitive restructuring and risk-taking. (Author/MCF)

Sleep Duration and Injury-Related Risk Behaviors Among High School Students--United States, 2007-2013.

PubMed

Wheaton, Anne G; Olsen, Emily O'Malley; Miller, Gabrielle F; Croft, Janet B

2016-04-08

Insufficient sleep is common among high school students and has been associated with an increased risk for motor vehicle crashes (1), sports injuries (2), and occupational injuries (3). To evaluate the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among U.S. high school students, CDC analyzed data from 50,370 high school students (grades 9-12) who participated in the national Youth Risk Behavior Surveys (YRBSs) in 2007, 2009, 2011, or 2013. The likelihood of each of the five risk behaviors was significantly higher for students who reported sleeping ≤7 hours on an average school night; infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students who reported sleeping ≥10 hours compared with 9 hours on an average school night. Although insufficient sleep directly contributes to injury risk, some of the increased risk associated with insufficient sleep might be caused by engaging in injury-related risk behaviors. Intervention efforts aimed at these behaviors might help reduce injuries resulting from sleepiness, as well as provide opportunities for increasing awareness of the importance of sleep.

The Effectiveness of an Intervention to Promote Awareness and Reduce Online Risk Behavior in Early Adolescence.

PubMed

Schilder, Janneke D; Brusselaers, Marjolein B J; Bogaerts, Stefan

2016-02-01

The current study explored the effect of a school-based intervention on online risk awareness and behavior in order to shed light on a relatively unexplored field with high practical relevance. More than 800 Belgium primary school children (grade 4 and 6) were assessed at two measurements (n T1 = 812, 51.2 % female; n T2 = 819, 51.3 % female) before and after the intervention. Half of them received a 10 min classroom intervention indicating online risks. Children in the control group received a 10 min presentation concerning online applications without any emphasis on risks. Children in the intervention group were more likely to be aware of online risks directly after the intervention; this effect was still noticeable 4 months after. Reporting of online risk behavior in the intervention group was also higher compared to the control group who did not receive the intervention. Overall online risk awareness and online risk behavior were negatively associated and the awareness did not modulate the association between the intervention and online risk behavior. Furthermore, individual differences were assessed. Girls were more likely to be aware of online risks and asserted less online risk behavior than boys were. In line with the imperative in adolescence to become more risk taking, children in a higher grade were more likely to behave in a risky manner when online. The current study provides a valuable starting point for further research on how to decrease online risk behavior in early adolescence.

Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes.

PubMed

Stang, Jamie; Huffman, Laurel G

2016-04-01

It is the position of the Academy of Nutrition and Dietetics that all women of reproductive age receive education about maternal and fetal risks associated with prepregnancy obesity, excessive gestational weight gain, and significant postpartum weight retention, including potential benefits of lifestyle changes. Behavioral counseling to improve dietary intake and physical activity should be provided to overweight and obese women, beginning in the preconception period and continuing throughout pregnancy, for at least 12 to 18 months postpartum. Weight loss before pregnancy may improve fertility and reduce the risk of poor maternal-fetal outcomes, such as preterm birth, gestational diabetes, gestational hypertension, pre-eclampsia, assisted delivery, and select congenital anomalies. Lifestyle interventions that moderate gestational weight gain may reduce the risk of poor pregnancy outcomes, such as gestational diabetes, gestational hypertension, large for gestational age, and macrosomia, as well as lower the risk for significant postpartum retention. Postpartum interventions that promote healthy diet and physical activity behaviors may reduce postpartum weight retention and decrease obesity-related risks in subsequent pregnancies. Analysis of the evidence suggests that there is good evidence to support the role of diet, physical activity, and behavior changes in promoting optimal weight gain during pregnancy; however, there is currently a relative lack of evidence in other areas related to reproductive outcomes. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

The impact of ethnic identity on changes in high risk HIV behaviors in sexually active migrant workers.

PubMed

Shehadeh, Nancy; Virginia McCoy, H; Rubens, Muni; Batra, Anamica; Renfrew, Roderick; Winter, Kelly

2012-02-01

Among migrant workers (MWs) in the US, HIV/AIDS prevalence may be as high as 13.5%. This serial cross-sectional study examines associations between Ethnic Identity (EI) in African American and Hispanic MWs and short-term changes in high-risk sexual behaviors. Baseline and 3-month follow-up data was collected from a larger HIV intervention study among MWs in Immokalee, Florida (n = 119) who reported unprotected sex in the past 30 days. The Multigroup Identity Measure was used to assess EI. A high EI score indicates less acculturation to one's new surroundings. Females had higher levels of positive behavior change. Lower EI was associated with higher levels of positive change in relation to HIV/AIDS risk behavior. Among Hispanics, education was negatively correlated with EI. Education was a predictor of behavior change. Future interventions should focus on reducing acculturation stress, which may prompt harmful coping behaviors, such as high-risk sex and substance abuse.

Not Getting Burned: The Importance of Fire

Treesearch

Gregory S. Amacher; Arun S. Malik; Robert G. Haight

2005-01-01

We extend existing stand-level models of forest landowner behavior in the presence of fire risk to include the level and timing of fuel management activities. These activities reduce losses if a stand ignites. Based on simulations, we find the standard result that fire risk reduces the optimal rotation age does not hold when landowners use fuel management. Instead,...

"Just Take a Moment and Breathe and Think": Young Women with Depression Talk about the Development of an Ecological Momentary Intervention to Reduce Their Sexual Risk.

PubMed

Shrier, Lydia A; Spalding, Allegra

2017-02-01

Depressed young women are at increased risk for adverse outcomes related to sexual behavior, including unintended pregnancy, HIV, and other sexually transmitted infections. Brief sexual risk reduction interventions have not targeted depressed young women's specific needs for affect management and impulse control. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We interviewed depressed young women ages 15-23 years engaging in sexual risk behavior about a proposed intervention approach. The approach was described as in-person counseling and cognitive-behavioral skills training, followed by an ecological momentary intervention (EMI) delivered via smartphone application for 4 weeks. The EMI would include reporting multiple times a day on affective states, self-efficacy for safer sex behavior, and sexual behavior, and receiving responsive messages to provide support and prompt use of cognitive-behavioral skills. Participants provided their perspectives on comfort, usability, burden, confidentiality, and potential efficacy of the EMI and recommended message content. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Thematic saturation was reached with 16 interviews. Participants expressed positive opinions about the EMI. They believed that reporting at random times would help them to recognize their feelings, receiving the messages would be reassuring, and overall the smartphone application would be experienced as therapeutic. They desired a high degree of personalization of the message quality, style, and voice, and provided a wide variety of message content. Depressed young women believed that a flexible, personalized approach to mobile momentary intervention for addressing the link between their symptoms and behavior would be acceptable, supportive, and effective in reducing sexual risk. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

A conceptual framework for reducing risky teen driving behaviors among minority youth.

PubMed

Juarez, P; Schlundt, D G; Goldzweig, I; Stinson, N

2006-06-01

Teenage drivers, especially males, have higher rates of motor vehicle crashes and engage in riskier driving behavior than adults. Motor vehicle deaths disproportionately impact youth from poor and minority communities and in many communities there are higher rates of risky behaviors among minority youth. In this paper, the authors review the data on teens, risky driving behaviors, and morbidity and mortality. They identify areas in which known disparities exist, and examine strategies for changing teen driving behavior, identifying what has worked for improving the use of seat belts and for reducing other risky behaviors. A multifaceted, multilevel model based on ecological theory is proposed for understanding how teens make choices about driving behaviors, and to understand the array of factors that can influence these choices. The model is used to create recommendations for comprehensive intervention strategies that can be used in minority communities to reduce disparities in risk behaviors, injury, disability, and death.

Sexual risk behavior in men attending Mardi Gras celebrations in New Orleans, Louisiana.

PubMed

Benotsch, Eric G; Nettles, Christopher D; Wong, Felicia; Redmann, Jean; Boschini, Jill; Pinkerton, Steven D; Ragsdale, Kathleen; Mikytuck, John J

2007-10-01

Previous research with travelers points to higher risk behaviors during vacations. Relative to their day-to-day lives, leisure travelers have more free time to pursue sexual activities and are likely to engage in higher rates of substance use than when at home. Risk behaviors during vacation have not been thoroughly examined in men who have sex with men (MSM), a key group at risk for HIV. The present investigation examined substance use, sexual risk behaviors, and components of the Information-Motivation-Behavioral Skills (IMB) Model in MSM attending Mardi Gras celebrations in New Orleans. Almost half of the sexually active men reported having sex with a partner of unknown HIV status while in New Orleans and a similar number did not disclose their own HIV status to all of their sexual partners. Drug use and excessive alcohol use were associated with unprotected sex (ps < .05). Components of the IMB model also predicted sexual risk behavior: individuals with more accurate HIV transmission information reported fewer unprotected sex acts, and motivation to engage in sexual activity on vacation was associated with more unprotected sex (ps < .05). Findings suggest that some MSM on vacation are placing themselves at risk for HIV. Traditional HIV prevention interventions do not readily lend themselves for use with transient populations. New intervention approaches are needed to reduce sexual risk behaviors in persons traveling for leisure.

SEXUAL RISK BEHAVIOR IN MEN ATTENDING MARDI GRAS CELEBRATIONS IN NEW ORLEANS, LOUISIANA

PubMed Central

Benotsch, Eric G.; Nettles, Christopher D.; Wong, Felicia; Redmann, Jean; Boschini, Jill; Pinkerton, Steven D.; Ragsdale, Kathleen; Mikytuck, John J.

2008-01-01

Previous research with travelers points to higher risk behaviors during vacations. Relative to their day-to-day lives, leisure travelers have more free time to pursue sexual activities and are likely to engage in higher rates of substance use than when at home. Risk behaviors during vacation have not been thoroughly examined in men who have sex with men (MSM), a key group at risk for HIV. The present investigation examined substance use, sexual risk behaviors, and components of the Information-Motivation-Behavioral Skills (IMB) Model in MSM attending Mardi Gras celebrations in New Orleans. Almost half of the sexually active men reported having sex with a partner of unknown HIV status while in New Orleans and a similar number did not disclose their own HIV status to all of their sexual partners. Drug use and excessive alcohol use were associated with unprotected sex (ps < .05). Components of the IMB model also predicted sexual risk behavior: individuals with more accurate HIV transmission information reported fewer unprotected sex acts, and motivation to engage in sexual activity on vacation was associated with more unprotected sex (ps < .05). Findings suggest that some MSM on vacation are placing themselves at risk for HIV. Traditional HIV prevention interventions do not readily lend themselves for use with transient populations. New intervention approaches are needed to reduce sexual risk behaviors in persons traveling for leisure. PMID:17922205

Pathways to adolescent sexual risk behaviors: Effects of prenatal cocaine exposure.

PubMed

Min, Meeyoung O; Minnes, Sonia; Lang, Adelaide; Albert, Jeffrey M; Kim, June-Yung; Singer, Lynn T

2016-04-01

To assess the impact of prenatal cocaine exposure (PCE) on adolescent sexual risk behaviors. Externalizing behavior, teen substance use, and early sexual intercourse were examined as pathways mediating the effects of PCE on sexual risk behaviors. Adolescents (N=364; 185 PCE, 179 non-cocaine exposure (NCE); 205 girls, 159 boys), primarily African-American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. Risky sexual behaviors were assessed at ages 15 and 17. Externalizing behavior at 12 years was assessed with the Youth Self-Report. Substance use, via self-report and biologic assays, and early (before age 15) sexual intercourse were assessed at age 15. Path analyses with the weighted least squares estimator with mean and variance adjustments were performed. The final structural equation model-based path model, χ(2)=31.97 (df=27), p=.23, CFI=.99, TLI=.99, RMSEA=.021, WRMR=.695, indicated a direct effect of PCE on sexual risk behavior (β=.16, p=.02). Although PCE was related to greater externalizing behavior (β=.14, p=.009), which in turn, predicted early sexual intercourse (β=.16, p=.03), leading to sexual risk behavior (β=.44, p<.001), bootstrapping indicated a non-significant indirect effect (β=.01, p>.10). Substance use was correlated with early sexual intercourse (r=.60, p<.001) and predicted sexual risk behavior by age 17 (β=.31, p=.01). Prenatal cocaine exposure was related to more engagement in sexual risk behaviors, suggesting the importance of reducing substance use among pregnant women as a means of prevention of offspring substance use and sexual risk behavior. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

UNDERSTANDING THE CONTEXT OF HIV RISK BEHAVIOR AMONG HIV-POSITIVE AND HIV-NEGATIVE FEMALE SEX WORKERS AND MALE BAR CLIENTS FOLLOWING ANTIRETROVIRAL THERAPY ROLLOUT IN MOMBASA, KENYA

PubMed Central

McClelland, Lauren; Wanje, George; Kashonga, Frances; Kibe, Lydiah; McClelland, R. Scott; Kiarie, James; Mandaliya, Kishorchandra; Peshu, Norbert; Kurth, Ann

2011-01-01

This study explored perceptions of HIV following local introduction of antiretroviral therapy (ART), among 30 HIV-positive and -negative female sex workers (FSWs) and 10 male bar patrons in Mombasa, Kenya. Semi-structured interviews were analyzed qualitatively to identify determinants of sexual risk behaviors. ART was not perceived as a barrier to safer sex and in some cases led to decreased high-risk behaviors. Barriers to safer sex included economic pressure and sexual partnership types. Many women reported that negotiating condom use is more difficult in long-term partnerships. These women favored short-term partnerships to minimize risk through consistent condom use. For women living with HIV, concern about maintaining health and avoiding HIV superinfection was a strong motivator of protective behaviors. For HIV-negative women, a negative HIV test was a powerful motivator. Incorporation of context- and serostatus-specific factors (e.g., self-protection for HIV-positive women) into tailored prevention counseling may support high-risk women to reduce risk behaviors. PMID:21861605

Induced changes in island fox (Urocyon littoralis) activity do not mitigate the extinction threat posed by a novel predator.

PubMed

Hudgens, Brian R; Garcelon, David K

2011-03-01

Prey response to novel predators influences the impacts on prey populations of introduced predators, bio-control efforts, and predator range expansion. Predicting the impacts of novel predators on native prey requires an understanding of both predator avoidance strategies and their potential to reduce predation risk. We examine the response of island foxes (Urocyon littoralis) to invasion by golden eagles (Aquila chrysaetos). Foxes reduced daytime activity and increased night time activity relative to eagle-naïve foxes. Individual foxes reverted toward diurnal tendencies following eagle removal efforts. We quantified the potential population impact of reduced diurnality by modeling island fox population dynamics. Our model predicted an annual population decline similar to what was observed following golden eagle invasion and predicted that the observed 11% reduction in daytime activity would not reduce predation risk sufficiently to reduce extinction risk. The limited effect of this behaviorally plastic predator avoidance strategy highlights the importance of linking behavioral change to population dynamics for predicting the impact of novel predators on resident prey populations.

Mental and Social Health Impacts the Use of Protective Behavioral Strategies in Reducing Risky Drinking and Alcohol Consequences

ERIC Educational Resources Information Center

LaBrie, Joseph W.; Kenney, Shannon R.; Lac, Andrew; Garcia, Jonathan A.; Ferraiolo, Paul

2009-01-01

The present study is the first to examine the moderating effects of mental and social health status in the relationship between protective behavioral strategies utilized to reduce high-risk drinking (e.g., alternating alcoholic and nonalcoholic drinks or avoiding drinking games) and alcohol outcomes (drinking variables and alcohol-related negative…

Reducing Sexual Risk Behaviors and Alcohol Use among HIV-Positive Men Who Have Sex with Men: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Velasquez, Mary M.; von Sternberg, Kirk; Johnson, David H.; Green, Charles; Carbonari, Joseph P.; Parsons, Jeffrey T.

2009-01-01

This randomized clinical trial (N = 253) evaluated the efficacy of a theory-based intervention designed to reduce both alcohol use and incidence of unprotected sexual behaviors among HIV-positive men who have sex with men with alcohol use disorders. An integrated, manualized intervention, using both individual counseling and peer group…

Safer choices: reducing teen pregnancy, HIV, and STDs.

PubMed Central

Coyle, K.; Basen-Engquist, K.; Kirby, D.; Parcel, G.; Banspach, S.; Collins, J.; Baumler, E.; Carvajal, S.; Harrist, R.

2001-01-01

OBJECTIVES: This study evaluated the long-term effectiveness of Safer Choices, a theory-based, multi-component educational program designed to reduce sexual risk behaviors and increase protective behaviors in preventing HIV, other STDs, and pregnancy among high school students. METHODS: The study used a randomized controlled trial involving 20 high schools in California and Texas. A cohort of 3869 ninth-grade students was tracked for 31 months from fall semester 1993 (baseline) to spring semester 1996 (31-month follow-up). Data were collected using self-report surveys administered by trained data collectors. Response rate at 31-month follow-up was 79%. RESULTS: Safer Choices had its greatest effect on measures involving condom use. The program reduced the frequency of intercourse without a condom during the three months prior to the survey, reduced the number of sexual partners with whom students had intercourse without a condom, and increased use of condoms and other protection against pregnancy at last intercourse. Safer Choices also improved 7 of 13 psychosocial variables, many related to condom use, but did not have a significant effect upon rates of sexual initiation. CONCLUSIONS: The Safer Choices program was effective in reducing important risk behaviors for HIV, other STDs, and pregnancy and in enhancing most psychosocial determinants of such behavior. PMID:11889277

Collaborating with Parents in Using Effective Strategies to Reduce Children's Challenging Behaviors

ERIC Educational Resources Information Center

Fettig, Angel; Schultz, Tia R.; Ostrosky, Michaelene M.

2013-01-01

Challenging behavior is often a source of frustration for parents. Challenging behavior is defined as any behavior that interferes with children's learning and development, is harmful to children and to others, and puts a child at risk for later social problems or school failure (Bailey & Wolery, 1992; Kaiser & Rasminsky, 2003). Children's…

Preschool Teachers' Responses to Challenging Behavior: The Role of Organizational Climate in Referrals and Expulsions

ERIC Educational Resources Information Center

Miller, Shauna; Smith-Bonahue, Tina; Kemple, Kristen

2017-01-01

Challenging behavior in preschool can lead to harmful outcomes for some children. While interventions have been shown to be effective in reducing or eliminating challenging behavior, evidence suggests that young children with challenging behavior are under-identified for services, increasing their risk for expulsion from early childhood programs.…

77 FR 27539 - Reports, Forms, and Recordkeeping Requirements; Agency Information Collection Activity Under OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-10

... risk is crucial to developing effective countermeasures to reduce motorcycle crashes and fatalities... history, self-reported behavior, and perceptions. After completing the on-road study, participants will be... characteristics, riding history, self-reported behavior, and perceptions are linked to his or her behavior on the...

Reduced risk-taking behavior as a trait feature of anxiety.

PubMed

Giorgetta, Cinzia; Grecucci, Alessandro; Zuanon, Sophia; Perini, Laura; Balestrieri, Matteo; Bonini, Nicolao; Sanfey, Alan G; Brambilla, Paolo

2012-12-01

Affect can have a significant influence on decision-making processes and subsequent choice. One particularly relevant type of negative affect is anxiety, which serves to enhance responses to threatening stimuli or situations. In its exaggerated form, it can lead to psychiatric disorders, with detrimental consequences for quality of life, including the ability to make choices. This study investigated, for the first time, how pathological anxiety affects risk-taking behavior. In this study, 20 anxious participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for either generalized anxiety disorder (n = 10) and for panic attack disorder (n = 10), as well as 20 matched nonanxious controls, performed a gambling task. To investigate the tendency toward either a risk-seeking or a risk-averse behavior, we employed a task that did not allow for learning from outcomes. Anxious participants made significantly fewer risky choices than matched nonanxious participants. Specifically, they become risk-avoidant after gains. Moreover, anxious participants not only were less happy after gains but were also less sad after losses, and they also evinced less desire to change their choices after losses than did nonanxious participants. Importantly, whereas the desire to switch choice was followed by actual choice switch for all participants, happiness directly predicted subsequent risky choices, particularly in the nonanxious participants. Further analyses revealed that the anxious participants' risk-avoidance behavior was independent of different types of anxiety disorder (panic attack disorder and generalized anxiety disorder) as well as of the effects of psychotropic drugs treatment. This study demonstrates a specific role for anxiety in individual decision making. In particular, hypersensitivity to potential threats and pessimistic evaluation of future events reduced risk-taking behavior. PsycINFO Database Record (c) 2012 APA, all rights reserved.

An Intervention for HPV Risk Reduction Based on the Theory of Planned Behavior: An Exploratory Study with College-Aged Women

ERIC Educational Resources Information Center

Sweeney, Jocelyn Brineman; McAnulty, Richard D.; Reeve, Charlie; Cann, Arnie

2015-01-01

The goal of the study was to examine the effectiveness of a group intervention in reducing risks of contracting human papillomavirus (HPV) among college-aged women. Using a randomized design, the study examined the effectiveness of an HPV educational group intervention guided by the Theory of Planned Behavior. The intervention was provided in a…

Fregoli Syndrome: An Underrecognized Risk Factor for Aggression in Treatment Settings

PubMed Central

Ashraf, Nauman; Antonius, Daniel; Sinkman, Arthur; Kleinhaus, Karine; Malaspina, Dolores

2011-01-01

Fregoli syndrome (FS) is commonly associated with verbal threats and aggressive behavior. We present a case of Fregoli syndrome leading to an assault. We discuss the possible underdiagnosis of FS, associated risk for aggression, and strategies to reduce that risk. PMID:22937404

A 12-week multidomain intervention versus active control to reduce risk of Alzheimer’s disease: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Disappointing results from clinical trials of disease-modifying interventions for Alzheimer’s dementia (AD), along with reliable identification of modifiable risk factors in mid life from epidemiological studies, have contributed to calls to invest in risk-reduction interventions. It is also well known that AD-related pathological processes begin more than a decade before the development of clinical signs. These observations suggest that lifestyle interventions might be most effective when targeting non-symptomatic adults at risk of AD. To date, however, the few dementia risk-reduction programs available have targeted individual risk factors and/or were restricted to clinical settings. The current study describes the development of an evidence-based, theoretically-driven multidomain intervention to reduce AD risk in adults at risk. Method The design of Body Brain Life (BBL) is a randomized controlled trial (RCT) to evaluate a 12-week online AD risk-reduction intervention. Eligible participants with several modifiable risk factors on the Australian National University (ANU) AD Risk Index (ANU-ADRI) are randomly allocated to an online only group, an online and face-to-face group, or an active control group. We aim to recruit 180 participants, to undergo a comprehensive cognitive and physical assessment at baseline, post-intervention, and 6-month follow-up assessment. The intervention comprises seven online modules (dementia literacy, risk factor education, engagement in physical, social, and cognitive lifestyles, nutrition, and health monitoring) designed using contemporary models of health behavior change. Discussion The BBL program is a novel online intervention to reduce the risk of AD in middle-aged adults at risk. The trial is currently under way. It is hypothesized that participants in the intervention arms will make lifestyle changes in several domains, and that this will lead to a reduction in their AD risk profile. We also expect to show that health behavior change is underpinned by changes in psychological determinants of behavior. If successful, the findings will contribute to the development of further dementia risk reduction interventions, and thus contribute to the urgent need to lower dementia risk factors in the population to alter future projections of disease prevalence. Longer follow-up of BBL participants and replications using large samples are required to examine whether reduction in AD risk factors will be associated with reduced prevalence. Trial registration Reg. no. ACTRN12612000147886 PMID:23442574

Correlates of HIV risk-taking behaviors among African-American college students: the effect of HIV knowledge, motivation, and behavioral skills.

PubMed Central

Bazargan, M.; Kelly, E. M.; Stein, J. A.; Husaini, B. A.; Bazargan, S. H.

2000-01-01

This study identifies theoretically based predictors of condom use in a sample of 253 sexually active African-American college students recruited from two historically African-American colleges. The Information-Motivation-Behavioral (IMB) skills model of AIDS-preventive behavior was employed to delineate the roles of HIV/AIDS knowledge, experiences with and attitudes toward condom use, peer influences, perceived vulnerability, monogamy, and behavioral skills. A predictive structural equation model revealed significant predictors of more condom use including: male gender, more sexual HIV knowledge, positive experiences and attitudes about condom use, nonmonogamy, and greater behavioral skills. Results imply that attention to behavioral skills for negotiating safer sex and training in the proper use of condoms are key elements in reducing high risk behaviors. Increasing the specific knowledge level of college students regarding the subtleties of sexual transmission of HIV is important and should be addressed. Heightening students' awareness of the limited protection of serial monogamy, and the need to address gender-specific training regarding required behavior change to reduce transmission of HIV should be an additional goal of college health professionals. PMID:10992684

Not just the needle: the state of HIV-prevention science among substance users and future directions.

PubMed

Shoptaw, Steve; Montgomery, Brooke; Williams, Chyvette T; El-Bassel, Nabila; Aramrattana, Apinun; Metsch, Lisa; Metzger, David S; Kuo, Irene; Bastos, Francisco I; Strathdee, Steffanie A

2013-07-01

Efforts to prevent HIV transmission among substance-using populations have focused primarily among injection drug users, which have produced measurable reductions in HIV incidence and prevalence. By contrast, the majority of substances used worldwide are administered by noninjectable means, and there is a dearth of HIV prevention interventions that target noninjecting substance users. Increased surveillance of trends in substance use, especially cocaine (including crack) and methamphetamine, in addition to new and emerging substances (eg, synthetic cannabinoids, cathinones, and other amphetamine analogs) are needed to develop and scale up effective and robust interventions for populations at risk for HIV transmission via sexual behaviors related to noninjection substance use. Strategies are needed that address unique challenges to HIV prevention for substance users who are HIV infected and those who are HIV uninfected and are at high risk. We propose a research agenda that prioritizes (1) combination HIV-prevention strategies in substance users; (2) behavioral HIV prevention programs that reduce sexual transmission behaviors in nontreatment seeking individuals; (3) medical and/or behavioral treatments for substance abuse that reduce/eliminate substance-related sexual transmission behaviors; and (4) structural interventions to reduce HIV incidence.

A qualitative study of factors related to cardiometabolic risk in rural men.

PubMed

Morgan, Emily H; Graham, Meredith L; Folta, Sara C; Seguin, Rebecca A

2016-04-11

Rural men are known to have poor health behaviors, which contribute to their elevated burden of cardiometabolic disorders in the United States. Although regular physical activity, healthy eating, and avoiding tobacco can reduce cardiometabolic risk, little is known about how to engage rural men in health promotion programs. To bridge this gap in evidence, we investigate knowledge of modifiable cardiometabolic risk factors among rural men in the western United States, identify their concerns related to heart health and motivation to reduce risk, and explore individual, social, and community-level influences on heart-healthy behaviors, specifically diet, physical activity, and tobacco use. We conducted seven focus groups with 54 sedentary, overweight/obese men (mean body mass index [BMI] = 31.3 ± 4.6) aged 43-88 residing in government-designated "medically underserved" rural Montana towns in September and October 2014. All sessions were audio-recorded and transcribed verbatim. Transcripts were coded and analyzed thematically using Nvivo software. Participants also completed a brief questionnaire about personal characteristics and health behaviors. These data were explored descriptively. Despite being classified as overweight/obese and sedentary, no participants reported to be in poor health. Many men described health relative to self-reliance and the ability to participate in outdoor recreation; concern with health appeared to be related to age. Participants were generally knowledgeable of heart-healthy behaviors, but many felt fatalistic about their own risk. Catalysts for behavior change included a serious medical event in the household and desire to reduce aging-associated functional decline. Barriers to adopting and maintaining healthy eating and physical activity habits and abstaining from tobacco included normative beliefs around masculinity and individual liberty, the limited social universe of small towns, winter weather, time constraints, and preferences for unhealthy foods. Facilitators included behavioral self-monitoring, exercising with a partner, and opportunities for preferred activities, such as hunting and team sports. These findings provide important insight about influences on rural men's health behaviors and provide guidance for possible intervention strategies to promote cardiometabolic health. ClinicalTrials.gov NCT02499731 . Registered 1 July 2015.

Risk and protective factors for sexual risk taking among adolescents involved in Prime Time.

PubMed

Garwick, Ann; Nerdahl, Peggy; Banken, Rachel; Muenzenberger-Bretl, Lynn; Sieving, Renee

2004-10-01

This article describes a preliminary qualitative evaluation of risk and protective factors associated with consistent contraceptive use and healthy sexual decision-making among ten of the first participants in the Prime Time intervention study. Prime Time is an 18-month intervention including one-on-one case management and peer educator training targeting sexually active 13-17-year-old girls who are recruited from health care clinics. Using an approach grounded in findings from previous research, social cognitive theory, and the social development model, Prime Time aims to improve participants' contraceptive use consistency, reduce number of sexual partners, and reduce unwanted sexual activity. Findings from this preliminary evaluation alert health care providers to the complex and dynamic nature of adolescent girls' sexual behaviors and to a broad range of risk and protective factors within individuals and their environments that may influence adolescent girls' sexual behaviors and contraceptive use. Findings suggest that an ongoing, supportive relationship with a case manager who is able to pace and tailor an intervention to the individual young person can have positive effects on adolescent girls' sexual behaviors and contraceptive use.

Childhood Cognition and Risk Factors for Cardiovascular Disease in Midadulthood: The 1958 British Birth Cohort Study

PubMed Central

Jefferis, Barbara J. M. H.; Manor, Orly

2010-01-01

Objectives. We sought to establish whether associations between childhood cognition and risk factors for cardiovascular disease in adulthood are explained by common causes, or adult social position or health behavior. Methods. We analyzed associations between cognition at age 11 and cardiovascular disease risk factors at age 45 in the 1958 British birth cohort (n = 9377), with and without adjustment for covariates. Results. General ability was inversely associated with systolic and diastolic blood pressure, glycosylated hemoglobin, triglycerides (in women), body mass index, and waist circumference. Systolic blood pressure decreased by 0.47 mm Hg (95% confidence interval [CI] = −0.90, –0.05) for a 1-standard-deviation increase in ability. Separate adjustment for social class at birth, education level by adulthood, adult social class, and health behaviors reduced the associations respectively by 14% to 34%, 36% to 50%, 14% to 36%, and 24% to 73%. Full adjustment reduced associations between ability and risk factors at age 45 years by 43% to 92%, abolishing all associations. Conclusions. Increments across the distribution of childhood cognition are associated with improvements in cardiovascular risk profile in midlife, with associations primarily mediated through adult health behavior and social destinations. PMID:19910352

Physiological and Behavioral Engagement in Social Contexts as Predictors of Adolescent Depressive Symptoms

PubMed Central

Morgan, Judith K.; Shaw, Daniel S.; Forbes, Erika E.

2013-01-01

Depressive symptoms are considered to have evolutionary social functions to reduce social risks with peers and family members. However, social processes and their relationship to depressive symptoms have been understudied in adolescent boys. Low engagement in social contexts may predict depressive symptoms in adolescent boys, as it may signify efforts to reduce social risks. To address these issues, this study focused on 160 boys at risk for affective problems based on low socioeconomic status. We evaluated how behavioral and physiological engagement in peer and family contexts, respectively, in late childhood predicted depressive symptoms at age 12 and age 15. Social withdrawal was measured across late childhood (ages 9 to 12) in a camp setting using a latent variable of the teacher ratings of withdrawn behavior, peer nominations of withdrawn behavior, and camp counselor ratings of withdrawn behavior. Physiological reactivity was measured during a provocative parent-child conversation using respiratory sinus arrhythmia (RSA) at age 12. Social withdrawal in late childhood predicted depressive symptoms at age 12. The combination of high levels of social withdrawal with peers from ages 9 to 12 and low RSA reactivity with a parent at age 12 predicted higher depressive symptoms at age 15. Withdrawal in multiple social contexts may place boys at risk for depressive symptoms during the vulnerable period of adolescence. PMID:22976840

Positive and negative effects of social impact on evolutionary vaccination game in networks

NASA Astrophysics Data System (ADS)

Ichinose, Genki; Kurisaku, Takehiro

2017-02-01

Preventing infectious disease like flu from spreading to large communities is one of the most important issues for humans. One effective strategy is voluntary vaccination, however, there is always the temptation for people refusing to be vaccinated because once herd immunity is achieved, infection risk is greatly reduced. In this paper, we study the effect of social impact on the vaccination behavior resulting in preventing infectious disease in networks. The evolutionary simulation results show that the social impact has both positive and negative effects on the vaccination behavior. Especially, in heterogeneous networks, if the vaccination cost is low the behavior is more promoted than the case without social impact. In contrast, if the cost is high, the behavior is reduced compared to the case without social impact. Moreover, the vaccination behavior is effective in heterogeneous networks more than in homogeneous networks. This implies that the social impact puts people at risk in homogeneous networks. We also evaluate the results from the social cost related to the vaccination policy.

Individual and Network Interventions With Injection Drug Users in 5 Ukraine Cities

PubMed Central

Lehman, Wayne E. K.; Latkin, Carl A.; Dvoryak, Sergey; Brewster, John T.; Royer, Mark S.; Sinitsyna, Larisa

2011-01-01

Objectives. We evaluated the effects of an individual intervention versus a network intervention on HIV-related injection and sexual risk behaviors among street-recruited opiate injection drug users in 5 Ukraine cities. Methods. Between 2004 and 2006, 722 opiate injection drug users were recruited to participate in interventions that were either individually based or based on a social network model in which peer educators intervened with their network members. Audio computer-assisted self-interview techniques were used to interview participants at baseline and follow-up. Results. Multiple logistic analyses controlling for baseline injection and sexual risks revealed that both peer educators and network members in the network intervention reduced injection-related risk behaviors significantly more than did those in the individually based intervention and that peer educators increased condom use significantly more than did those in the individual intervention. Individual intervention participants, however, showed significantly greater improvements than did network members with respect to reductions in sexual risk behaviors. Conclusions. Social network interventions may be more effective than individually based interventions in changing injection risk behaviors among both peer educators and network members. The effectiveness of network interventions in changing sexual risk behaviors is less clear, probably owing to network composition and inhibitions regarding discussing sexual risk behaviors. PMID:20395584

Relationships Between Social-Emotional Intelligence and Sexual Risk Behaviors in Adolescent Girls

PubMed Central

Lando-King, Elizabeth; McRee, Annie-Laurie; Gower, Amy L.; Shlafer, Rebecca J.; McMorris, Barbara J.; Pettingell, Sandra; Sieving, Renee E.

2015-01-01

Social-emotional intelligence (SEI) has been linked with a number of health behaviors in adolescent populations. However, little is known about the influence of SEI on sexual behavior. This study examined associations between three indicators of SEI (intrapersonal skills, interpersonal skills, stress management skills) and adolescent girls’ sexual risk behaviors. Data come from a cross-sectional sample of sexually active adolescent girls (ages 13 to 17 years) at high risk for pregnancy (N = 253), recruited from health care clinics in a Midwest metropolitan area during 2007 and 2008. Results of multivariable regression models controlling for participants’ age and race/ethnicity indicated that each aspect of SEI was related to distinct sexual risk behaviors. Specifically, girls with greater intrapersonal skills had significantly fewer male sex partners in the past six months (b = −0.16). Participants with greater interpersonal skills reported earlier communication with their sexual partner about sexual risk (b = 0.14), and those with a better ability to manage stress reported more consistent condom use (b = 0.31). Study findings suggest that SEI may provide a protective buffer against sexual risk behaviors. Building adolescent girls’ social and emotional skills may be an effective strategy for reducing their risk for early pregnancy and sexually transmitted infections. PMID:25621508

Sexual Risk Behavior in Young Adulthood: Broadening the Scope Beyond Early Sexual Initiation

PubMed Central

Epstein, Marina; Bailey, Jennifer A.; Manhart, Lisa E.; Hill, Karl G.; Hawkins, J. David

2013-01-01

A robust link between early sexual initiation and sexual risk-taking behavior is reported in previous studies. The relationship may not be causal, however, as the effect of common risk factors is often not considered. The current study examined whether early initiation is a key predictor of risky sexual behavior in the 20s and 30s, over and above co-occurring individual and environmental factors. Data were drawn from the Seattle Social Development Project, a longitudinal panel of 808 youth. Early predictors (ages 10–15) and sexual risk-taking (ages 21–24 and 30–33) were assessed prospectively. Early sexual initiation (before age 15) was entered into a series of probit regressions that also included family, neighborhood, peer, and individual risk factors. Although a positive bivariate relation between early sexual initiation and sexual risk-taking was observed at both ages, the link did not persist when co-occurring risk factors were included. Behavioral disinhibition and antisocial peer influences emerged as the strongest predictors of sexual risk over and above early sexual initiation. These results suggest that early sexual initiation must be considered in the context of common antecedents; public health policy aimed at delaying sexual intercourse alone is unlikely to substantially reduce sexual risk behavior in young adulthood. PMID:24423058

Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda.

PubMed

Ssewamala, Fred M; Bermudez, Laura Gauer; Neilands, Torsten B; Mellins, Claude A; McKay, Mary M; Garfinkel, Irv; Sensoy Bahar, Ozge; Nakigozi, Gertrude; Mukasa, Miriam; Stark, Lindsay; Damulira, Christopher; Nattabi, Jennifer; Kivumbi, Apollo

2018-06-05

Asset-based economic empowerment interventions, which take an integrated approach to building human, social, and economic capital, have shown promise in their ability to reduce HIV risk for young people, including adolescent girls, in sub-Saharan Africa. Similarly, community and family strengthening interventions have proven beneficial in addressing mental health and behavioral challenges of adolescents transitioning to adulthood. Yet, few programs aimed at addressing sexual risk have applied combination interventions to address economic stability and mental health within the traditional framework of health education and HIV counseling/testing. This paper describes a study protocol for a 5-year, NIMH-funded, cluster randomized-controlled trial to evaluate a combination intervention aimed at reducing HIV risk among adolescent girls in Uganda. The intervention, titled Suubi4Her, combines savings-led economic empowerment through youth development accounts (YDA) with an innovative family strengthening component delivered via Multiple Family Groups (MFG). Suubi4Her will be evaluated via a three-arm cluster randomized-controlled trial design (YDA only, YDA + MFG, Usual Care) in 42 secondary schools in the Central region of Uganda, targeting a total of 1260 girls (ages 15-17 at enrollment). Assessments will occur at baseline, 12, 24, and 36 months. This study addresses two primary outcomes: 1) change in HIV risk behavior and 2) change in mental health functioning. Secondary exploratory outcomes include HIV and STI incidence, pregnancy, educational attainment, financial savings behavior, gender attitudes, and self-esteem. For potential scale-up, cost effectiveness analysis will be employed to compare the relative costs and outcomes associated with each study arm. Suubi4Her will be one of the first prospective studies to examine the impact and cost of a combination intervention integrating economic and social components to reduce known HIV risk factors and improve mental health functioning among adolescent girls, while concurrently exploring mental health as a mediator in HIV risk reduction. The findings will illuminate the pathways that connect economic needs, mental health, family support, and HIV risk. If successful, the results will promote holistic HIV prevention strategies to reduce risk among adolescent girls in Uganda and potentially the broader sub-Saharan Africa region. Clinical Trials NCT03307226 (Registered: 10/11/17).

An Agent-Based Model of Evolving Community Flood Risk.

PubMed

Tonn, Gina L; Guikema, Seth D

2018-06-01

Although individual behavior plays a major role in community flood risk, traditional flood risk models generally do not capture information on how community policies and individual decisions impact the evolution of flood risk over time. The purpose of this study is to improve the understanding of the temporal aspects of flood risk through a combined analysis of the behavioral, engineering, and physical hazard aspects of flood risk. Additionally, the study aims to develop a new modeling approach for integrating behavior, policy, flood hazards, and engineering interventions. An agent-based model (ABM) is used to analyze the influence of flood protection measures, individual behavior, and the occurrence of floods and near-miss flood events on community flood risk. The ABM focuses on the following decisions and behaviors: dissemination of flood management information, installation of community flood protection, elevation of household mechanical equipment, and elevation of homes. The approach is place based, with a case study area in Fargo, North Dakota, but is focused on generalizable insights. Generally, community mitigation results in reduced future damage, and individual action, including mitigation and movement into and out of high-risk areas, can have a significant influence on community flood risk. The results of this study provide useful insights into the interplay between individual and community actions and how it affects the evolution of flood risk. This study lends insight into priorities for future work, including the development of more in-depth behavioral and decision rules at the individual and community level. © 2017 Society for Risk Analysis.

42 CFR 410.15 - Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and...

Code of Federal Regulations, 2012 CFR

2012-10-01

... risk factors and improving self management, or community-based lifestyle interventions to reduce health risks and promote self-management and wellness, including weight loss, physical activity, smoking... satisfaction, stress, anger, loneliness/social isolation, pain, and fatigue. (D) Behavioral risks, including...

From Correlates to Causes: Can Quasi-Experimental Studies and Statistical Innovations Bring Us Closer to Identifying the Causes of Antisocial Behavior?

PubMed Central

Jaffee, Sara R.; Strait, Luciana B.; Odgers, Candice L.

2011-01-01

Longitudinal, epidemiological studies have identified robust risk factors for youth antisocial behavior, including harsh and coercive discipline, maltreatment, smoking during pregnancy, divorce, teen parenthood, peer deviance, parental psychopathology, and social disadvantage. Nevertheless, because this literature is largely based on observational studies, it remains unclear whether these risk factors have truly causal effects. Identifying causal risk factors for antisocial behavior would be informative for intervention efforts and for studies that test whether individuals are differentially susceptible to risk exposures. In this paper, we identify the challenges to causal inference posed by observational studies and describe quasi-experimental methods and statistical innovations that may move us beyond discussions of risk factors to allow for stronger causal inference. We then review studies that use these methods and we evaluate whether robust risk factors identified from observational studies are likely to play a causal role in the emergence and development of youth antisocial behavior. For most of the risk factors we review, there is evidence that they have causal effects. However, these effects are typically smaller than those reported in observational studies, suggesting that familial confounding, social selection, and misidentification might also explain some of the association between risk exposures and antisocial behavior. For some risk factors (e.g., smoking during pregnancy, parent alcohol problems) the evidence is weak that they have environmentally mediated effects on youth antisocial behavior. We discuss the implications of these findings for intervention efforts to reduce antisocial behavior and for basic research on the etiology and course of antisocial behavior. PMID:22023141

From correlates to causes: can quasi-experimental studies and statistical innovations bring us closer to identifying the causes of antisocial behavior?

PubMed

Jaffee, Sara R; Strait, Luciana B; Odgers, Candice L

2012-03-01

Longitudinal, epidemiological studies have identified robust risk factors for youth antisocial behavior, including harsh and coercive discipline, maltreatment, smoking during pregnancy, divorce, teen parenthood, peer deviance, parental psychopathology, and social disadvantage. Nevertheless, because this literature is largely based on observational studies, it remains unclear whether these risk factors have truly causal effects. Identifying causal risk factors for antisocial behavior would be informative for intervention efforts and for studies that test whether individuals are differentially susceptible to risk exposures. In this article, we identify the challenges to causal inference posed by observational studies and describe quasi-experimental methods and statistical innovations that may move researchers beyond discussions of risk factors to allow for stronger causal inference. We then review studies that used these methods, and we evaluate whether robust risk factors identified from observational studies are likely to play a causal role in the emergence and development of youth antisocial behavior. There is evidence of causal effects for most of the risk factors we review. However, these effects are typically smaller than those reported in observational studies, suggesting that familial confounding, social selection, and misidentification might also explain some of the association between risk exposures and antisocial behavior. For some risk factors (e.g., smoking during pregnancy, parent alcohol problems), the evidence is weak that they have environmentally mediated effects on youth antisocial behavior. We discuss the implications of these findings for intervention efforts to reduce antisocial behavior and for basic research on the etiology and course of antisocial behavior.

Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

PubMed Central

Eshrati, Babak; Asl, Rahim Taghizadeh; Dell, Colleen Anne; Afshar, Parviz; Millson, Peggy Margaret E; Kamali, Mohammad; Weekes, John

2008-01-01

Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM) and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices. PMID:18541032

Sense of Belonging and Youth Suicidal Behaviors: What Do Communities and Schools Have to Do with It?

PubMed

Olcoń, Katarzyna; Kim, Yeonwoo; Gulbas, Lauren E

2017-01-01

Situating Thomas Joiner's concept of belonging within an ecological perspective, this study examined the associations between school and community belonging and suicidal ideation and attempts among high school students. The study used data from the 2013 Texas Youth Risk Behavior Survey (N = 2,560). Results demonstrated that community belonging reduced the odds of youth suicidal behaviors. School bullying, feeling unsafe at school, and being threatened or injured at a school increased the odds of suicidal behaviors. Findings suggest that fostering safe and inclusive environments and strengthening youth's experiences of school and community belonging may reduce suicidal behaviors in high school youth.

A randomized, controlled trial to test the efficacy of an online, parent-based intervention for reducing the risks associated with college-student alcohol use

PubMed Central

Donovan, Elizabeth; Wood, Mollie; Frayjo, Kezia; Black, Ryan A.; Surette, Daniel A.

2011-01-01

Alcohol consumption among college students remains a major public health concern. Universal, Web-based interventions to reduce risks associated with student alcohol consumption have been found to be effective in changing their alcohol-related behavior. Recent studies also indicate that parent-based interventions, delivered in booklet form, are effective. A parent-based intervention that is also Web-based may be well suited to a dispersed parent population; however, no such tool is currently available. The purpose of this study was to test the efficacy of an online parent-based intervention designed to (1) increase communication between parents and students about alcohol and (2) reduce risks associated with alcohol use to students. A total of 558 participants, comprising 279 parent-teen dyads, were enrolled in the study. The findings suggested that parents who participated in the online intervention were more likely to discuss protective behavioral strategies, particularly those related to manner of drinking and stopping/limiting drinking, with their teens, as compared with parents in an e-newsletter control group. Moreover, students whose parents received the intervention were more likely to use a range of protective behavioral strategies, particularly those related to manner of drinking and stopping/limiting drinking, as compared with students whose parents did not receive the intervention. A universal, online, parent-based intervention to reduce risks associated with student alcohol consumption may be an efficient and effective component of a college’s overall prevention strategy. PMID:21963316

Motivating the Skeptical and Unconcerned: Considering Values, Worldviews, and Norms When Planning Messages Encouraging Energy Conservation and Efficiency Behaviors

ERIC Educational Resources Information Center

Arpan, Laura M.; Opel, Andrew R.; Lu, Jia

2013-01-01

The current study examined the association of personal values or worldviews with individual motivations for reduced energy use and energy-use-related risk perceptions. We also investigated how perceptions of others' energy use influenced motivation to reduce use among those with high, versus low, risk perceptions. The perception that others were…

Wearing a Bicycle Helmet Can Increase Risk Taking and Sensation Seeking in Adults

PubMed Central

Gamble, Tim; Walker, Ian

2016-01-01

Humans adapt their risk-taking behavior on the basis of perceptions of safety; this risk-compensation phenomenon is typified by people taking increased risks when using protective equipment. Existing studies have looked at people who know they are using safety equipment and have specifically focused on changes in behaviors for which that equipment might reduce risk. Here, we demonstrated that risk taking increases in people who are not explicitly aware they are wearing protective equipment; furthermore, this happens for behaviors that could not be made safer by that equipment. In a controlled study in which a helmet, compared with a baseball cap, was used as the head mount for an eye tracker, participants scored significantly higher on laboratory measures of both risk taking and sensation seeking. This happened despite there being no risk for the helmet to ameliorate and despite it being introduced purely as an eye tracker. The results suggest that unconscious activation of safety-related concepts primes globally increased risk propensity. PMID:26740528

Access to Sterile Injecting Equipment is More Important Than Awareness of HCV Status for Injection Risk Behaviors Among Drug Users

PubMed Central

COX, JOSEPH; MORISSETTE, CAROLE; DE, PRITHWISH; TREMBLAY, CLAUDE; ALLARD, ROBERT; GRAVES, LISA; STEPHENSON, RANDOLPH; ROY, ÉLISE

2010-01-01

Awareness of hepatitis C virus (HCV) infection status is expected to influence risk behaviors. In 2004–2005, injection drug users (IDUs) recruited from syringe exchange programs (SEPs) and methadone clinics in Montreal, Canada, were interviewed on drug use behaviors (past 6 months) and HCV testing. Subjects (n = 230) were classified as low/intermediate risk (20.4% borrowed drug preparation equipment only) and high risk (19.6% borrowed syringes), and 54.5% reported being HCV positive. Logistic regression modeling showed that compared to no risk (60% borrowed nothing), low/intermediate risk was associated with fewer noninjecting social network members, poor physical health, and problems obtaining sterile injecting equipment. High risk was associated with all of these factors except social networks. HCV status was not associated with any level of risk. Improved access to sterile injecting equipment may be more important than knowledge of HCV status in reducing injection risks among this IDU population. The study limitations are noted and recommendations discussed. PMID:19242863

Routine brief risk-reduction counseling with biannual STD testing reduces STD incidence among HIV-infected men who have sex with men in care.

PubMed

Patel, Pragna; Bush, Tim; Mayer, Kenneth; Milam, Joel; Richardson, Jean; Hammer, John; Henry, Keith; Overton, Turner; Conley, Lois; Marks, Gary; Brooks, John T

2012-06-01

We evaluated whether routine biannual sexually transmitted disease (STD) testing coupled with brief risk-reduction counseling reduces STD incidence and high-risk behaviors. The SUN study is a prospective observational HIV cohort study conducted in 4 US cities. At enrollment and every 6 months thereafter, participants completed a behavioral survey and were screened for STDs, and if diagnosed, were treated. Medical providers conducted brief risk-reduction counseling with all patients. Among men who have sex with men (MSM), we examined trends in STD incidence and rates of self-reported risk behaviors before and after exposure to the risk-reduction intervention. The "preintervention" visit was the study visit that was at least 6 months after enrollment STD screening and treatment and at which the participant was first exposed to the intervention. The "postintervention" visit was 12 months later. Among 216 MSM with complete STD and behavioral data, median age was 44.5 years; 77% were non-Hispanic white; 83% were on highly active antiretroviral treatment; 84% had an HIV RNA level <400 copies/mL and the median CD4 (cluster of differentiation 4) count was 511 cells/mm. Twelve months after first exposure to the risk-reduction intervention, STD incidence declined from 8.8% to 4.2% (P = 0.041). Rates of unprotected receptive or insertive anal intercourse with HIV-positive partners increased (19% to 25%, P = 0.024), but did not change with HIV-negative partners or partners of unknown HIV status (24% to 22%, P = 0.590). STD incidence declined significantly among HIV-infected MSM after implementing frequent, routine STD testing coupled with risk-reduction counseling. These findings support adoption of routine STD screening and risk-reduction counseling for HIV-infected MSM.

RCT of an integrated CBT-HIV intervention on depressive symptoms and HIV risk.

PubMed

Tobin, Karin; Davey-Rothwell, Melissa A; Nonyane, Bareng A S; Knowlton, Amy; Wissow, Lawrence; Latkin, Carl A

2017-01-01

Depression and depressive symptoms mediate the association between drug use and HIV risk. Yet, there are few interventions that target depressive symptoms and HIV risk for people who use drugs (PWUD). This study was a randomized controlled trial of an integrated cognitive behavioral therapy and HIV prevention intervention to reduce depressive symptoms, injection risk behaviors and increase condom use in a sample of urban people who used heroin or cocaine in the prior 6 months. A total of 315 individuals aged 18-55, who self-reported at least one HIV drug and sex risk behavior and scored ≥16 and <40 on the Centers for Epidemiologic Studies-Depression (CES-D) scale were randomized using a two-block design, stratified by sex to ensure equivalent numbers, to a 10 session intervention arm (n = 162) or a single session control arm (n = 153). The outcomes of interest were decreases in CES-D score and injection risk behaviors and increases in condom use. The sample was majority African American (85%) and unemployed (94%). Nearly half (47%) reported injection in the prior 6 months and only 19% were taking medication for depression. Follow-up assessments were conducted at 6 and 12 months. Retention at 12 months was 94%. Intervention arm was associated with statistically significantly lower CES-D score at 12 month compared to control. No differences were observed between arms in injection risk. At 6 month, intervention was associated with greater odds of condom use with non-main partner. These findings suggest the potential role of the integrated intervention in reducing depressive symptoms, but weak impact on HIV risk. This trial is registered with ClinicalTrials.gov under the title "Neighborhoods, Networks, Depression, and HIV Risk" number NCT01380613.

Beyond Anal Sex: Sexual Practices Associated with HIV Risk Reduction among Men Who Have Sex with Men in Boston, Massachusetts

PubMed Central

Reisner, Sari L.; Skeer, Margie; Mayer, Kenneth H.

2009-01-01

Abstract Men who have sex with men (MSM) continue to bear a disproportionate HIV and sexually transmitted disease (STD) burden. The current study examined the frequency and associations of sexual risk reduction behaviors among a sample of MSM in the greater Boston, Massachusetts area. One hundred eighty-nine MSM completed a one-time behavioral and psychosocial assessment between March 2006 and May 2007. Logistic regression procedures examined the association of demographic, psychosocial, and behavioral factors with risk reduction practices. Twenty percent of the sample reported rimming, mutual masturbation, digital penetration, using sex toys, or 100% condom use as a means to reduce their risk of acquiring or transmitting HIV in the prior 12 months. In bivariate analyses, risk reducers were more likely to disclose their MSM status (i.e., be “out”; odds ratio [OR] = 3.64; p < 0.05), and report oral sex with a condom in the prior 12 months (OR = 4.85; p < 0.01). They were less likely to report: depression (Center for Epidemiologic Studies Depression Scale [CES-D] score 16+ OR = 0.48; p < 0.05), a history of one or more sexually transmitted diseases (STDs; OR = 0.40; p < 0.05), and meeting sexual partners at public cruising areas (OR = 0.32; p < 0.01). In a multivariable model, risk reducers were less likely to report: alcohol use during sex (adjusted odds ratio [AOR] = 0.33; p < 0.05), depression (CESD score 16+ AOR = 0.32; p < 0.05), or meeting sexual partners at public cruising areas (AOR = 0.30; p < 0.05), or via the Internet (AOR = 0.12; p < 0.05) in the previous 12 months. Identifying and understanding such factors associated with risk reduction behaviors may be important to consider in designing effective prevention interventions to promote sexual health for MSM. PMID:19534602

Beyond anal sex: sexual practices associated with HIV risk reduction among men who have sex with men in Boston, Massachusetts.

PubMed

Reisner, Sari L; Mimiaga, Matthew J; Skeer, Margie; Mayer, Kenneth H

2009-07-01

Men who have sex with men (MSM) continue to bear a disproportionate HIV and sexually transmitted disease (STD) burden. The current study examined the frequency and associations of sexual risk reduction behaviors among a sample of MSM in the greater Boston, Massachusetts area. One hundred eighty-nine MSM completed a one-time behavioral and psychosocial assessment between March 2006 and May 2007. Logistic regression procedures examined the association of demographic, psychosocial, and behavioral factors with risk reduction practices. Twenty percent of the sample reported rimming, mutual masturbation, digital penetration, using sex toys, or 100% condom use as a means to reduce their risk of acquiring or transmitting HIV in the prior 12 months. In bivariate analyses, risk reducers were more likely to disclose their MSM status (i.e., be "out"; odds ratio [OR] = 3.64; p < 0.05), and report oral sex with a condom in the prior 12 months (OR = 4.85; p < 0.01). They were less likely to report: depression (Center for Epidemiologic Studies Depression Scale [CES-D] score 16+; OR = 0.48; p < 0.05), a history of one or more sexually transmitted diseases (STDs; OR = 0.40; p < 0.05), and meeting sexual partners at public cruising areas (OR = 0.32; p < 0.01). In a multivariable model, risk reducers were less likely to report: alcohol use during sex (adjusted odds ratio [AOR] = 0.33; p < 0.05), depression (CESD score 16+; AOR = 0.32; p < 0.05), or meeting sexual partners at public cruising areas (AOR = 0.30; p < 0.05), or via the Internet (AOR = 0.12; p < 0.05) in the previous 12 months. Identifying and understanding such factors associated with risk reduction behaviors may be important to consider in designing effective prevention interventions to promote sexual health for MSM.

Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men.

PubMed

Grov, Christian; Golub, Sarit A; Mustanski, Brian; Parsons, Jeffrey T

2010-09-01

Researchers have identified a strong link between sexual compulsivity (SC) and risky sexual behavior among men who have sex with men (MSM). Meanwhile, affect/mood has also been connected with negative sexual health outcomes (sexually transmitted infection/human immunodeficiency virus [HIV] transmission, sexual risk, sex under the influence of drugs/alcohol). Given that SC is characterized by marked distress around one's own sexual behavior, affect may play a central role in SC and HIV risk behavior. Data were taken from the Pillow Talk Project, a pilot study conducted in 2008-2009 with 50 highly sexually active MSM (9 or more male sex partners, ≤ 90 days), of which half displayed SC symptoms and half did not. Forty-seven men completed a daily diary online for 30 days (n = 1,060 diary days), reporting on their sexual behavior and concurrent affect: positive activation, negative activation, anxious arousal, and sexual activation. We conducted HLM analyses using daily affect (Level 1, within subjects) and SC and HIV status (Level 2, between subjects) to predict sexual behavior outcomes. Increased negative activation (characterized by fear, sadness, anger, and disgust) was associated with reduced sexual risk behavior, but less so among sexually compulsive MSM. Sexual activation was associated with increased sexual risk taking, but less so among sexually compulsive MSM. Anxious arousal was associated with increased sexual behavior, but not necessarily sexual risk taking. Findings indicate that affect plays key roles in sexual behavior and sexual risk taking; however, the association between affect and behavior may be different for sexually compulsive and non-sexually compulsive MSM.

Cyber bullying and physical bullying in adolescent suicide: the role of violent behavior and substance use.

PubMed

Litwiller, Brett J; Brausch, Amy M

2013-05-01

The impact of bullying in all forms on the mental health and safety of adolescents is of particular interest, especially in the wake of new methods of bullying that victimize youths through technology. The current study examined the relationship between victimization from both physical and cyber bullying and adolescent suicidal behavior. Violent behavior, substance use, and unsafe sexual behavior were tested as mediators between two forms of bullying, cyber and physical, and suicidal behavior. Data were taken from a large risk-behavior screening study with a sample of 4,693 public high school students (mean age = 16.11, 47 % female). The study's findings showed that both physical bullying and cyber bullying associated with substance use, violent behavior, unsafe sexual behavior, and suicidal behavior. Substance use, violent behavior, and unsafe sexual behavior also all associated with suicidal behavior. Substance use and violent behavior partially mediated the relationship between both forms of bullying and suicidal behavior. The comparable amount of variance in suicidal behavior accounted for by both cyber bullying and physical bullying underscores the important of further cyber bullying research. The direct association of each risk behavior with suicidal behavior also underscores the importance of reducing risk behaviors. Moreover, the role of violence and substance use as mediating behaviors offers an explanation of how risk behaviors can increase an adolescent's likelihood of suicidal behavior through habituation to physical pain and psychological anxiety.

Using topic coding to understand the nature of change language in a motivational intervention to reduce alcohol and sex risk behaviors in emergency department patients.

PubMed

Kahler, Christopher W; Caswell, Amy J; Laws, M Barton; Walthers, Justin; Magill, Molly; Mastroleo, Nadine R; Howe, Chanelle J; Souza, Timothy; Wilson, Ira; Bryant, Kendall; Monti, Peter M

2016-10-01

To elucidate patient language that supports changing a health behavior (change talk) or sustaining the behavior (sustain talk). We developed a novel coding system to characterize topics of patient speech in a motivational intervention targeting alcohol and HIV/sexual risk in 90 Emergency Department patients. We further coded patient language as change or sustain talk. For both alcohol and sex, discussions focusing on benefits of behavior change or change planning were most likely to involve change talk, and these topics comprised a large portion of all change talk. Greater discussion of barriers and facilitators of change also was associated with more change talk. For alcohol use, benefits of drinking behavior was the most common topic of sustain talk. For sex risk, benefits of sexual behavior were rarely discussed, and sustain talk centered more on patterns and contexts, negations of drawbacks, and drawbacks of sexual risk behavior change. Topic coding provided unique insights into the content of patient change and sustain talk. Patients are most likely to voice change talk when conversation focuses on behavior change rather than ongoing behavior. Interventions addressing multiple health behaviors should address the unique motivations for maintaining specific risky behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dating violence among college students: the risk and protective factors.

PubMed

Kaukinen, Catherine

2014-10-01

The research review synthesizes the knowledge base on risk and protective factors for dating violence while highlighting its relevance to violence against college women. In particular, the review highlights the personal, family, relationship, and behavioral factors that heighten the risk of dating violence victimization and perpetration while also noting the methodological limitations of the current body of empirical research and identifying directions for future academic work. Researchers have identified the correlation between risky health and behavioral factors and dating violence, most often modeling these as part of the etiology of dating violence among college students. Less often have scholars explored these as co-occurring risk factors. This approach to dating violence may be used to develop meaningful and impactful interventions to reduce the incidence and prevalence of college dating violence while also addressing the other health risk behaviors that impact academic success and place students' well-being at risk. © The Author(s) 2014.

Outcomes of a Behavioral Intervention to Reduce HIV Risk among Drug-involved Female Sex Workers

PubMed Central

Surratt, Hilary L.; O’Grady, Catherine; Kurtz, Steven P.; Levi-Minzi, Maria A.; Chen, Minxing

2014-01-01

Although street-based female sex workers (FSWs) are highly vulnerable to HIV, they often lack access to needed health services and medical care. This paper reports the results of a recently completed randomized intervention trial for FSWs in Miami, Florida, which tested the relative efficacy of two case management interventions that aimed to link underserved FSWs with health services and to reduce risk behaviors for HIV. Participants were recruited using targeted sampling strategies and were randomly assigned to: a Strengths-Based/Professional Only (PO) or a Strengths-Based/Professional-Peer condition (PP). Follow-up data were collected 3 and 6 months post-baseline. Outcome analyses indicated that both intervention groups displayed significant reductions in HIV risk behaviors and significant increases in services utilization; the Professional-Peer condition provided no added benefit. HIV seropositive FSWs responded particularly well to the interventions, suggesting the utility of brief strengths-based case management interventions for this population in future initiatives. PMID:24558098

The Relationship between Screen Time and Sexual Behaviors among Middle School Students

ERIC Educational Resources Information Center

Barr, Elissa M.; Moore, Michele J.; Johnson, Tammie; Merten, Julie; Stewart, William P.

2014-01-01

Reducing risky sexual behaviors and their negative health outcomes in youth remains a priority for health educators. Years of research have documented media's effect on various adolescent health risks, including sexual behaviors. As technology evolves and youth access to media increases, understanding the role of media in adolescent health risk…

Breast Cancer Knowledge among College Students: Influencing Factors and Resultant Behaviors

ERIC Educational Resources Information Center

Justice, Mary F.; King, Keith A.; Vidourek, Rebecca A.; Merianos, Ashley L.

2018-01-01

Background: Many misconceptions about breast cancer exist. College students have the opportunity to perform breast cancer risk-reducing behaviors. Purpose: The purpose of this study was to assess breast cancer knowledge among university students and examine the influence of breast cancer knowledge on health behaviors for breast cancer prevention.…

Gender-based Violence and HIV Sexual Risk Behavior: Alcohol Use and Mental Health Problems as Mediators among Women in Drinking Venues, Cape Town

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Sikkema, Kathleen J.; Watt, Melissa H.; Skinner, Donald

2012-01-01

Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use. PMID:22832324

Gender-based violence and HIV sexual risk behavior: alcohol use and mental health problems as mediators among women in drinking venues, Cape Town.

PubMed

Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Sikkema, Kathleen J; Watt, Melissa H; Skinner, Donald

2012-10-01

Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use. Copyright © 2012 Elsevier Ltd. All rights reserved.

Psychosexual and social-cognitive correlates of sexual risk behavior among male clients of female sex workers in Tijuana, Mexico

PubMed Central

Semple, Shirley J.; Strathdee, Steffanie A.; Gallardo Cruz, Manuel; Robertson, Angela; Goldenberg, Shira; Patterson, Thomas L.

2011-01-01

Male clients of female sex workers (FSWs) may act as a bridge to the general population contributing to the spread of HIV and other sexually transmitted infections in the United States and Mexico. This study used cross-sectional data to identify psychosexual and social cognitive factors associated with sexual risk behavior in a bi-national sample of 300 male clients of FSWs recruited in Tijuana, Mexico from June to October, 2008. In a multiple regression analysis, the number of unprotected vaginal sex acts with FSWs was associated with higher sexual compulsivity scores, lower self-efficacy for condom use, greater use of illicit drugs, and more financial need. Behavioral interventions are urgently needed to assist clients of FSWs in reducing high-risk behaviors in an effort to prevent the spread of HIV/STIs in this high-risk population and their sexual partners. PMID:21154035

Mediators of the Relation between Childhood Sexual Abuse and Women’s Sexual Risk Behavior: A Comparison of Two Theoretical Frameworks

PubMed Central

Senn, Theresa E.; Carey, Michael P.; Coury-Doniger, Patricia

2012-01-01

Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood, but little research has investigated processes that might mediate this relation. The purpose of this study was to investigate whether constructs suggested by the traumagenic dynamics (TD) model (a theory of the effects of CSA) or constructs suggested by the Information-Motivation-Behavioral skills (IMB) model (a theory of the antecedents of sexual risk behavior) better mediated the relation between CSA and sexual risk behavior in adulthood. Participants were 481 women attending an STI clinic (66% African American) who completed a computerized survey as well as behavioral simulations assessing condom application and sexual assertiveness skills. Forty-five percent of the sample met criteria for CSA and CSA was associated with sexual risk behavior in adulthood. In multiple mediator models, the TD constructs mediated the relation between CSA and the number of sexual partners whereas the IMB constructs mediated the relation between CSA and unprotected sex. In addition, the TD constructs better mediated the relation between CSA and the number of sexual partners; the TD and IMB constructs did not differ in their ability to mediate the relation between CSA and unprotected sex. Sexual risk reduction interventions for women who were sexually abused should target not only the constructs from health behavior models (e.g., motivation and skills to reduce sexual risk), but also constructs that are specific to sexual abuse (e.g., traumatic sexualization and guilt). PMID:22282323

Antenatal Training with Music and Maternal Talk Concurrently May Reduce Autistic-Like Behaviors at around 3 Years of Age

PubMed Central

Ruan, Zeng-Liang; Liu, Li; Strodl, Esben; Fan, Li-Jun; Yin, Xiao-Na; Wen, Guo-Min; Sun, Deng-Li; Xian, Dan-Xia; Jiang, Hui; Jing, Jin; Jin, Yu; Wu, Chuan-An; Chen, Wei-Qing

2018-01-01

Antenatal training through music and maternal talk to the unborn fetus is a topic of general interest for parents-to-be in China, but we still lack a comprehensive assessment of their effects on the development of autistic-like behaviors during early childhood. During 2014–2016, 34,749 parents of children around the age of 3 years who were enrolled at kindergarten in the Longhua district of Shenzhen participated in this study. Self-administered questionnaires regarding demographics, antenatal music training, and maternal talk to the fetus during pregnancy were completed by the children’s primary caregivers. Autistic-like behaviors were assessed using the Autism Behavioral Checklist. Tobit regression analyses revealed that antenatal music training and maternal talk to the fetus was associated with a reduction in autistic-like behaviors in children, with a dose-dependent relationship. Furthermore, factorial analysis of covariance indicated a significant interaction effect between antenatal music training and maternal talk to the fetus on the autistic-like behaviors and found that children who often experienced antenatal music training and maternal talk concurrently had the lowest risk of autistic-like behaviors, while children who were never exposed to maternal talk and only sometimes experienced antenatal music training had the highest risk. Our results suggest that antenatal training through both music and maternal talk to the unborn fetus might reduce the risk of children’s autistic-like behaviors at around 3 years of age. PMID:29375407

Antenatal Training with Music and Maternal Talk Concurrently May Reduce Autistic-Like Behaviors at around 3 Years of Age.

PubMed

Ruan, Zeng-Liang; Liu, Li; Strodl, Esben; Fan, Li-Jun; Yin, Xiao-Na; Wen, Guo-Min; Sun, Deng-Li; Xian, Dan-Xia; Jiang, Hui; Jing, Jin; Jin, Yu; Wu, Chuan-An; Chen, Wei-Qing

2017-01-01

Antenatal training through music and maternal talk to the unborn fetus is a topic of general interest for parents-to-be in China, but we still lack a comprehensive assessment of their effects on the development of autistic-like behaviors during early childhood. During 2014-2016, 34,749 parents of children around the age of 3 years who were enrolled at kindergarten in the Longhua district of Shenzhen participated in this study. Self-administered questionnaires regarding demographics, antenatal music training, and maternal talk to the fetus during pregnancy were completed by the children's primary caregivers. Autistic-like behaviors were assessed using the Autism Behavioral Checklist. Tobit regression analyses revealed that antenatal music training and maternal talk to the fetus was associated with a reduction in autistic-like behaviors in children, with a dose-dependent relationship. Furthermore, factorial analysis of covariance indicated a significant interaction effect between antenatal music training and maternal talk to the fetus on the autistic-like behaviors and found that children who often experienced antenatal music training and maternal talk concurrently had the lowest risk of autistic-like behaviors, while children who were never exposed to maternal talk and only sometimes experienced antenatal music training had the highest risk. Our results suggest that antenatal training through both music and maternal talk to the unborn fetus might reduce the risk of children's autistic-like behaviors at around 3 years of age.

Adaptive Learning and Risk Taking

ERIC Educational Resources Information Center

Denrell, Jerker

2007-01-01

Humans and animals learn from experience by reducing the probability of sampling alternatives with poor past outcomes. Using simulations, J. G. March (1996) illustrated how such adaptive sampling could lead to risk-averse as well as risk-seeking behavior. In this article, the author develops a formal theory of how adaptive sampling influences risk…

Increased feeding frequency increased milk fat yield and may reduce the severity of subacute ruminal acidosis in higher-risk cows.

PubMed

Macmillan, K; Gao, X; Oba, M

2017-02-01

The objectives of this study were to determine whether feeding behavior is different between cows at higher or lower risk for subacute ruminal acidosis (SARA) and whether increasing feeding frequency could be used to reduce the severity of SARA in higher-risk cows. In preliminary studies, 16 ruminally cannulated lactating cows were fed high-grain diets once per day to increase the risk of SARA. After a 17-d diet adaptation, ruminal pH was measured every 30 s over 24 h. Cows were classified as higher-risk (n = 7) or lower-risk (n = 9) for SARA based on an acidosis index (area of pH <5.8/dry matter intake). Feeding behavior was recorded every 5 min over the same 24 h. The 24-h observation period was analyzed in 3 periods of 8 h after feeding. Although there was no significant difference in overall dry matter intake, higher-risk cows spent more time eating in the first 8-h period after feeding than lower-risk cows (186 vs. 153 min) and less time eating in the third 8-h period (19 vs. 43 min). In the primary experiment, 8 ruminally cannulated lactating cows were fed a high-grain diet once per day (1×; 0800 h) or 3 times per day (3×; 0800, 1500, and 2000 h) in a crossover design with 21-d periods (16 d of treatment adaptation and 5 d of data collection). Rumen pH and feeding behavior were measured over 72 h. Behavior data were summarized separately for the 3 periods (0800 to 1500, 1500 to 2200, and 2200 to 0800 h). Four cows were categorized as higher-risk and 4 as lower-risk, based on their acidosis index. The 3× feeding reduced eating time between 0800 and 1500 h (99 vs. 145 min) and increased eating time between 2200 and 0800 h (76 vs. 43 min) for all cows, regardless of category, compared with 1× feeding. For higher-risk cows, 3× feeding reduced the area below pH 5.8 (51 vs. 98 pH × min/d), but it did not affect rumen pH for the lower-risk cows. Milk yield was not different between groups, but 3× feeding increased milk fat yield (1.22 vs. 1.08 kg/d) for all cows, regardless of category, compared to 1× feeding. Our results suggest that cows at higher risk for SARA eat less evenly throughout the day; increasing feeding frequency may reduce the severity of SARA in higher-risk cows and may also increase milk fat yield. The Authors. Published by the Federation of Animal Science Societies and Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

Sustained sexual behavior change following acute HIV diagnosis in Malawi.

PubMed

Rucinski, Katherine B; Rutstein, Sarah E; Powers, Kimberly A; Pasquale, Dana K; Dennis, Ann M; Phiri, Sam; Hosseinipour, Mina C; Kamanga, Gift; Nsona, Dominic; Massa, Cecilia; Hoffman, Irving F; Miller, William C; Pettifor, Audrey E

2018-06-05

Identification of acute HIV infection (AHI) allows important opportunities for HIV prevention through behavior change and biomedical intervention. Here, we evaluate changes in sexual risk behaviors among persons with AHI enrolled in a combined behavioral and biomedical intervention designed to reduce onward transmission of HIV. Participants were randomized to standard HIV counseling, a multi-session behavioral intervention, or a multi-session behavioral intervention plus antiretrovirals. Sexual behaviors were assessed periodically over one year. Four weeks after diagnosis, the predicted probability of reporting multiple sexual partners decreased from 24% to 9%, and the probability of reporting unprotected sex from 71% to 27%. These declines in sexual risk behaviors were sustained over follow-up irrespective of study arm. AHI diagnosis alone may be sufficient to achieve immediate and sustained behavior change during this highly infectious period.

HIV transmission risk behavior among HIV-positive patients receiving antiretroviral therapy in KwaZulu-Natal, South Africa.

PubMed

Shuper, Paul A; Kiene, Susan M; Mahlase, Gethwana; MacDonald, Susan; Christie, Sarah; Cornman, Deborah H; Fisher, William A; Greener, Ross; Lalloo, Umesh G; Pillay, Sandy; van Loggerenberg, Francois; Fisher, Jeffrey D

2014-08-01

The aim of this investigation was to identify factors associated with HIV transmission risk behavior among HIV-positive women and men receiving antiretroviral therapy (ART) in KwaZulu-Natal, South Africa. Across 16 clinics, 1,890 HIV+ patients on ART completed a risk-focused audio computer-assisted self-interview upon enrolling in a prevention-with-positives intervention trial. Results demonstrated that 62 % of HIV-positive patients' recent unprotected sexual acts involved HIV-negative or HIV status unknown partners. For HIV-positive women, multivariable correlates of unprotected sex with HIV-negative or HIV status unknown partners were indicative of poor HIV prevention-related information and of sexual partnership-associated behavioral skills barriers. For HIV-positive men, multivariable correlates represented motivational barriers, characterized by negative condom attitudes and the experience of depressive symptomatology, as well as possible underlying information deficits. Findings suggest that interventions addressing gender-specific and culturally-relevant information, motivation, and behavioral skills barriers could help reduce HIV transmission risk behavior among HIV-positive South Africans.

An HIV-Prevention Intervention for Sex Workers in Tijuana, Mexico: A Pilot Study

ERIC Educational Resources Information Center

Patterson, Thomas L.; Semple, Shirley J.; Fraga, Miguel; Bucardo, Jesus; Davila-Fraga, Wendy; Strathdee, Steffanie A.

2005-01-01

Female sex workers (FSW) are at high risk of acquiring sexually transmitted infections (STIs), including HIV, and putting their clients and other partners at risk for infection. There is considerable evidence that Social Cognitive Theory (SCT)?based interventions are effective in reducing high-risk sexual behavior among at-risk populations in the…

Potential mediating pathways through which sports participation relates to reduced risk of suicidal ideation.

PubMed

Taliaferro, Lindsay A; Rienzo, Barbara A; Miller, M David; Pigg, R Morgan; Dodd, Virginia J

2010-09-01

Suicide ranks as the third leading cause of death for American youth. Researchers examining sport participation and suicidal behavior have regularly found inverse relationships. This study represents the first effort to test a model depicting potential mechanisms through which sport participation relates to reduced risk of suicidal ideation. The participants were 450 undergraduate students. Measures assessed participants' involvement in university-run sports and other activities; frequency of physical activity; and perceived social support, self-esteem, depression, hopelessness, loneliness, and suicidal ideation. Regression analyses confirmed a path model and tested for mediation effects. Vigorous activity mediated relationships between sport participation and self-esteem and depression; and self-esteem and depression mediated the relationship between vigorous activity and suicidal ideation. Social support mediated relationships between sport participation and depression, hopelessness, and loneliness; and each of these risk factors partially mediated the relationship between social support and suicidal ideation. However no variable fully mediated the relationship between sport participation and suicidal ideation. This study provides a foundation for research designed to examine pathways through which sport participation relates to reduced risk of suicidal behavior.

Brief motivational intervention to reduce alcohol and HIV/sexual risk behavior in emergency department patients: A randomized controlled trial.

PubMed

Monti, Peter M; Mastroleo, Nadine R; Barnett, Nancy P; Colby, Suzanne M; Kahler, Christopher W; Operario, Don

2016-07-01

Given the prevalence of co-occurring risky sexual behavior and drinking among emergency department (ED) patients, we developed a motivational intervention (MI) to address both behaviors. This study tested efficacy of a single-session MI compared to brief advice (BA) for reducing heavy drinking and condomless sex in adult ED patients screening positive for both. We randomized 372 patients to MI (n = 184) or BA (n = 188). Alcohol and sex risk outcomes were assessed over 9 months. Generalized estimating equations models analyzing 327 patients with follow-up data provided strong support for efficacy of this integrated alcohol and sex-risk MI. Compared to BA, and after controlling for baseline covariates, those in MI reported significantly fewer heavy drinking days, drinks per week, and were less likely to engage in excessive drinking over follow-up (all ps < .05). MI was also favored over BA for reducing sex risk. Compared to BA, those in MI reported significantly fewer days on which they engaged in condomless sex with casual partners, had lower odds of reporting any condomless sex with a casual partner, and reported fewer days of sex under the influence of alcohol/other drugs (all ps < .05). This innovative MI was acceptable, feasible, and successfully delivered in 2 community hospitals and thus shows great promise for scalability and dissemination into complex health settings where newly insured at-risk individuals are likely to seek care. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Seasonal fecundity and costs to λ are more strongly affected by direct than indirect predation effects across species

USGS Publications Warehouse

LaManna, Joseph A.; Martin, Thomas E.

2017-01-01

Increased perceived predation risk can cause behavioral and physiological responses to reduce direct predation mortality, but these responses can also cause demographic costs through reduced reproductive output. Such indirect costs of predation risk have received increased attention in recent years, but the relative importance of direct vs. indirect predation costs to population growth (λ) across species remains unclear. We measured direct nest predation rates as well as indirect benefits (i.e., reduced predation rates) and costs (i.e., decreased reproductive output) arising from parental responses to perceived offspring predation risk for 10 songbird species breeding along natural gradients in nest predation risk. We show that reductions in seasonal fecundity from behavioral responses to perceived predation risk represent significant demographic costs for six of the 10 species. However, demographic costs from these indirect predation effects on seasonal fecundity comprised only 12% of cumulative predation costs averaged across species. In contrast, costs from direct predation mortality comprised 88% of cumulative predation costs averaged across species. Demographic costs from direct offspring predation were relatively more important for species with higher within-season residual-reproductive value (i.e., multiple-brooded species) than for species with lower residual-reproductive value (i.e., single-brooded species). Costs from indirect predation effects were significant across single- but not multiple-brooded species. Ultimately, demographic costs from behavioral responses to offspring predation risk differed among species as a function of their life-history strategies. Yet direct predation mortality generally wielded a stronger influence than indirect effects on seasonal fecundity and projected λ across species.

Investigating the Influences of Language Delay and/or Familial Risk for Dyslexia on Brain Structure in 5-Year-Olds

PubMed Central

Raschle, Nora Maria; Becker, Bryce Larkin Chessell; Smith, Sara; Fehlbaum, Lynn Valérie; Wang, Yingying; Gaab, Nadine

2017-01-01

Abstract Early language delay has often been associated with atypical language/literacy development. Neuroimaging studies further indicate functional disruptions during language and print processing in school-age children with a retrospective report of early language delay. Behavioral data of 114 5-year-olds with a retrospective report of early language delay in infancy (N = 34) and those without (N = 80) and with a familial risk for dyslexia and those without are presented. Behaviorally, children with a retrospective report of early language delay exhibited reduced performance in language/reading-related measures. A voxel-based morphometry analysis in a subset (N = 46) demonstrated an association between reduced gray matter volume and early language delay in left-hemispheric middle temporal, occipital, and frontal regions. Alterations in middle temporal cortex in children with a retrospective report of early language delay were observed regardless of familial risk for dyslexia. Additionally, while children with isolated familial risk for dyslexia showed gray matter reductions in temporoparietal and occipitotemporal regions, these effects were most profound in children with both risk factors. An interaction effect of early language delay and familial risk was revealed in temporoparietal, occipital, and frontal cortex. Our findings support a cumulative effect of early behavioral and genetic risk factors on brain development and may ultimately inform diagnosis/treatment. PMID:26585334

Aggregating indices of risk and protection for adolescent behavior problems: the Communities That Care Youth Survey.

PubMed

Feinberg, Mark E; Ridenour, Ty A; Greenberg, Mark T

2007-06-01

To facilitate research on adolescent risk and protection regarding behavior problems, and to facilitate community decision-making regarding resource allocation for intervention programs, by creating a reduced set of coherent aggregate indices of adolescent risk and protection. We examined the 31 risk and protective factor scales in the Communities That Care Youth Survey (CTC-YS). Data came from two waves of the CTC-YS administered to sixth through 12th graders in Pennsylvania (2001 n = 43,842; 2003 n =101,988). Factor analysis and calculation of internal reliability were used to create aggregate indices of risk/protective factor domains. Correlations of aggregate indices with each other and with problem behaviors (antisocial behavior, substance use) were examined. Theory and empirical results led to the creation of seven coherent indices: Community Cohesion, Family Cohesion, Family Risk, School Support for Prosocial Activities, Antisocial Peer Domain, Attitudes toward Risky Behavior, Risky Behavioral Tendencies. Four scales were not included in the aggregate index (Religiosity, Academic Performance, Personal Transitions and Mobility, and Early Initiation of Drug Use and Antisocial Behavior). The indices were related to each other and to adolescent problem behaviors (antisocial behavior and substance use) in expected ways. Results were consistent across waves of data. The construction of theoretically meaningful and empirically defensible aggregate measures of adolescent risk and protective factors is possible, although analyses of other data sets and further discussion are warranted. The use of aggregate indices by researchers and communities is recommended as a way to facilitate research and decision-making.

Suicide in Tourette's and Chronic Tic Disorders.

PubMed

Fernández de la Cruz, Lorena; Rydell, Mina; Runeson, Bo; Brander, Gustaf; Rück, Christian; D'Onofrio, Brian M; Larsson, Henrik; Lichtenstein, Paul; Mataix-Cols, David

2017-07-15

Persons with neuropsychiatric disorders are at increased risk of suicide, but there is little data concerning Tourette's and chronic tic disorders (TD/CTD). We aimed to quantify the risk of suicidal behavior in a large nationwide cohort of patients with TD/CTD, establish the contribution of psychiatric comorbidity to this risk, and identify predictors of suicide. Using a validated algorithm, we identified 7736 TD/CTD cases in the Swedish National Patient Register during a 44-year period (1969-2013). Using a matched case-cohort design, patients were compared with general population control subjects (1:10 ratio). Risk of suicidal behavior was estimated using conditional logistic regressions. Predictors of suicidal behavior in the TD/CTD cohort were studied using Cox regression models. In unadjusted models, TD/CTD patients, compared with control subjects, had an increased risk of both dying by suicide (odds ratio: 4.39; 95% confidence interval [CI]: 2.89-6.67) and attempting suicide (odds ratio: 3.86; 95% CI: 3.50-4.26). After adjusting for psychiatric comorbidities, the risk was reduced but remained substantial. Persistence of tics beyond young adulthood and a previous suicide attempt were the strongest predictors of death by suicide in TD/CTD patients (hazard ratio: 11.39; 95% CI: 3.71-35.02, and hazard ratio: 5.65; 95% CI: 2.21-14.42, respectively). TD/CTD are associated with substantial risk of suicide. Suicidal behavior should be monitored in these patients, particularly in those with persistent tics, history of suicide attempts, and psychiatric comorbidities. Preventive and intervention strategies aimed to reduce the suicidal risk in this group are warranted. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Power of Peer Support to Change Health Behavior to Reduce Risks for Heart Disease and Stroke for African American Men in a Faith-Based Community.

PubMed

Lee, Sohye; Schorr, Erica; Hadidi, Niloufar Niakosari; Kelley, Robin; Treat-Jacobson, Diane; Lindquist, Ruth

2018-02-01

Peer support has powerful potential to improve outcomes in a program of health behavior change; yet, how peer support is perceived by participants, its role, and how it contributes to intervention efficacy is not known, especially among African Americans. The purpose of this study was to identify the subjectively perceived experience and potential contributions of peer support to the outcomes of a peer group behavioral intervention designed to change health behavior to reduce risks for heart disease and stroke in African American men in a faith-based community. A peer support group intervention was implemented to increase health knowledge and to improve health behaviors in line with the American Heart Association's Life Simple 7 domains (get active, control cholesterol, eat better, manage blood pressure, lose weight, reduce blood sugar, and stop smoking). Fourteen peer group sessions and eight follow-up interviews with program participants were recorded, transcribed, and analyzed. Seven key themes emerged, including (1) enhancing access to health behavior information and resources, (2) practicing and applying problem-solving skills with group feedback and support, (3) discussing health behavior challenges and barriers, (4) sharing health behavior changes, (5) sharing perceived health outcome improvements and benefits, (6) feelings of belonging and being cared for, and (7) addressing health of family and community. Qualitative findings revealed a positive perception of peer support and greater understanding of potential reasons why it may be an effective strategy for African American men.

Framing recommendations to promote prevention behaviors among people at high risk: A simulation study of responses to melanoma genetic test reporting.

PubMed

Taber, Jennifer M; Aspinwall, Lisa G

2015-10-01

A CDKN2A/p16 mutation confers 76 % lifetime risk of developing melanoma to US residents, and high-risk individuals are counseled to use sunscreen. Generally, for patients at population risk, gain framing more effectively promotes prevention behaviors; however, it is unknown whether loss frames might more effectively promote behavioral intentions and perceived control over disease risk among high-risk patients. Undergraduates (N = 146) underwent a simulated genetic counseling and test reporting session for hereditary melanoma. Participants watched a video of a genetic counselor providing information in which genetic risk of melanoma (Low: 15 %; High: 76 %) and framed recommendations to use sunscreen (Loss: Risk may increase by 15 % if don't use sunscreen; Gain: Risk may decrease by 15 % if use sunscreen) were manipulated. Controlling for baseline sunscreen use, high-risk participants given loss frames reported greater beliefs that sunscreen would reduce risk than high-risk participants given gain frames. Further, high-risk participants with fair skin tended to report greater intentions to use sunscreen when given loss frames versus gain frames. Perceived control over risk mediated the effect of message frame and disease risk on intentions to use sunscreen. When counseling patients with elevated cancer risk, genetic counselors may consider framing prevention behavioral recommendations in terms of potential losses.

Effectiveness of a combination of cognitive behavioral therapy and task-oriented balance training in reducing the fear of falling in patients with chronic stroke: study protocol for a randomized controlled trial.

PubMed

Liu, Tai-Wa; Ng, Gabriel Y F; Ng, Shamay S M

2018-03-07

The consequences of falls are devastating for patients with stroke. Balance problems and fear of falling are two major challenges, and recent systematic reviews have revealed that habitual physical exercise training alone cannot reduce the occurrence of falls in stroke survivors. However, recent trials with community-dwelling healthy older adults yielded the promising result that interventions with a cognitive behavioral therapy (CBT) component can simultaneously promote balance and reduce the fear of falling. Therefore, the aim of the proposed clinical trial is to evaluate the effectiveness of a combination of CBT and task-oriented balance training (TOBT) in promoting subjective balance confidence, and thereby reducing fear-avoidance behavior, improving balance ability, reducing fall risk, and promoting independent living, community reintegration, and health-related quality of life of patients with stroke. The study will constitute a placebo-controlled single-blind parallel-group randomized controlled trial in which patients are assessed immediately, at 3 months, and at 12 months. The selected participants will be randomly allocated into one of two parallel groups (the experimental group and the control group) with a 1:1 ratio. Both groups will receive 45 min of TOBT twice per week for 8 weeks. In addition, the experimental group will receive a 45-min CBT-based group intervention, and the control group will receive 45 min of general health education (GHE) twice per week for 8 weeks. The primary outcome measure is subjective balance confidence. The secondary outcome measures are fear-avoidance behavior, balance ability, fall risk, level of activities of daily living, community reintegration, and health-related quality of life. The proposed clinical trial will compare the effectiveness of CBT combined with TOBT and GHE combined with TOBT in promoting subjective balance confidence among chronic stroke patients. We hope our results will provide evidence of a safe, cost-effective, and readily transferrable therapeutic approach to clinical practice that reduces fear-avoidance behavior, improves balance ability, reduces fall risk, promotes independence and community reintegration, and enhances health-related quality of life. ClinicalTrials.gov, NCT02937532 . Registered on 17 October 2016.

The Role of Adult Perceptions and Supervision Behavior in Preventing Child Injury.

PubMed

Huynh, Ha T; Demeter, Natalie E; Burke, Rita V; Upperman, Jeffrey S

2017-08-01

Supervision is an important factor in reducing injury risk. There are multiple factors that can affect the appropriate level of supervision including risk perception, anticipation of injury, and distracted behaviors. This study examined the perceived risks of child injury among parents and child caregivers and their supervision behavior among adults in an urban playground. Participant data from 25 individuals were collected through observations and anonymous self-reported surveys. More than half of the participants indicated practice of appropriate supervisory behavior, including attentiveness to their child's behavior and proximity to their child during play. Caregivers were more likely to report more careful levels of supervision. One-fourth of participants reported a change in the supervisory behavior during periods of distraction, specifically with phone use. Of the variables tested, there was a significant association between the variable 'talking to other adults' during supervision and 'prior injury' (P value = 0.04, 95% CI 0.03-0.91). Parents were more likely to report that they would leave their child unattended if they believed that the playground was a safe environment for play. There was a difference between self-reported behaviors and actual observed behavior, which is likely due to varying perspectives regarding child safety and injury prevention. In regards to injury risk, findings highlight the important role of appropriate supervisory behaviors and risk perceptions in preventing child injuries.

The neural basis of social risky decision making in females with major depressive disorder.

PubMed

Shao, Robin; Zhang, Hui-jun; Lee, Tatia M C

2015-01-01

Recent evidence indicates that Major Depressive Disorder (MDD) may be associated with reduced tendency of committing noncompliant actions during social decision-making even when the risk of being punished is low. The neural underpinnings of this behavioral pattern are unknown, although it likely relates to compromised functioning of the lateral prefrontal-striatal/limbic networks implicated in executive control, emotion regulation and risk/value-based instrumental behaviors. We employed a modified trust game (TG) that provided explicit information on the risk levels of cheating behaviors being detected and punished. Behavioral and neuro-image data were acquired and analyzed from 14 first-episode female MDD patients and 15 age- and gender-matched controls performing the role of trustee in the TG. Relative to controls, MDD patients exhibited less behavioral switching to making cheating choices under low risk, and reduced activity in the dorsal putamen, anterior insula and dorsolateral prefrontal cortex (DLPFC) during making low-risk cheating versus benevolent choices, with limited evidence indicating abnormal bilateral inferior frontal gyrus activities of patients when making high-risk cheating versus benevolent choices. Patients' left dorsal putamen/anterior insular signals correlated positively with their frequency of low-risk cheating. MDD patients' symptom severity correlated positively with their signals in the lateral prefrontal networks during decision-making. A psycho-physiological interaction analysis provided tentative evidence for the recruitment of IFG-striatal/limbic circuitry among the control participants, but greater frontopolar-striatal/limbic connectivity among the MDD patients, during low-risk decision-making. We propose that making risky social decisions based on the balancing of self-gain and other's welfare relies on the functioning of the integrated lateral prefrontal-striatal/limbic networks, which are less efficient and dysregulated among MDD patients compared with controls, impacting negatively on the patients' social capacity and highlighting a key therapeutic target for MDD. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessing air quality index awareness and use in Mexico City.

PubMed

Borbet, Timothy C; Gladson, Laura A; Cromar, Kevin R

2018-04-23

The Mexico City Metropolitan Area has an expansive urban population and a long history of air quality management challenges. Poor air quality has been associated with adverse pulmonary and cardiac health effects, particularly among susceptible populations with underlying disease. In addition to reducing pollution concentrations, risk communication efforts that inform behavior modification have the potential to reduce public health burdens associated with air pollution. This study investigates the utilization of Mexico's IMECA risk communication index to inform air pollution avoidance behavior among the general population living in the Mexico City Metropolitan Area. Individuals were selected via probability sampling and surveyed by phone about their air quality index knowledge, pollution concerns, and individual behaviors. The results indicated reasonably high awareness of the air quality index (53% of respondents), with greater awareness in urban areas, among older and more educated individuals, and for those who received air quality information from a healthcare provider. Additionally, behavior modification was less influenced by index reports as it was by personal perceptions of air quality, and there was no difference in behavior modification among susceptible and non-susceptible groups. Taken together, these results suggest there are opportunities to improve the public health impact of risk communication through an increased focus on susceptible populations and greater encouragement of public action in response to local air quality indices.

The association of peer pressure and peer affiliation with the health risk behaviors of secondary school students in Hong Kong.

PubMed

Loke, A Y; Mak, Y W; Wu, C S T

2016-08-01

The aim of this study was to explore the relationship between peer pressure and the health risk behaviors of secondary school students. Cross-sectional study using a self-completed questionnaire. Secondary school students in Year 3 were the target population of this study. Information was solicited from students on their perceptions of peer pressure using a questionnaire employing the Peer Pressure Inventory and their involvement in risk behaviors using a modified global school-based student health survey. A total of 840 secondary students from Hong Kong completed the questionnaires. The prevalence of secondary students who had ever smoked was 6.4%, consumed alcohol 39.2%, ever used drugs 0.5%, were sexually active 3.9%, and involved in bullying 20.5%. A higher proportion of secondary students involved in risk behaviors were affiliated with peers who were involved in the same activities: smoking (48.9%), drinking alcohol (86.5%), using drugs (18.2%), engaged in sexual activity (34.5%), and bullying (82.6%). The perception of peer conformity and peer involvement was found to be significantly correlated with the students' health risk behaviors, particularly with regard to smoking, drinking alcohol, and bullying. A logistic regression analysis showed that having friends who are involved in the same risk behaviors is the single most important factor associated with the participation of secondary students in those specific risk behaviors. The results of this study provided a better understanding of the association between peer pressure and the adoption of health behaviors. The development of effective peer-led prevention programs to reduce the uptake of health risk behaviors should therefore be promoted to prevent adolescents from developing serious health problems. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Unhealthy behaviors and psychosocial difficulties among overweight adolescents: the potential impact of familial factors.

PubMed

Mellin, Alison E; Neumark-Sztainer, Dianne; Story, Mary; Ireland, Marjorie; Resnick, Michael D

2002-08-01

To compare overweight and non-overweight youth on a selection of self-reported eating, physical activity, dieting, educational, and emotional variables and identify familial factors that serve as protective forces against unhealthy behaviors and psychosocial difficulties among overweight adolescents. Data were taken from a 1996 cross-sectional school-based survey of 9957 adolescents in grades 7, 9, and 11. Based on self-reported heights and weights, respondents were categorized as "overweight" (body mass index) > or =85th percentile or "non-overweight." Student's t-tests were used to compare the non-overweight and overweight sample on the self-reported health-related behaviors and psychosocial variables. Logistic and linear regressions were used to identify familial factors associated with a reduced risk of engaging in unhealthy behaviors and experiencing psychosocial distress. Overweight adolescents reported engaging in significantly more unhealthy behaviors and experiencing more psychosocial distress than their non-overweight peers. Among the overweight youth, higher levels of reported family connectedness and parental expectations and moderate levels of parental monitoring were associated with the lowest levels of unhealthy behaviors and psychosocial distress. Satisfying and developmentally appropriate parent-adolescent relationships are associated with reduced behavioral and psychosocial risk factors associated with overweight during adolescence.

Modifiable Lifestyle Behaviors Are Associated With Metabolic Syndrome in a Taiwanese Population.

PubMed

Lin, Kuei-Man; Chiou, Jeng-Yuan; Ko, Shu-Hua; Tan, Jung-Ying; Huang, Chien-Ning; Liao, Wen-Chun

2015-11-01

To explore associations between metabolic syndrome and modifiable lifestyle behaviors among the adult population in Taiwan. This cross-sectional study analyzed data from a nationally representative sample that participated in the 2005-2008 Nutrition and Health Survey in Taiwan. The sample (2,337 participants older than 19 years) provided data on demographic characteristics, modifiable lifestyle behaviors, anthropometric measurements, and blood chemistry panel. These data were analyzed by descriptive statistics, univariate logistic regression, and multivariate logistic regression to determine factors associated with metabolic syndrome. Metabolic syndrome had a prevalence of 25.2%, and this prevalence increased with age. In univariate regression analysis, metabolic syndrome was associated with age, living with family members, educational level, and modifiable lifestyle behaviors (smoking, drinking, betel quid chewing, and physical activity). Individuals with a smoking history and currently chewing betel quid had the highest risk for metabolic syndrome. The risk for metabolic syndrome might be reduced by public health campaigns to encourage people to quit smoking cigarettes and chewing betel quid. Implementing more modifiable lifestyle behaviors in daily life will decrease metabolic syndrome in Taiwan. Considering that betel quid chewing and tobacco smoking interact to adversely affect metabolic syndrome risk, public health campaigns against both behaviors seem to be a cost-effective and efficient health promotion strategy to reduce the prevalence rate of metabolic syndrome. © 2015 Sigma Theta Tau International.

Intimate Violence as It Relates to Risky Sexual Behavior Among At-Risk Females.

PubMed

Hill, Danielle C; Stein, L A R; Rossi, Joseph S; Magill, Molly; Clarke, Jennifer G

2017-10-05

Rates of sexually transmitted infections (STIs) among adolescents are on the rise. The majority of adolescents who contract STIs do so through risky sexual behavior. Previous literature has identified multiple correlates of risky sexual behaviors among adolescents, including physical and sexual victimization, mental health concerns, and substance use. Few studies, however, have examined these relationships together in a comprehensive model. The primary purpose of this study was to examine whether relationship violence was related to risky sexual behavior, and whether mental health symptoms and substance use mediated this relationship. A cross-sectional design was used, and adolescent females (N = 179), recruited from social service agencies, were 18.9 years old on average and were 37.2% White, 19.3% Black, 37.9% multiracial, and 5.6% other. Regression results revealed that females who were physically assaulted and sexually victimized by their intimate partners did engage in more sex without condoms. Mediational analyses indicated that PTSD symptoms significantly influenced the relationship between (1) physical assault and risky sexual behavior and (2) sexual victimization and risky sexual behavior. Contrary to expectations, PTSD may act to reduce risk perhaps by reducing interest in sex. It is important to address victimization, PTSD, and sexual risk in young women. More work is needed to understand these complex relationships using longitudinal designs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The influence of substance use, social sexual environment, psychosocial factors, and partner characteristics on high-risk sexual behavior among young Black and Latino men who have sex with men living with HIV: A qualitative study.

PubMed

VanDevanter, Nancy; Duncan, Alexandra; Burrell-Piggott, Tiphani; Bleakley, Amy; Birnbaum, Jeffrey; Siegel, Karolynn; Lekas, Helen-Marie; Schrimshaw, Eric; Cohall, Alwyn; Ramjohn, Destiny

2011-02-01

Understanding the sexual risk behaviors of youths living with HIV/AIDS is critical to secondary prevention of HIV. As part of a larger qualitative study of youths living with HIV, in-depth interviews were conducted with 27 African American and Latino, HIV-infected young men who have sex with men, aged 16-24 years, living in New York City. The study explored the role of substance use, the social-sexual-environmental, and psychological contexts in which sexual risk behaviors occurred. Since learning of their HIV infection, the majority of participants had reduced their risky sexual behaviors; however, a subset (26%) of participants continued to have unprotected sex, in most cases with multiple partners. Substance use, the social environmental context of the sexual encounter, the psychological impact of HIV on sexual behavior, and partner characteristics were associated with high-risk sexual behaviors in this group. Among high-risk participants, factors associated with risky sexual behaviors clustered, with 57% reporting two or more factors. More intensive interventions are needed for this subset of youths living with HIV, including assessment and treatment for substance use and mental health issues, strategies for stress reduction, and partner interventions.

Interparental aggression, attention skills, and early childhood behavior problems

PubMed Central

TOWE-GOODMAN, NISSA R.; STIFTER, CYNTHIA A.; COCCIA, MICHAEL A.; COX, MARTHA J.

2014-01-01

The current study explored longitudinal associations between interparental aggression, the development of child attention skills, and early childhood behavior problems in a diverse sample of 636 families living in predominately low-income, nonmetropolitan communities. The results of latent-variable, cross-lagged longitudinal models revealed that maternal-reported interparental aggression in infancy predicted reduced observed attention skills in toddlerhood; no association was observed, however, between attention in infancy and interparental aggression during the toddler years. Further, reduced toddler attention and high interparental aggression were both associated with increased risk for attention-deficit/hyperactivity disorder symptoms and conduct problems at 3 years of age. Processes largely operated in similar ways regardless of child gender or low-income status, although a few differences were observed. Overall, the results suggest that interparental aggression undermines attention development, putting children’s early behavioral adjustment at risk. PMID:23786696

An Evaluation of the Effectiveness of Efforts over the last Two Decades to Reduce Human Losses due to Natural Hazards, and A Proposal for Future Efforts (Invited)

NASA Astrophysics Data System (ADS)

Tucker, B. E.; Chakos, A.

2009-12-01

While there is evidence that efforts over the last 20 years to reduce human and fiscal losses due to natural hazards have been effective, there is also evidence that, despite these efforts, we can expect large and, perhaps, even increasing losses in the future. If this conclusion is correct—and unacceptable—then what should be done differently to reduce these losses? One piece of the answer can be found through analyzing why the efforts to date have not been more effective. Another piece can be found through examining the characteristics of successful social movements. For a social movement is what we are talking about when we advocate changing human behavior in order to reduce risk from natural hazards. We cannot attribute the disappointingly modest success of past risk reduction efforts to inadequate science or engineering: the reduction of natural disaster losses in both the U.S. and Japan over the last century indicates that humans possess the required scientific and engineering expertise to reduce the risk of natural hazards, and reduce it significantly. If the problem is that this expertise is not being applied outside of Japan and the U.S., where the risk is concentrated, then we need to understand why. There are numerous examples, after all, of widespread, rapid adoption of modern technologies (such as the internet), once these technologies were perceived to be beneficial. Yet not only have earthquake engineering advances failed to be adopted where they are needed, even existing building codes are often not followed. To understand this behavioral paradox better, we turn to human psychology. In the last several years, Nicholas Kristof of the New York Times has invoked the work of psychologists, in order to explore how our brains may not have yet evolved to respond properly to certain types of modern risks. Kristof refers, for example, to Professor Daniel Gilbert, who argues that threats that will catch our attention will either be personalized, imminent, or rapidly increasing. Unfortunately, some of the starkest risks that confront humanity today—including natural hazards and global warming—manifest none of those characteristics. How, then, can we make real to people both the risks that they face and the pressing need to change behavior, in order to manage them? We believe that we can find a valuable model in other social movements—such as the campaigns to use seat belts or to stop smoking—that have succeeded in changing human behavior by making psychologically “remote” risks real to people. We propose applying approaches that have worked for these movements to the challenge of natural hazard risk management. If we want to make faster progress toward reducing human losses due to natural hazards, then it is time to look beyond advancing research in earth science and structural engineering, improving public education, and constructing risk management plans. All of these efforts are most welcome and necessary but, based on recent trends, insufficient. We suggest convening a forum of “strange bedfellows”-seismologists, earthquake engineers, psychologists, legislators, government regulators, as well as people from the construction industry, Madison Avenue and Transparency International-to devise improved, unorthodox means to reduce the risk of natural hazards.

Stress, behavior, and biology: Risk factors for cardiovascular diseases in youth

USDA-ARS?s Scientific Manuscript database

Psychological stress is associated with cardiovascular disease (CVD) pathogenesis during childhood. Stress promotes atherogenic behaviors in children including snacking of energy dense foods and reduced physical activity; and it also increases adiposity. Stress-induced CV reactivity may also be athe...

Stress, behavior, and biology: Risk factors for cardiovascular disease in youth

USDA-ARS?s Scientific Manuscript database

Psychological stress is associated with cardiovascular disease (CVD) pathogenesis during childhood. Stress promotes atherogenic behaviors in children including snacking of energy dense foods and reduced physical activity; and it also increases adiposity. Stress-induced CV reactivity may also be athe...

[Cancer prevention in France: Implication of health professionals].

PubMed

Lasserre, Andrea; Gaillot, Julie; Deutsch, Antoine; Chauvet, Claire; Bessette, Dominique; Ancellin, Raphaëlle

2017-03-01

Almost 40% of cancers are attributable to preventable cancer risk factors related to behavior. Health professionals must take into account the respective weight of the different causes of cancer to enforce effective cancer prevention. Their involvement is needed on several levels. In primary prevention, not only for vaccinations, detection and support the withdrawal of addiction, but also by a greater consideration in their patients of all cancer risk behavioral factors. This involvement is essential in the care and monitoring of patients with cancer. Thus, enhancing patient compliance with cancer prevention tips (stopping smoking, reducing alcohol consumption, practice physical activity, physical inactivity reduction, reduction of overweight, adopting a diversified and balanced diet) appears as a new challenge of personalized care in oncology that not only aims to reduce the incidence of cancer but also to reduce the risks of morbidity and long-term mortality. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Does a medical history of hypertension influence disclosing genetic testing results of the risk for salt-sensitive hypertension, in primary care?

PubMed

Okayama, Masanobu; Takeshima, Taro; Harada, Masanori; Ae, Ryusuke; Kajii, Eiji

2016-01-01

Disclosing genetic testing results may contribute to the prevention and management of many common diseases. However, whether the presence of a disease influences these effects is unclear. This study aimed to clarify the difference in the effects of disclosing genetic testing results of the risk for developing salt-sensitive hypertension on the behavioral modifications with respect to salt intake in hypertensive and nonhypertensive patients. A cross-sectional study using a self-administered questionnaire was conducted for outpatients aged >20 years (N=2,237) at six primary care clinics and hospitals in Japan. The main factors assessed were medical histories of hypertension, salt preferences, reduced salt intakes, and behavior modifications for reducing salt intake. Behavioral modifications of participants were assessed using their behavior stages before and after disclosure of the hypothetical genetic testing results. Of the 2,237 participants, 1,644 (73.5%) responded to the survey. Of these respondents, 558 (33.9%) patients were hypertensive and 1,086 (66.1%) were nonhypertensive. After being notified of the result "If with genetic risk", the nonhypertensive participants were more likely to make positive behavioral modifications compared to the hypertensive patients among all participants and in those aged <65 years (adjusted relative ratio [ad-RR], 1.76; 95% confidence interval, 1.12-2.76 and ad-RR, 1.99; 1.11-3.57, respectively). In contrast, no difference in negative behavioral modifications between hypertensive and nonhypertensive patients was detected after being notified of the result "If without genetic risk" (ad-RR, 1.05; 95% confidence interval, 0.70-1.57). The behavior of modifying salt intake after disclosure of the genetic testing results differed between hypertensive and nonhypertensive patients. Disclosing a genetic risk for salt-sensitive hypertension was likely to cause nonhypertensive patients, especially those aged <65 years, to improve their behavior regarding salt intake. We conclude that disclosing genetic testing results could help prevent hypertension, and that the doctor should communicate the genetic testing results to those patients with a medical history of hypertension, or those who are at risk of developing hypertension.

Collaborative care intervention targeting violence risk behaviors, substance use, and posttraumatic stress and depressive symptoms in injured adolescents: a randomized clinical trial.

PubMed

Zatzick, Douglas; Russo, Joan; Lord, Sarah Peregrine; Varley, Christopher; Wang, Jin; Berliner, Lucy; Jurkovich, Gregory; Whiteside, Lauren K; O'Connor, Stephen; Rivara, Frederick P

2014-06-01

Violence and injury risk behaviors, alcohol and drug use problems, and posttraumatic stress disorder (PTSD) and depressive symptoms occur frequently among adolescents presenting to acute care medical settings after traumatic physical injury. To test the effectiveness of a stepped collaborative care intervention targeting this constellation of risk behaviors and symptoms in randomly sampled hospitalized adolescents with and without traumatic brain injury. A pragmatic randomized clinical trial was conducted at a single US level I trauma center. Participants included 120 adolescents aged 12 to 18 years randomized to intervention (n = 59) and control (n = 61) conditions. Stepped collaborative care intervention included motivational interviewing elements targeting risk behaviors and substance use as well as medication and cognitive behavioral therapy elements targeting PTSD and depressive symptoms. Adolescents were assessed at baseline before randomization and 2, 5, and 12 months after injury hospitalization. Standardized instruments were used to assess violence risk behaviors, alcohol and drug use, and PTSD and depressive symptoms. The investigation attained more than 95% adolescent follow-up at each assessment point. At baseline, approximately one-third of the participants endorsed the violence risk behavior of carrying a weapon. Regression analyses demonstrated that intervention patients experienced significant reductions in weapon carrying compared with controls during the year after injury (group × time effect, F3,344 = 3.0; P = .03). At 12 months after the injury, 4 (7.3%) intervention patients vs 13 (21.3%) control patients reported currently carrying a weapon (relative risk, 0.31; 95% CI, 0.11-0.90). The intervention was equally effective in reducing the risk of weapon carrying among injured adolescents with and without traumatic brain injury. Other treatment targets, including alcohol and drug use problems and high levels of PTSD and depressive symptoms, occurred less frequently in the cohort relative to weapon carrying and were not significantly affected by the intervention. Collaborative care intervention reduced the risk of adolescent weapon carrying during the year after the injury hospitalization. Future investigation should replicate this preliminary observation. If the finding is replicated, orchestrated investigative and policy efforts could systematically implement and evaluate screening and intervention procedures targeting youth violence prevention at US trauma centers. clinicaltrials.gov identifier: NCT00619255.

Drug Use in Soldiers: Family and Peer Contextual Associations.

PubMed

Habibi, Mojtaba; Darharaj, Mohammad; Kelly, Adrian B; Shahmiri, Hasan; Malekianjabali, Mona; Kheirolomoom, Seyedeh Leili

2017-08-24

Given the stressful nature of military life, people in the armed forces are vulnerable to substance use. The aim of this study was to explore the relationship between family and peers with drug use among military forces in Iran. Convenience sampling was used to recruit a total of 422 draftees doing military service in army units in Tehran, Iran. Measures of family and peers' risk and protective factors, alcohol use, and other drug use were administered. Findings indicated significant relationships between family (i.e., family models for risk behavior, parent sanctions, and family controls) and peers (i.e., peer modeling for risk behavior, peer controls, support from friends) with drug use. A multiple regression analysis revealed that peer modeling for risk behavior, family models for risk behavior, and parent sanctions were significant predictors of drug use in soldiers. These results were consistent with the influence of family and peer on drug use amongst soldiers. Programs designed to reduce alcohol and other drug use may benefit from tailoring to fit risk and protective files amongst peer and family networks.

Binge-Eating Disorder in Adults: A Systematic Review and Meta-analysis.

PubMed

Brownley, Kimberly A; Berkman, Nancy D; Peat, Christine M; Lohr, Kathleen N; Cullen, Katherine E; Bann, Carla M; Bulik, Cynthia M

2016-09-20

The best treatment options for binge-eating disorder are unclear. To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. English-language publications in EMBASE, the Cochrane Library, Academic OneFile, CINAHL, and ClinicalTrials.gov through 18 November 2015, and in MEDLINE through 12 May 2016. 9 waitlist-controlled psychological trials and 25 placebo-controlled trials that evaluated pharmacologic (n = 19) or combination (n = 6) treatment. All were randomized trials with low or medium risk of bias. 2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence. Therapist-led cognitive behavioral therapy, lisdexamfetamine, and second-generation antidepressants (SGAs) decreased binge-eating frequency and increased binge-eating abstinence (relative risk, 4.95 [95% CI, 3.06 to 8.00], 2.61 [CI, 2.04 to 3.33], and 1.67 [CI, 1.24 to 2.26], respectively). Lisdexamfetamine (mean difference [MD], -6.50 [CI, -8.82 to -4.18]) and SGAs (MD, -3.84 [CI, -6.55 to -1.13]) reduced binge-eating-related obsessions and compulsions, and SGAs reduced symptoms of depression (MD, -1.97 [CI, -3.67 to -0.28]). Headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal occurred more frequently with lisdexamfetamine than placebo (relative risk range, 1.63 to 4.28). Other forms of cognitive behavioral therapy and topiramate also increased abstinence and reduced binge-eating frequency and related psychopathology. Topiramate reduced weight and increased sympathetic nervous system arousal, and lisdexamfetamine reduced weight and appetite. Most study participants were overweight or obese white women aged 20 to 40 years. Many treatments were examined only in single studies. Outcomes were measured inconsistently across trials and rarely assessed beyond end of treatment. Cognitive behavioral therapy, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related psychopathology, and lisdexamfetamine and topiramate reduced weight in adults with binge-eating disorder. Agency for Healthcare Research and Quality.

Neighborhood effects on birthweight: an exploration of psychosocial and behavioral pathways in Baltimore, 1995--1996.

PubMed

Schempf, Ashley; Strobino, Donna; O'Campo, Patricia

2009-01-01

Neighborhood characteristics have been proposed to influence birth outcomes through psychosocial and behavioral pathways, yet empirical evidence is lacking. Using data from an urban, low-income sample, this study examined the impact of the neighborhood environment on birthweight and evaluated mediation by psychosocial and behavioral factors. The sample included 726 women who delivered a live birth at Johns Hopkins Hospital in Baltimore, Maryland, USA between 1995 and 1996. Census-tract data were used to create a principal component index of neighborhood risk based on racial and economic stratification (% Black, % poverty), social disorder (violent crime rate), and physical deterioration (% boarded-up housing) (alpha=0.82). Information on sociodemographic, psychosocial, and behavioral factors was gathered from a postpartum interview and medical records. Random intercept multilevel models were used to estimate neighborhood effects and assess potential mediation. Controlling for sociodemographic characteristics, a standard deviation increase in neighborhood risk conferred a 76g birthweight decrement. This represents an approximate 300g difference between the best and worst neighborhoods. Although stress (daily hassles), perceived locus-of-control, and social support were related to birthweight, their adjustment reduced the neighborhood coefficient by only 12%. In contrast, the neighborhood effect was reduced by an additional 30% and was no longer statistically significant after adjustment for the behavioral factors of smoking, drug use, and delayed prenatal care. These findings suggest that neighborhood factors may influence birthweight by shaping maternal behavioral risks. Thus, neighborhood level interventions should be considered to address multiple maternal and infant health risks. Future studies should examine more direct measures of neighborhood stress, such as perceived neighborhood disorder, and evaluate alternative mechanisms by which neighborhood factors influence behavior (e.g., social norms and access to goods and services).

Strength-Based Assessment of Behavior Competencies to Distinguish Students Referred for Disciplinary Intervention from Nonreferred Peers

ERIC Educational Resources Information Center

Albrecht, Susan Fread; Braaten, Sheldon

2008-01-01

Early identification of the lack of behavioral competencies followed by subsequent intervention is critical to reducing the number of students at risk for increasing disciplinary responses and school failure. This study examined scores on the Behavior Objective Sequence (BOS) of elementary school students referred for out-of-classroom disciplinary…

Effects of Youth Assets on Adolescent Alcohol, Tobacco, Marijuana Use, and Sexual Behavior

ERIC Educational Resources Information Center

Dunn, Michael S.; Kitts, Cathy; Lewis, Sandy; Goodrow, Bruce; Scherzer, Gary D.

2011-01-01

Background: Alcohol, tobacco, marijuana use, and sexual behaviors are consistently reported by high school students in the United States and can contribute to reduced quality of life. Empirical research finds that many assets may act as a protective factor for adolescent risk behaviors. As such, the purpose of this study was to examine the…

High risk behavior for HIV transmission among former injecting drug users: a survey from Indonesia.

PubMed

Iskandar, Shelly; Basar, Diba; Hidayat, Teddy; Siregar, Ike M P; Pinxten, Lucas; van Crevel, Reinout; Van der Ven, Andre J A M; De Jong, Cor A J

2010-08-10

Injecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce HIV-transmission. However, former injecting drug users (fIDUs) are often overlooked as a high risk group for HIV transmission. We compared HIV risk behavior among current and former injecting drug users (IDUs) in Indonesia, which has a rapidly growing HIV-epidemic largely driven by injecting drug use. Current and former IDUs were recruited by respondent driven sampling in an urban setting in Java, and interviewed regarding drug use and HIV risk behavior using the European Addiction Severity Index and the Blood Borne Virus Transmission Questionnaire. Drug use and HIV transmission risk behavior were compared between current IDUs and former IDUs, using the Mann-Whitney and Pearson Chi-square test. Ninety-two out of 210 participants (44%) were self reported former IDUs. Risk behavior related to sex, tattooing or piercing was common among current as well as former IDUs, 13% of former IDUs were still exposed to contaminated injecting equipment. HIV-infection was high among former (66%) and current (60%) IDUs. Former IDUs may contribute significantly to the HIV-epidemic in Indonesia, and HIV-prevention should therefore also target this group, addressing sexual and other risk behavior.

Modeling combination HCV prevention among HIV-infected men who have sex with men and people who inject drugs

PubMed Central

Martin, Natasha K.; Skaathun, Britt; Vickerman, Peter; Stuart, David

2017-01-01

Background People who inject drugs (PWID) and HIV-infected men who have sex with men (MSM) are key risk groups for hepatitis C virus (HCV) transmission. Mathematical modeling studies can help elucidate what level and combination of prevention intervention scale-up is required to control or eliminate epidemics among these key populations. Methods We discuss the evidence surrounding HCV prevention interventions and provide an overview of the mathematical modeling literature projecting the impact of scaled-up HCV prevention among PWID and HIV-infected MSM. Results Harm reduction interventions such as opiate substitution therapy and needle and syringe programs are effective in reducing HCV incidence among PWID. Modeling and limited empirical data indicate HCV treatment could additionally be used for prevention. No studies have evaluated the effectiveness of behavior change interventions to reduce HCV incidence among MSM, but existing interventions to reduce HIV risk could be effective. Mathematical modeling and empirical data indicates that scale-up of harm reduction could reduce HCV transmission, but in isolation is unlikely to eliminate HCV among PWID. By contrast, elimination is possibly achievable through combination scale-up of harm reduction and HCV treatment. Similarly, among HIV-infected MSM, eliminating the emerging epidemics will likely require HCV treatment scale-up in combination with additional interventions to reduce HCV-related risk behaviors. Conclusions Elimination of HCV will likely require combination prevention efforts among both PWID and HIV-infected MSM populations. Further empirical research is required to validate HCV treatment as prevention among these populations, and to identify effective behavioral interventions to reduce HCV incidence among MSM. PMID:28534885

Overweight and Obese Adolescent Girls: The Importance of Promoting Sensible Eating and Activity Behaviors from the Start of the Adolescent Period

PubMed Central

Todd, Alwyn S.; Street, Steven J.; Ziviani, Jenny; Byrne, Nuala M.; Hills, Andrew P.

2015-01-01

The adolescent period is associated with changes in eating and activity behaviors in girls. Less reliance on parental provision and choice of food, coupled with a decrease in participation in physical activity and sport, can create an energy imbalance, predisposing to weight gain. Physiological alterations to body composition, reduction in insulin sensitivity, and psychological adjustments may further amplify the risk of becoming overweight and maintaining an unhealthy level of body fat into childbearing years. During pregnancy excess body fat is a risk factor for poor pregnancy outcomes and may predispose an infant to a lifelong heightened risk of being overweight and developing chronic disease. Interventions aimed at preventing the accumulation of body fat in adolescent girls and young women may have far reaching impact and be critically important in reducing intergenerational weight gain. Lifestyle interventions in adolescence have the potential to modify adult obesity risk by switching at-risk individuals from a high to lower obesity risk trajectory. This paper discusses multiple approaches to assist at-risk individuals reduce obesity risk. A key focus is placed on engagement in food preparation and choice, and opportunities for physical activity and sport. Support, education, and opportunity at home and at school, are often associated with the success of lifestyle interventions, and may enable adolescents to make positive choices, and engage in health promoting behaviors during adolescence and childbearing years. PMID:25690003

Examining the Efficacy of HIV Risk-Reduction Counseling on the Sexual Risk Behaviors of a National Sample of Drug Abuse Treatment Clients: Analysis of Subgroups

PubMed Central

Metsch, Lisa R.; Pereyra, Margaret R.; Malotte, C. Kevin; Haynes, Louise F.; Douaihy, Antoine; Chally, Jack; Mandler, Raul N.; Feaster, Daniel J.

2016-01-01

HIV counseling with testing has been part of HIV prevention in the U.S. since the 1980s. Despite the long-standing history of HIV testing with prevention counseling, the CDC released HIV testing recommendations for health care settings contesting benefits of prevention counseling with testing in reducing sexual risk behaviors among HIV-negatives in 2006. Efficacy of brief HIV risk-reduction counseling (RRC) in decreasing sexual risk among subgroups of substance use treatment clients was examined using multisite RCT data. Interaction tests between RRC and subgroups were performed; multivariable regression evaluated the relationship between RRC (with rapid testing) and sex risk. Subgroups were defined by demographics, risk type and level, attitudes/perceptions, and behavioral history. There was an effect (p < .0028) of counseling on number of sex partners among some subgroups. Certain subgroups may benefit from HIV RRC; this should be examined in studies with larger sample sizes, designed to assess the specific subgroup(s). PMID:26837631

HIV-related sexual risk behaviors among male-to-female transgender people in Nepal.

PubMed

Bhatta, Dharma Nand

2014-05-01

Transgender women are a vulnerable and key risk group for HIV, and most research has shown an increased frequency of HIV infection among this minority population. This study examined the prevalence of HIV-related sexual risk behaviors and the socio-demographic correlates with HIV-related sexual risk behaviors among male-to-female (MtF) transgender persons. Data were collected from a sample of 232 individuals through venue-based and snowball sampling and face-to-face interviews. The HIV-related sexual risk behaviors among the MtF transgender persons were: sex without using a condom (48.3%; 95% confidence interval (CI) 41.8-54.8), unprotected anal sex (68.1%; 95% CI 62.0-74.2), and unprotected sex with multiple partners (88.4%; 95% CI 84.3-92.5). Statistically significant differences were found for age, income, education, alcohol habit, and sex with more than two partners per day for these three different HIV-related sexual risk behaviors. MtF transgender persons with a secondary or higher level of education were three times (OR 2.93) more likely to have unprotected sex with multiple partners compared to those with a primary level or no education. Age, education, income, frequency of daily sexual contact, and an alcohol habit remain significant with regard to HIV-related sexual risk behavior. There is an urgent need for programs and interventions to reduce risky sexual behaviors in this minority population. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

Skip the trip: air travelers' behavioral responses to pandemic influenza.

PubMed

Fenichel, Eli P; Kuminoff, Nicolai V; Chowell, Gerardo

2013-01-01

Theory suggests that human behavior has implications for disease spread. We examine the hypothesis that individuals engage in voluntary defensive behavior during an epidemic. We estimate the number of passengers missing previously purchased flights as a function of concern for swine flu or A/H1N1 influenza using 1.7 million detailed flight records, Google Trends, and the World Health Organization's FluNet data. We estimate that concern over "swine flu," as measured by Google Trends, accounted for 0.34% of missed flights during the epidemic. The Google Trends data correlates strongly with media attention, but poorly (at times negatively) with reported cases in FluNet. Passengers show no response to reported cases. Passengers skipping their purchased trips forwent at least $50 M in travel related benefits. Responding to actual cases would have cut this estimate in half. Thus, people appear to respond to an epidemic by voluntarily engaging in self-protection behavior, but this behavior may not be responsive to objective measures of risk. Clearer risk communication could substantially reduce epidemic costs. People undertaking costly risk reduction behavior, for example, forgoing nonrefundable flights, suggests they may also make less costly behavior adjustments to avoid infection. Accounting for defensive behaviors may be important for forecasting epidemics, but linking behavior with epidemics likely requires consideration of risk communication.

Preventing Student Expulsions through Policies, and Procedures for At-Risk Students

ERIC Educational Resources Information Center

Smith, Michael Dale

2012-01-01

Staff members working at alternative schools must use best practices to effectively serve at-risk students and reduce expulsion rates. Expulsion is directly linked to high school dropout rates, with subsequent social costs. Today's alternative schools serve at-risk students who exhibit problematic behaviors, providing them an opportunity to…

Changes in sexual behavior of HIV-infected older adults enrolled in a clinical trial of standalone group psychotherapies targeting depression.

PubMed

Lovejoy, Travis I; Heckman, Timothy G; Sikkema, Kathleen J; Hansen, Nathan B; Kochman, Arlene

2015-01-01

By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30 % of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults.

Changes in sexual behavior of HIV-infected older adults enrolled in a clinical trial of standalone group psychotherapies targeting depression

PubMed Central

Lovejoy, Travis I.; Heckman, Timothy G.; Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene

2014-01-01

By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30% of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥ 50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults. PMID:24668254

Child Maltreatment and Risky Sexual Behavior.

PubMed

Thompson, Richard; Lewis, Terri; Neilson, Elizabeth C; English, Diana J; Litrownik, Alan J; Margolis, Benyamin; Proctor, Laura; Dubowitz, Howard

2017-02-01

Risky sexual behavior is a serious public health problem. Child sexual abuse is an established risk factor, but other forms of maltreatment appear to elevate risky behavior. The mechanisms by which child maltreatment influence risk are not well understood. This study used data from 859 high-risk youth, followed through age 18. Official reports of each form of maltreatment were coded. At age 16, potential mediators (trauma symptoms and substance use) were assessed. At age 18, risky sexual behavior (more than four partners, unprotected sex, unassertiveness in sexual refusal) was assessed. Neglect significantly predicted unprotected sex. Substance use predicted unprotected sex and four or more partners but did not mediate the effects of maltreatment. Trauma symptoms predicted unprotected sex and mediated effects of emotional maltreatment on unprotected sex and on assertiveness in sexual refusal and the effects of sexual abuse on unprotected sex. Both neglect and emotional maltreatment emerged as important factors in risky sexual behavior. Trauma symptoms appear to be an important pathway by which maltreatment confers risk for risky sexual behavior. Interventions to reduce risky sexual behavior should include assessment and treatment for trauma symptoms and for history of child maltreatment in all its forms.

Romance, risk, and replication: Can consumer choices and risk-taking be primed by mating motives?

PubMed

Shanks, David R; Vadillo, Miguel A; Riedel, Benjamin; Clymo, Ashley; Govind, Sinita; Hickin, Nisha; Tamman, Amanda J F; Puhlmann, Lara M C

2015-12-01

Interventions aimed at influencing spending behavior and risk-taking have considerable practical importance. A number of studies motivated by the costly signaling theory within evolutionary psychology have reported that priming inductions (such as looking at pictures of attractive opposite sex members) designed to trigger mating motives increase males' stated willingness to purchase conspicuous consumption items and to engage in risk-taking behaviors, and reduce loss aversion. However, a meta-analysis of this literature reveals strong evidence of either publication bias or p-hacking (or both). We then report 8 studies with a total sample of over 1,600 participants which sought to reproduce these effects. None of the studies, including one that was fully preregistered, was successful. The results question the claim that romantic primes can influence risk-taking and other potentially harmful behaviors. (c) 2015 APA, all rights reserved).

The Impact of the Good Behavior Game, a Universal Classroom-Based Preventive Intervention in First and Second Grades, on High-Risk Sexual Behaviors and Drug Abuse and Dependence Disorders into Young Adulthood

PubMed Central

Wang, Wei; Mackenzie, Amelia C. L.; Brown, C. Hendricks; Ompad, Danielle C.; Or, Flora; Ialongo, Nicholas S.; Poduska, Jeanne M.; Windham, Amy

2013-01-01

The Good Behavior Game (GBG), a method of teacher classroom behavior management, was tested in first-and second-grade classrooms in 19 Baltimore City Public Schools beginning in the 1985–1986 school year. The intervention was directed at the classroom as a whole to socialize children to the student role and reduce aggressive, disruptive behaviors, confirmed antecedents of a profile of externalizing problem outcomes. This article reports on the GBG impact on the courses and interrelationships among aggressive, disruptive behavior through middle school, risky sexual behaviors, and drug abuse and dependence disorders through ages 19–21. In five poor to lower-middle class, mainly African American urban areas, classrooms within matched schools were assigned randomly to either the GBG intervention or the control condition. Balanced assignment of children to classrooms was made, and teachers were randomly assigned to intervention or control. Analyses involved multilevel growth mixture modeling. By young adulthood, significant GBG impact was found in terms of reduced high-risk sexual behaviors and drug abuse and dependence disorders among males who in first grade and through middle school were more aggressive, disruptive. A replication with the next cohort of first-grade children with the same teachers occurred during the following school year, but with minimal teacher mentoring and monitoring. Findings were not significant but generally in the predicted direction. A universal classroom-based prevention intervention in first- and second-grade classrooms can reduce drug abuse and dependence disorders and risky sexual behaviors. PMID:23070695

The impact of the Good Behavior Game, a universal classroom-based preventive intervention in first and second grades, on high-risk sexual behaviors and drug abuse and dependence disorders into young adulthood.

PubMed

Kellam, Sheppard G; Wang, Wei; Mackenzie, Amelia C L; Brown, C Hendricks; Ompad, Danielle C; Or, Flora; Ialongo, Nicholas S; Poduska, Jeanne M; Windham, Amy

2014-02-01

The Good Behavior Game (GBG), a method of teacher classroom behavior management, was tested in first- and second-grade classrooms in 19 Baltimore City Public Schools beginning in the 1985-1986 school year. The intervention was directed at the classroom as a whole to socialize children to the student role and reduce aggressive, disruptive behaviors, confirmed antecedents of a profile of externalizing problem outcomes. This article reports on the GBG impact on the courses and interrelationships among aggressive, disruptive behavior through middle school, risky sexual behaviors, and drug abuse and dependence disorders through ages 19-21. In five poor to lower-middle class, mainly African American urban areas, classrooms within matched schools were assigned randomly to either the GBG intervention or the control condition. Balanced assignment of children to classrooms was made, and teachers were randomly assigned to intervention or control. Analyses involved multilevel growth mixture modeling. By young adulthood, significant GBG impact was found in terms of reduced high-risk sexual behaviors and drug abuse and dependence disorders among males who in first grade and through middle school were more aggressive, disruptive. A replication with the next cohort of first-grade children with the same teachers occurred during the following school year, but with minimal teacher mentoring and monitoring. Findings were not significant but generally in the predicted direction. A universal classroom-based prevention intervention in first- and second-grade classrooms can reduce drug abuse and dependence disorders and risky sexual behaviors.

The role of health-risk appraisals in disease management.

PubMed

Hudson, Laurel R; Pope, James E

2006-02-01

Managed care organizations and disease management vendors often find themselves in the position of responding to employers who want to administer a health-risk appraisal (HRA) without committing to implementation of a comprehensive health promotion program. The assumption appears to be that information on health risks is sufficient to motivate employees to change their health behaviors in order to reduce estimated health risks. A review of the relevant literature does not substantiate the efficacy of a stand-alone HRA for motivating behavior change. The challenge is to engage employers in informed conversations on what works in health promotion and achieve cost-effective benefits.

Assessment of predation risk through conspecific alarm odors by spiny lobsters

PubMed Central

2009-01-01

Strong “alarm odors” emanating from lethally injured conspecifics may indicate an imminent risk of predation to spiny lobsters. In laboratory trials,1 strong conspecific alarm odors elicited avoidance in Panulirus argus, a highly gregarious species that displays collective defense behavior, but not in Panulirus guttatus, a species that tends to aggregate when reproductive activity is high (spring) but not when it is low (late summer) and does not display collective defensive behavior. To reduce predation risk, however, lobsters may autotomize limbs, thus sustaining nonlethal injuries. I tested the response of these lobsters to scents emanating from intact, lethally-injured and non-lethally injured conspecifics. In P. argus, these scents elicited, respectively, attraction, avoidance and a random response, suggesting that, in P. argus, avoidance of conspecific alarm odors depends on their strength. In contrast, P. guttatus lobsters responded at random to scents of lethally injured conspecifics and showed a similar response to scents of intact and non-lethally injured conspecifics in the spring (attraction) and in the summer (random), reflecting the more cryptic defensive behavior of this species. Therefore, both species use conspecific alarm odors for risk-assessment, but each responds to these cues in the most effective way to reduce its risk of predation. PMID:19721871

Assessment of predation risk through conspecific alarm odors by spiny lobsters: How much is too much?

PubMed

Briones-Fourzán, Patricia

2009-07-01

Strong "alarm odors" emanating from lethally injured conspecifics may indicate an imminent risk of predation to spiny lobsters. In laboratory trials,1 strong conspecific alarm odors elicited avoidance in Panulirus argus, a highly gregarious species that displays collective defense behavior, but not in Panulirus guttatus, a species that tends to aggregate when reproductive activity is high (spring) but not when it is low (late summer) and does not display collective defensive behavior. To reduce predation risk, however, lobsters may autotomize limbs, thus sustaining nonlethal injuries. I tested the response of these lobsters to scents emanating from intact, lethally-injured and non-lethally injured conspecifics. In P. argus, these scents elicited, respectively, attraction, avoidance and a random response, suggesting that, in P. argus, avoidance of conspecific alarm odors depends on their strength. In contrast, P. guttatus lobsters responded at random to scents of lethally injured conspecifics and showed a similar response to scents of intact and non-lethally injured conspecifics in the spring (attraction) and in the summer (random), reflecting the more cryptic defensive behavior of this species. Therefore, both species use conspecific alarm odors for risk-assessment, but each responds to these cues in the most effective way to reduce its risk of predation.

Evaluation of a Voluntary Worksite Weight Loss Program on Metabolic Syndrome.

PubMed

Earnest, Conrad P; Church, Timothy S

2015-11-01

Health care costs increase with the presence of metabolic syndrome and present a significant burden to companies throughout the world. Identifying effective behavioral programs within the workplace can reduce health care costs. We examined the effect of a voluntary worksite program on weight loss and metabolic syndrome. Participants (N = 3880, from 93 companies) volunteered within their workplaces to participate in a 10-week weight loss program (Naturally Slim) focused on self-monitoring, eating behaviors, understanding hunger signals, reducing refined carbohydrate and sugar intake, and increasing protein intake to 25%-30%. Primary outcomes included weight loss and metabolic syndrome prevalence. Secondary analyses examined the individual components of metabolic syndrome and a categorical analysis within each World Health Organization body mass index category. Overall, women and men lost 9.4 (-4.8%) and 13.2 pounds (-5.8%), respectively. Each metabolic risk factor for both genders had a significant improvement but men exhibited the largest relative improvement for each risk factor. At baseline, 43% of women and 52% of men presented with metabolic syndrome, which was reduced to 30% in women and 26% in men (P < 0.001 for each) at the conclusion of the program. Secondary analysis demonstrated that individuals with greater baseline levels of metabolic dysfunction had larger metabolic improvements, similar benefits to risk factors across baseline body mass index categories, and the greater the weight loss, the greater the metabolic benefit. Our results demonstrate that a worksite program targeting core behavioral skills associated with weight loss is an effective strategy to reduce weight and improve the components of metabolic syndrome amongst at-risk employees.

Project Date SMART: a Dating Violence (DV) and Sexual Risk Prevention Program for Adolescent Girls with Prior DV Exposure.

PubMed

Rizzo, Christie J; Joppa, Meredith; Barker, David; Collibee, Charlene; Zlotnick, Caron; Brown, Larry K

2018-05-01

This study assessed the initial feasibility, acceptability, and efficacy of an intervention aimed at reducing dating violence and sexual risk behavior in a sample of adolescent girls (ages 14-17) with prior exposure to physical dating violence (DV). One hundred and nine girls were randomly assigned to Date SMART (Skills to Manage Aggression in Relationships for Teens) or a Knowledge-only (KO) comparison group. Both intervention arms consisted of six, weekly 2-h sessions and one "booster" session 6 weeks later. Based on principles of cognitive behavioral therapy, the Date SMART intervention was designed to target common underlying skills deficits linked to both DV and sexual risk behavior in adolescent females: depression, self-regulation deficits, and interpersonal skills deficits. Assessments were administered at four time points (baseline, 3, 6, and 9 months). The Date SMART group was effective as reducing sexual DV involvement across the 9-month follow-up period. Both groups evidenced clinically meaningful reductions in physical, emotional, and digital DV involvement, total time in dating relationships, as well as reductions in depression. Findings indicate that delivering a DV and sexual risk prevention intervention to DV-affected adolescent girls is feasible and well-received. Furthermore, a skills-based approach that addresses the co-occurrence of DV and sexual risk behavior may be particularly useful for promoting reductions of sexual DV among high-risk adolescent girls. A future, large-scale trial with an inactive comparison condition is needed to evaluate the efficacy of Date SMART further. Clinical Trials, NCT01326195, and http://www.clinicaltrials.gov.

Skills training versus health education to prevent STDs/HIV in heterosexual women: a randomized controlled trial utilizing biological outcomes.

PubMed

Baker, Sharon A; Beadnell, Blair; Stoner, Susan; Morrison, Diane M; Gordon, Judith; Collier, Cheza; Knox, Kay; Wickizer, Lauren; Stielstra, Sorrel

2003-02-01

We compared the effectiveness of two different 16-session group interventions for reducing new STD infection among heterosexual women. Two hundred twenty-nine at-risk heterosexual women were randomly assigned to skills training (ST) based on the relapse prevention model or health education (HE). Participants were monitored during the year following intervention for STD acquisition, self-reports of sexual behavior, and risk reduction skills. Participants in the ST intervention were significantly less likely to be diagnosed with a STD in the year following intervention and demonstrated superior risk reduction skills at 12-month follow-up. Both conditions showed statistically significant reductions in self reports of risky sexual behavior following intervention and at 12-month follow-up. In this sample, the ST intervention was superior to HE for reducing STD acquisition.

HPTN 062: A Pilot Randomized Controlled Trial Exploring the Effect of a Motivational-Interviewing Intervention on Sexual Behavior among Individuals with Acute HIV Infection in Lilongwe, Malawi.

PubMed

Pettifor, Audrey; Corneli, Amy; Kamanga, Gift; McKenna, Kevin; Rosenberg, Nora E; Yu, Xuesong; Ou, San-San; Massa, Cecilia; Wiyo, Patricia; Lynn, Diana; Tharaldson, Jenae; Golin, Carol; Hoffman, Irving

2015-01-01

We pilot tested a Motivational Interviewing (MI) -based counseling intervention for individuals with Acute HIV Infection (AHI) to reduce risky sexual behavior in Lilongwe, Malawi. Twenty-eight individuals diagnosed with AHI were randomized to receive either brief education alone, or the brief education plus the MI-based intervention, called Uphungu Wanga. Participants in Uphungu Wanga received four sessions delivered on the day of diagnosis, three days later and at weeks 1 and 2 with a booster session at week 8; participants were followed for 24 weeks from diagnosis. An interviewer administered quantitative questionnaire was conducted at baseline and at weeks 2, 4, 8, 12, 16, 20 and 24. Semi-structured qualitative interviews (SSI) were conducted at weeks 2, 8, 12, and 24. The majority of participants in both arms reported rapid and sustained behavior change following diagnosis with AHI. Very few participants reported having sex without a condom after diagnosis. Participants reported a trend towards fewer sex partners and abstaining from sex during study follow-up. Participants in the MI-based arm provided concrete examples of risk reduction strategies in the SSIs while those in the brief education arm primarily described reducing risk behavior, suggesting that the MI-based group may have acquired more risk reduction skills. Individuals in both study arms reduced risky sexual behaviors after diagnosis with AHI. We found few major differences between study arms during the 6-month follow up period in self-reported sexual behaviors therefore a MI-based intervention may not be needed to trigger behavior change following AHI. However, comparing the MI-based intervention to repeated brief education sessions made it difficult to assess the potential benefit of an MI-based intervention in a setting where standard counseling often consists of one post-test session. Nevertheless, provision of counseling immediately following diagnosis with HIV to support behavior change should remain a priority. ClinicalTrials.gov NCT01197027.

Investigating relationships between ancestry, lifestyle behaviors and perceptions of heart disease and breast cancer among Canadian women with British and with South Asian ancestry.

PubMed

Curtin, Kimberley D; Berry, Tanya R; Courneya, Kerry S; McGannon, Kerry R; Norris, Colleen M; Rodgers, Wendy M; Spence, John C

2018-04-01

Ethnic minority groups including Asians in Canada have different knowledge and perceptions of heart disease and breast cancer compared with the ethnic majority group. Examine relationships between perceptions of heart disease and breast cancer, and lifestyle behaviors for Canadian women with British and with South Asian ancestry. Women with South Asian ( n = 170) and with British ( n = 373) ancestry ( M age = 33.01, SD = 12.86) reported leisure time physical activity, intended fruit and vegetable consumption, disease perceptions (ability to reduce risk, control over getting the diseases, and influence of family history), and demographic information. Mann-Whitney tests and multiple hierarchical linear regressions were used to examine the relationships between lifestyle behaviors and disease perceptions, with ancestry explored as a possible moderator. Participants with South Asian ancestry believed they had greater ability to reduce their risk and have control over getting breast cancer than participants with British ancestry. Family history influences on getting either disease was perceived as higher for women with British ancestry. Age was positively related to all three perceptions in both diseases. Intended fruit and vegetable consumption was positively related to perceptions of ability to reduce risk and control of both diseases, but was stronger for women with South Asian ancestry regarding perceptions of breast cancer. Leisure time physical activity was positively related to perceptions of control over getting heart disease for women with British ancestry. Women's disease perceptions can vary by ancestry and lifestyle behaviors. Accurate representation of diseases is essential in promoting effective preventative behaviors.

A reanalysis of a behavioral intervention to prevent incident HIV infections: Including indirect effects in modeling outcomes of Project EXPLORE

PubMed Central

Eaton, Lisa A.; Kalichman, Seth C.; Kenny, David A.; Harel, Ofer

2013-01-01

Background Project EXPLORE -- a large-scale, behavioral intervention tested among men who have sex with men (MSM) at-risk for HIV infection --was generally deemed as ineffective in reducing HIV incidence. Using novel and more precise data analytic techniques we reanalyzed Project EXPLORE by including both direct and indirect paths of intervention effects. Methods Data from 4,296 HIV negative MSM who participated in Project EXPLORE, which included ten sessions of behavioral risk reduction counseling completed from 1999-2005, were included in the analysis. We reanalyzed the data to include parameters that estimate the overtime effects of the intervention on unprotected anal sex and the over-time effects of the intervention on HIV status mediated by unprotected anal sex simultaneously in a single model. Results We found the indirect effect of intervention on HIV infection through unprotected anal sex to be statistically significant up through 12 months post-intervention, OR=.83, 95% CI=.72-.95. Furthermore, the intervention significantly reduced unprotected anal sex up through 18 months post-intervention, OR=.79, 95% CI=.63-.99. Discussion Our results reveal effects not tested in the original model that offer new insight into the effectiveness of a behavioral intervention for reducing HIV incidence. Project EXPLORE demonstrated that when tested against an evidence-based, effective control condition can result in reductions in rates of HIV acquisition at one year follow-up. Findings highlight the critical role of addressing behavioral risk reduction counseling in HIV prevention. PMID:23245226

Constructing the Suicide Risk Index (SRI): does it work in predicting suicidal behavior in young adults mediated by proximal factors?

PubMed

O'Connor, Maebh; Dooley, Barbara; Fitzgerald, Amanda

2015-01-01

Suicide is a key concern among young adults. The aim of the study was to (1) construct a suicide risk index (SRI) based on demographic, situational, and behavioral factors known to be linked to suicidal behavior and (2) investigate whether the association between the SRI and suicidal behavior was mediated by proximal processes (personal factors, coping strategies, and emotional states). Participants consisted of 7,558 individuals aged 17-25 years (M = 20.35, SD = 1.91). Nearly 22% (n = 1,542) reported self-harm and 7% (n = 499) had attempted suicide. Mediation analysis revealed both a direct effect (ß = .299, 95% CI = [.281, .317], p < .001), and a mediated effect (ß = .204, 95% CI = [.186, .222], p < .001), between the risk index and suicidal behavior. The strongest mediators were levels of self-esteem, depression, and avoidant coping. Interventions to increase self-esteem, reduce depression, and encourage adaptive coping strategies may prevent suicidal behavior in young people.

A Systematic Review of the Effects of Behavioral Counseling on Sexual Risk Behaviors and HIV/STI Prevalence in Low- and Middle-Income Countries.

PubMed

Zajac, Kristyn; Kennedy, Caitlin E; Fonner, Virginia A; Armstrong, Kevin S; O'Reilly, Kevin R; Sweat, Michael D

2015-07-01

The purpose of this study was to assess the effectiveness of behavioral counseling interventions in reducing sexual risk behaviors and HIV/STI prevalence in low- and middle-income countries. A systematic review of papers published between 1990 and 2011 was conducted, identifying studies that utilized either a multi-arm or pre-post design and presented post-intervention data. Standardized methods of searching and data abstraction were used, and 30 studies met inclusion criteria. Results are summarized by intervention groups: (a) people living with HIV; (b) people who use drugs and alcohol; (c) serodiscordant couples; (d) key populations for HIV prevention; and (e) people at low to moderate HIV risk. Evidence for the effectiveness of behavioral counseling was mixed, with more rigorously designed studies often showing modest or no effects. Recommendations about the use of behavioral counseling in developing countries are made based on study results and in light of the field's movement towards combination prevention programs.

Anger and the heart: perspectives on cardiac risk, mechanisms and interventions.

PubMed

Suls, Jerry

2013-01-01

In the popular imagination, anger has long been linked to cardiovascular diseases (CVD), but empirical validation from case-control and prospective studies emerged only in the 1970's. After describing the multidimensional nature of anger and its assessment (via self-report or observed in structured interviews), this paper selectively reviews evidence in (a) behavioral epidemiology, (b) stress and biological processes with implications for cardiopathogenesis, and (c) behavioral/pharmacological interventions for anger/hostility reduction. Although evidence is inconsistent, chronic feelings of anger, cynical distrust and antagonistic behavior are at least modestly associated with risk of both initiation and progression of CVD. Anger/hostility also is linked to stress exposure and reactivity, exaggerated autonomic function, reduced heart rate variability, platelet aggregation and inflammation. Clinical and pharmacologic treatment of anger/hostility has the potential to reduce anger and its health-damaging effects. Limitations, including third-variable explanations and overlap among the negative emotions, and implications for cardiology and behavioral medicine research and practice are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

Using incentives to reduce substance use and other health risk behaviors among people with serious mental illness.

PubMed

Tidey, Jennifer W

2012-11-01

Serious mental illness (SMI) is associated with high rates of tobacco and other drug dependence, poor treatment compliance, obesity and low levels of physical activity, which have severe medical and psychosocial consequences. Interventions that effectively reduce these health risk behaviors among people with SMI are urgently needed. Published reports from studies evaluating incentive-based treatments for promoting tobacco and other drug abstinence, treatment attendance, medication use and increased physical activity are reviewed. Results of this review indicate the efficacy of incentive-based treatments for reducing tobacco and other drug use among people with SMI. Few studies have examined whether incentive-based treatments improve treatment attendance, medication use and physical activity levels in people with SMI; however, initial evidence is positive and indicates that further research in these areas is warranted. Given the medical and psychosocial costs of tobacco and other drug use, treatment non-compliance and physical inactivity, and the efficacy of incentive-based treatments for improving these behaviors, such interventions should be further developed and integrated into behavioral health treatment programs for people with SMI. Copyright © 2011 Elsevier Inc. All rights reserved.

Do empowerment strategies facilitate knowledge and behavioral change? The impact of family health advocacy on health outcomes.

PubMed

Baffour, Tiffany D; Chonody, Jill M

2012-01-01

This study evaluates the impact of a Family Health Advocacy (FHA) intervention on 46 African American women ages 13 to 35 living in a rural southern community. FHA utilizes empowerment strategies to provide education and social support to reduce risk factors for poor pregnancy outcomes. Use of a paired t test demonstrated a statistically significant difference between pretest and posttest scores in the acquisition of knowledge of safer sex practices, alcohol consumption, early prenatal care, maternal infection, and nutrition. Behavioral change was not realized in the areas of nutrition or behaviors that cause risk of maternal infection. Social workers can influence behavioral change for at-risk populations by addressing microlevel barriers such as education and resources and macrolevel barriers such as advocacy for expanded health and social services.

Behavioral sexual risk-reduction counseling in primary care to prevent sexually transmitted infections: a systematic review for the U.S. Preventive Services Task Force.

PubMed

O'Connor, Elizabeth A; Lin, Jennifer S; Burda, Brittany U; Henderson, Jillian T; Walsh, Emily S; Whitlock, Evelyn P

2014-12-16

Sexually transmitted infections (STIs) are common and preventable. To update a previous systematic review about the benefits and harms of sexual risk-reduction counseling to prevent STIs for the U.S. Preventive Services Task Force. Selected databases from January 2007 through October 2013, manual searches of references lists and gray literature, and studies from the previous review. English-language fair- or good-quality trials conducted in adolescents or adults. One investigator abstracted data and a second checked the abstraction. Study quality was dual-reviewed. 31 trials were included: 16 (n=56,110) were newly published and 15 (n=14,214) were from the previous review. Most trials targeted persons at increased risk for STIs based on sociodemographic characteristics, risky sexual behavior, or history of an STI. High-intensity (>2 hours) interventions reduced STI incidence in adolescents (odds ratio, 0.38 [95% CI, 0.24 to 0.60]) and adults (odds ratio, 0.70 [CI, 0.56 to 0.87]). Lower-intensity interventions were generally not effective in adults, but some approaches were promising. Although moderate-intensity interventions may be effective in adolescents, data were very sparse. Reported behavioral outcomes were heterogeneous and most likely to show a benefit with high-intensity interventions at 6 months or less. No consistent evidence was found that sexual risk-reduction counseling was harmful. Low-risk populations and male adolescents were underrepresented. Reliability of self-reported behavioral outcomes was unknown. High-intensity counseling on sexual risk reduction can reduce STIs in primary care and related settings, especially in sexually active adolescents and in adults at increased risk for STIs. Agency for Healthcare Research and Quality.

Web-Based Intervention to Change Perceived Norms of College Student Alcohol Use and Sexual Behavior on Spring Break

PubMed Central

Patrick, Megan E.; Lee, Christine M.; Neighbors, Clayton

2014-01-01

The purpose of the present study was to evaluate an adapted web-based multi-component personalized feedback intervention to reduce college student alcohol use and risky sexual behavior during Spring Break. This is one of the first interventions focused on Spring Break alcohol use and related sexual behavior. Personalized feedback intervention components addressed intentions, expected consequences, norms, motivations, protective behavioral strategies, and pacts with friends. Participants were college students (N=263; 55% women) between the ages of 18 and 21 who planned to go on a Spring Break trip with their friends. Effects were not significant in reducing alcohol use or sexual behavior during Spring Break or some of the proposed intervention mechanisms. However, consistent results showed that the intervention succeeded in reducing perceived social norms for Spring Break drinking and sexual behavior. Findings suggest that changing norms alone is not sufficient for changing risk behavior during this event and alternative strategies are needed to impact other putative mediators. PMID:24333038

Modifying Children's Responses to Unsecured Firearms and Modifying the Keeping and Storage of Firearms in Families of Elementary School Children: A Possible Role for Child Behavior Therapy.

ERIC Educational Resources Information Center

Vacha, Edward F.; McLaughlin, T. F.

2000-01-01

Article outlines potential strategies for reducing the disproportionate rate of firearm accidents among low-income children. Suggests this problem stems from risky gun storage practices that are in response to high rates of victimization and fear of crime. Discusses the role that child behavior therapy can have in reducing the risk of firearm…

HIV infection and HIV-associated behaviors among persons who inject drugs--20 cities, United States, 2012.

PubMed

Spiller, Michael W; Broz, Dita; Wejnert, Cyprian; Nerlander, Lina; Paz-Bailey, Gabriela

2015-03-20

In the United States, an estimated 7% of new diagnoses of human immunodeficiency virus (HIV) infection in 2012 were attributed to injection drug use, and an additional 3% to male-to-male sexual contact and injection drug use. To monitor HIV prevalence and behaviors associated with HIV risk and prevention among persons who inject drugs (PWID), CDC's National HIV Behavioral Surveillance (NHBS) system conducts interviews and HIV testing in selected cities. This report summarizes HIV prevalence and behaviors among PWID interviewed and tested in 20 cities in 2012. Of the 10,002 PWID tested, 11% had a positive HIV test result. Among 9,425 PWID included in the behavioral analysis, 30% receptively shared syringes, 70% had vaginal sex without a condom, 25% had heterosexual anal sex without a condom, and 5% of males had male-to-male sexual contact without a condom in the previous 12 months. Fifty-one percent of PWID included in the behavioral analysis had been tested for HIV, 25% participated in an HIV behavioral intervention, and 39% participated in substance abuse treatment in the previous 12 months. Additional efforts are needed to reduce risk behaviors and increase access to HIV testing, drug treatment, and other HIV prevention programs to further reduce HIV infections among PWID.

Personalized assessment and management of women at risk for breast cancer in North America.

PubMed

Pruthi, Sandhya; Heisey, Ruth; Bevers, Therese

2015-03-01

Many women at increased risk for breast cancer would benefit from referral for genetic testing, enhanced screening, preventive therapy or risk-reducing surgery. We present a visual model and a step-wise approach to assist with a personalized risk stratification and management of these women. We present current recommendations with respect to lifestyle behaviors and mammographic screening, and we review the current evidence regarding enhanced screening and risk-reducing therapies. We discuss the usefulness of three risk-assessment tools in determining whether a woman qualifies for genetic testing, enhanced screening or preventive therapy and present four cases to demonstrate the usefulness of this approach in the clinical setting.

Profiles of African American College Students' Alcohol Use and Sexual Behaviors: Associations With Stress, Racial Discrimination, and Social Support.

PubMed

Metzger, Isha W; Cooper, Shauna M; Ritchwood, Tiarney D; Onyeuku, Chisom; Griffin, Charity Brown

2017-01-01

Though studies show that alcohol use and sexual activity increase during emerging adulthood, few studies examine within-ethnic group differences, particularly among African American college students. This investigation utilized a latent class analytic methodology to identify risk behavior profiles of alcohol use (frequency and amount of alcohol consumed), sexual activity (number of intimate partners), and co-occurring risk behaviors (drinking before sexual intercourse) among 228 African American college students. This investigation also examined whether identified risk behavior profiles were associated with stress (interpersonal, intrapersonal, academic, and environmental), experiences of racial discrimination, and social support (from family, friends, and the college community). Results identified five distinct profiles within this sample: (a) High Sexual Risk-above-average sexual activity; (b) Abstainers-below-average alcohol use and sexual activity; (c) Low Risk-average alcohol use and sexual activity; (d) Alcohol Risk-above-average alcohol use and below-average sexual activity; and (e) Co-Occurring Risk-above-average alcohol use and sexual activity. Identified profiles differed across interpersonal and environmental stress, and self-reported frequency of experiences with racial discrimination. Implications for prevention programs and interventions aimed at reducing alcohol and sexual activity for African American college students are discussed.

Arrest history as an indicator of adolescent/young adult substance use and HIV risk.

PubMed

Tolou-Shams, Marina; Brown, Larry K; Gordon, Glenn; Fernandez, Isabel

2007-04-17

Juvenile offenders are particularly at risk for HIV because of their substantially high rates of risk behaviors, high rates of substance use disorders and psychopathology. Most studies have focused on risk behaviors among incarcerated youth. This study sought to determine if an arrest history could serve as a marker for HIV risk and substance abuse among a community-based sample of high-risk adolescents and young adults. Adolescents (N=1400; mean age=18 years) who participated in a larger multi-site HIV prevention program in three states (GA, FL and RI) provided baseline data on sexual risk, substance use, attitudes and mental health history. Participants were grouped as arrestees (N=404) and non-arrestees (N=996) based on self-reported arrest history. Juvenile arrestees reported more alcohol and drug use, substance use during sex, unprotected sex acts, STI diagnoses, suicide attempts and psychiatric hospitalizations than non-arrestees. Having an arrest history may serve as a marker for adolescent HIV risk and substance abuse. Effectively screening adolescents for legal history and responding to the psychosocial and health needs of these high-risk adolescents could increase necessary engagement in substance use and mental health treatment, reduce HIV risk in the community, and reduce costs to the legal, medical and mental health systems.

Design of a randomized controlled trial for multiple cancer risk behaviors among Spanish-speaking Mexican-origin smokers.

PubMed

Castro, Yessenia; Basen-Engquist, Karen; Fernandez, Maria E; Strong, Larkin L; Eakin, Elizabeth G; Resnicow, Ken; Li, Yisheng; Wetter, David W

2013-03-18

Smoking, poor diet, and physical inactivity account for as much as 60% of cancer risk. Latinos experience profound disparities in health behaviors, as well as the cancers associated with them. Currently, there is a dearth of controlled trials addressing these health behaviors among Latinos. Further, to the best of our knowledge, no studies address all three behaviors simultaneously, are culturally sensitive, and are guided by formative work with the target population. Latinos represent 14% of the U.S. population and are the fastest growing minority group in the country. Efforts to intervene on these important lifestyle factors among Latinos may accelerate the elimination of cancer-related health disparities. The proposed study will evaluate the efficacy of an evidence-based and theoretically-driven Motivation And Problem Solving (MAPS) intervention, adapted and culturally-tailored for reducing cancer risk related to smoking, poor diet, and physical inactivity among high-risk Mexican-origin smokers who are overweight/obese (n = 400). Participants will be randomly assigned to one of two groups: Health Education (HE) or MAPS (HE + up to 18 MAPS counseling calls over 18 months). Primary outcomes are smoking status, servings of fruits and vegetables, and both self-reported and objectively measured physical activity. Outcome assessments will occur at baseline, 6 months, 12 months, and 18 months. The current study will contribute to a very limited evidence base on multiple risk factor intervention studies on Mexican-origin individuals and has the potential to inform both future research and practice related to reducing cancer risk disparities. An effective program targeting multiple cancer risk behaviors modeled after chronic care programs has the potential to make a large public health impact because of the dearth of evidence-based interventions for Latinos and the extended period of support that is provided in such a program. National Institutes of Health Clinical Trials Registry # NCT01504919.

Risky driving behavior and road traffic crashes among young Asian Australian drivers: findings from the DRIVE study.

PubMed

Boufous, Soufiane; Ivers, Rebecca; Senserrick, Teresa; Norton, Robyn; Stevenson, Mark; Chen, Huei-Yang; Lam, Lawrence T

2010-06-01

To examine differences in risky driving behavior and likelihood of traffic crash according to the country of birth of recently licensed young drivers. The groups examined include those born in Australia, those born in Asia, and those born in other countries. The DRIVE study is a prospective cohort study of drivers aged 17-24 years holding their first-year provisional driver license in New South Wales, Australia. Information obtained from 20,822 participants who completed a baseline questionnaire was linked to police-reported traffic crashes. Self-reported risky driving behaviors and police-reported traffic crashes in young drivers. Young drivers who were born in Asian countries were less likely to report engaging in risky driving behaviors than their Australian-born counterparts. The proportion of participants reporting a high level of risky driving was 31.5 percent (95% confidence intervale [CI], 30.8-32.1) among Australian-born drivers compared to 25.6 percent (95% CI, 23.1-28.2) among Asian-born drivers and 30.4 percent (95% CI, 28.4-32.5) among those born in other regions. Asian-born participants had half the risk of a crash as a driver than their Australian-born counterparts (relative risk [RR] 0.55; 95% CI, 0.41-0.75) after adjusting for a number of demographic factors and driving and risk-taking behaviors. The comparative risk was even lower among those aged 17 years (RR 0.29; 95% CI, 0.29-0.75). Risk estimates for people born in other regions did not differ to those for Australian-born respondents. The study highlights the lower level of risky driving and significantly reduced crash risk for Australian drivers born in Asian countries relative to those born locally. Further research is needed to examine factors underlying this reduced risk and the impact of the length of residence in the host country.

Exposure to Different Types of Violence and Subsequent Sexual Risk Behavior among Female STD Clinic Patients: A Latent Class Analysis

PubMed Central

Walsh, Jennifer L.; Senn, Theresa E.; Carey, Michael P.

2013-01-01

Objective Diverse forms of violence, including childhood maltreatment (CM), intimate partner violence (IPV), and exposure to community violence (ECV), have been linked separately with sexual risk behaviors. However, few studies have explored multiple experiences of violence simultaneously in relation to sexual risk-taking, especially in women who are most vulnerable to violent experiences. Methods Participants were 481 women (66% African American, Mage = 27 years) attending a publicly-funded STD clinic who reported on their past and current experiences with violence and their current sexual risk behavior. We identified patterns of experience with violence using latent class analysis (LCA) and investigated which combinations of experiences were associated with the riskiest sexual outcomes. Results Four classes of women with different experiences of violence were identified: Low Violence (39%), Predominantly ECV (20%), Predominantly CM (23%), and Multiply Victimized (18%). Women in the Multiply Victimized and Predominantly ECV classes reported the highest levels of sexual risk behavior, including more lifetime sexual partners and a greater likelihood of receiving STD treatment and using substances before sex. Conclusions Women with different patterns of violent experiences differed in their sexual risk behavior. Interventions to reduce sexual risk should address violence against women, focusing on experiences with multiple types of violence and experiences specifically with ECV. Additional research is needed to determine the best ways to address violence in sexual risk reduction interventions. PMID:23626921

Changing health behaviors to improve health outcomes after angioplasty: a randomized trial of net present value versus future value risk communication.

PubMed

Charlson, M E; Peterson, J C; Boutin-Foster, C; Briggs, W M; Ogedegbe, G G; McCulloch, C E; Hollenberg, J; Wong, C; Allegrante, J P

2008-10-01

Patients who have undergone angioplasty experience difficulty modifying at-risk behaviors for subsequent cardiac events. The purpose of this study was to test whether an innovative approach to framing of risk, based on 'net present value' economic theory, would be more effective in behavioral intervention than the standard 'future value approach' in reducing cardiovascular morbidity and mortality following angioplasty. At baseline, all patients completed a health assessment, received an individualized risk profile and selected risk factors for modification. The intervention randomized patients into two varying methods for illustrating positive effects of behavior change. For the experimental group, each selected risk factor was assigned a numeric biologic age (the net present value) that approximated the relative potential to improve current health status and quality of life when modifying that risk factor. In the control group, risk reduction was framed as the value of preventing future health problems. Ninety-four percent of patients completed 2-year follow-up. There was no difference between the rates of death, stroke, myocardial infarction, Class II-IV angina or severe ischemia (on non-invasive testing) between the net present value group and the future value group. Our results show that a net present risk communication intervention did not result in significant differences in health outcomes.

Smoking, health behavior, and values: a replication, refinement, and extension.

PubMed

Kristiansen, C M

1985-01-01

Within a larger study, 181 female undergraduates completed the Rokeach instrumental value survey and a version of the terminal value survey which included the value 'health', as well as measures of general preventive health behavior and social desirability. Analyses showed that nonsmokers reported better health behavior, and particularly direct rather than indirect-risk behavior, than smokers. While there was no difference in the value of 'health', smokers gave more priority to being 'broadminded' than nonsmokers gave. Smokers were also more concerned with 'freedom', being 'independent' and not being 'obedient', suggesting that smokers were more concerned with being 'flexible' or 'unconstrained'. Further, the value of being 'broadminded' was inversely related to the general health behavior and direct-risk behavior of smokers. Together with other research, these findings suggest that decreasing the extent to which smokers value 'broadmindedness' might not only reduce their smoking behavior but also affect their general preventive health behavior.

Does the use of the revised psychosocial assessment tool (PATrev) result in improved quality of life and reduced psychosocial risk in Canadian families with a child newly diagnosed with cancer?

PubMed

Barrera, M; Hancock, K; Rokeach, A; Atenafu, E; Cataudella, D; Punnett, A; Johnston, D; Cassidy, M; Zelcer, S; Silva, M; Jansen, P; Bartels, U; Nathan, P C; Shama, W; Greenberg, C

2014-02-01

Early psychosocial screening may guide interventions and ameliorate the adverse psychosocial effects of childhood cancer. The revised psychosocial assessment tool provides risk information - Universal (typical distress), Targeted (additional specific distress), and Clinical (severe distress) - about the child with cancer and his or her family. This pilot study investigated the benefits of providing a summary of family psychosocial risk information to the medical team treating the newly diagnosed child (Experimental Group, EG). We conducted a pilot randomized control trial with a sample of 67 parents, comparing the EG to the control group (CG) on parental perception of family psychosocial difficulties (revised psychosocial assessment tool risk levels), child behavior (behavior assessment scale for children-2), pediatric quality of life (PedsQL), and parental anxiety (state-anxiety scale of the state-trait anxiety inventory ), 2-4 weeks after diagnosis (Time 1) and 6 months later (Time 2). Compared to the CG, participants in the EG had significantly reduced targeted and clinical risk (p < 0.001), and improved pain related PedsQL at Time 2 (p < 0.05). Scores for PedsQL total and nearly all subscales improved over time in both groups (p < 0.05 to p < 0.001). No changes in behavior scores were noted. Preliminary findings suggest that providing a summary of the Psychosocial Assessment Tool to the treating team shortly after diagnosis may help reduce family wide psychosocial risk 6 months later and improve quality of life related to pain for children who are undergoing treatment for cancer. Copyright © 2013 John Wiley & Sons, Ltd.

Cigarette smoking risk-reducing beliefs: Findings from the United States Health Information National Trends Survey.

PubMed

Kaufman, Annette R; Coa, Kisha I; Nguyen, Anh B

2017-09-01

Cigarette smoking risk-reducing beliefs are ideas that certain health promoting behaviors (e.g., exercise) may mitigate the risks associated with smoking. The objective of this study was to describe smoking risk-reducing beliefs and the belief that quitting can reduce the harmful effects of smoking among the U.S. adult population and the associations between these beliefs, current smoking status, and sociodemographics. Data were from the Health Information National Trends Survey 4 (HINTS 4) Cycles 3 and 4 (2013-2014; N=6862). Descriptive analyses were conducted to examine bivariate associations among the quit smoking belief, smoking risk-reducing beliefs, and covariates. Weighted ordinal logistic regression models examined the adjusted associations between smoking status and sociodemographics, with quit smoking belief and risk-reducing beliefs. Eighty-two percent of the population reported that quitting cigarette smoking can help reduce the harmful effects of smoking a lot: former smokers and individuals with higher educational attainment were more likely to endorse this belief than never smokers and those with lower educational attainment. Many people endorsed smoking risk-reducing beliefs about exercise (79.3%), fruits and vegetables (71.8%), vitamins (67.2%), and sleep (68.5%). Former smokers were less likely to subscribe to these beliefs than never smokers. Vulnerable populations who may be most at risk of smoking attributable morbidity and mortality were more likely to endorse risk-reducing beliefs. Future studies are needed to better understand how risk-reducing beliefs are formed and if modifying these beliefs may help to reduce cigarette smoking in the U.S. Published by Elsevier Inc.

Reducing Internalizing Symptoms among High-Risk, Hispanic Adolescents: Mediators of a Preventive Family Intervention

PubMed Central

Perrino, Tatiana; Brincks, Ahnalee; Howe, George; Brown, C. Hendricks; Prado, Guillermo; Pantin, Hilda

2016-01-01

Familias Unidas is a family-focused preventive intervention that has been found to reduce drug use and sexual risk behaviors among Hispanic adolescents. In some trials, Familias Unidas has also been found to be efficacious in reducing adolescent internalizing symptoms (i.e., depressive and anxiety symptoms), even though the intervention did not specifically target internalizing symptoms. This study examines potential mediators or mechanisms by which Familias Unidas influences internalizing symptoms, specifically the role of intervention-targeted improvements in parent-adolescent communication and reductions in youth externalizing behaviors. A total of 213 Hispanic eighth grade students with a history of externalizing behavior problems and their primary caregivers were recruited from the public school system. Participants, with a mean age of 13.8 years, were randomized into the Familias Unidas intervention or community practice control condition, and assessed at baseline, 6-months, 18-months, and 30-months post-baseline. A cascading mediation model was tested in which the Familias Unidas intervention was hypothesized to decrease adolescent internalizing symptoms through two mediators: improvements in parent-adolescent communication leading to decreases in externalizing behaviors. Findings show that the intervention had significant direct effects on youth internalizing symptoms at 30-months post-baseline. In addition, the cascading mediation model was supported in which the Familias Unidas intervention predicted significant improvements in parent-adolescent communication at 6-months, subsequently decreasing externalizing behaviors at 18-months, and ultimately reducing youth internalizing symptoms at 30-months post-baseline. Implications for prevention interventions are discussed. PMID:27154768

Structural and Social Contexts of HIV Risk Among African Americans

PubMed Central

Cooper, Hannah L. F.; Osborne, Andrew H.

2009-01-01

HIV continues to be transmitted at unacceptably high rates among African Americans, and most HIV-prevention interventions have focused on behavioral change. To theorize additional approaches to HIV prevention among African Americans, we discuss how sexual networks and drug-injection networks are as important as behavior for HIV transmission. We also describe how higher-order social structures and processes, such as residential racial segregation and racialized policing, may help shape risk networks and behaviors. We then discuss 3 themes in African American culture—survival, propriety, and struggle—that also help shape networks and behaviors. Finally, we conclude with a discussion of how these perspectives might help reduce HIV transmission among African Americans. PMID:19372519

A Group-Based Motivational Interviewing Brief Intervention to Reduce Substance Use and Sexual Risk Behavior among Homeless Young Adults

PubMed Central

Tucker, Joan S.; D’Amico, Elizabeth J.; Ewing, Brett A.; Miles, Jeremy N. V.; Pedersen, Eric R.

2017-01-01

Homeless young adults ages 18–25 exhibit high rates of alcohol and other drug (AOD) use, and sexual risk behaviors such as unprotected sex. Yet few programs exist for this population that are both effective and can be easily incorporated into settings serving this population. This pilot cluster cross-over randomized controlled trial evaluates AWARE, a voluntary four session group-based motivational interviewing (MI) intervention to reduce AOD use and sexual risk behavior. We evaluated AWARE with 200 homeless young adults using drop-in center services in Los Angeles County (mean age=21.8 years; 73% male; 79% heterosexual; 31% non-Hispanic White, 25% African American, 24% Hispanic, 21% multiracial/other). Surveys were completed at baseline and three months after program completion. Retention in the AWARE program was excellent (79% attended multiple sessions) and participants reported high levels of satisfaction with the program. AWARE participants self-reported positive change in their past 3 month and past 30 day alcohol use (ps ≤ .05), motivation to change drug use (ps < .05), and condom use self-efficacy (p = .05) compared to the control group. Among those with multiple sex partners, AWARE participants showed a decrease in unprotected sexual events (p < .05), whereas the control group did not. Results from this pilot evaluation are promising, suggesting that a brief group-MI risk reduction intervention can be effective in helping homeless young adults make positive changes in their alcohol and condom use. Further work is needed to more fully evaluate the efficacy of AWARE on AOD behavior and sexual risk behavior outcomes. PMID:28340904

Exposure to indoor air pollution from household energy use in rural China: the interactions of technology, behavior, and knowledge in health risk management.

PubMed

Jin, Yinlong; Ma, Xiao; Chen, Xining; Cheng, Yibin; Baris, Enis; Ezzati, Majid

2006-06-01

Indoor air pollution (IAP) from household use of biomass and coal is a leading environmental health risk in many developing nations. Much of the initial research on household energy technology overlooked the complex interactions of technological, behavioral, economic, and infrastructural factors that determine the success of environmental health interventions. Consequently, despite enormous interest in reducing the large and inequitable risks associated with household energy use in international development and global health, there is limited empirical research to form the basis for design and delivery of effective interventions. We used data from four poor provinces in China (Gansu, Guizhou, Inner Mongolia, and Shaanxi) to examine the linkages among technology, user knowledge and behavior, and access and infrastructure in exposure to IAP from household energy use. We conclude that broad health risk education is insufficient for successful risk mitigation when exposure behaviors are closely linked to day-to-day activities of households such as cooking and heating, or have other welfare implications, and hence cannot be simply stopped. Rather, there should be emphasis on the economic and infrastructure determinants of access to technology, as well as the details of behaviors that affect exposure. Better understanding of technology-behavior interface would also allow designing technological interventions that account for, and are robust to, behavioral factors or to provide individuals and households with alternative behaviors. Based on the analysis, we present technological and behavioral interventions for these four Chinese provinces.

Using mHealth to Deliver Behavior Change Interventions Within Prenatal Care at Community Health Centers.

PubMed

Mauriello, Leanne M; Van Marter, Deborah F; Umanzor, Cindy D; Castle, Patricia H; de Aguiar, Emma L

2016-09-01

To test an iPad-delivered multiple behavior tailored intervention (Healthy Pregnancy: Step by Step) for pregnant women that addresses smoking cessation, stress management, and fruit and vegetable consumption. A randomized 2 × 5 factorial repeated measures design was employed with randomization on the individual level stratified on behavior risk. Women completed three sessions during pregnancy and two postpartum at postdelivery months 1 and 4. Women were recruited from six locations of federally funded health centers across three states. Participants (N = 335) were English- and Spanish-speaking women at up to 18 weeks gestation. The treatment group received three interactive sessions focused on two priority health behavior risks. The sessions offered individually tailored and stage-matched change strategies based on the transtheoretical model of behavior change. The usual care group received March of Dimes brochures. The primary outcome was the number of behavior risks. Stage of change and continuous measures for all behaviors also were assessed. Data were analyzed across all time points using generalized estimating equations examining repeated measures effects. Women in the treatment group reported significantly fewer risks than those in usual care at 1 month (.85 vs. 1.20, odds ratio [OR] = .70) and 4 months postpartum (.72 vs. .91, OR = .81). Healthy Pregnancy is an evidence-based and personalized program that assists pregnant women with reducing behavior risks and sustaining healthy lifestyle behaviors. © 2016 by American Journal of Health Promotion, Inc.

42 CFR 483.352 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... resident's behavior in a way that reduces the safety risk to the resident or others; (2) Has the temporary... unanticipated resident behavior that places the resident or others at serious threat of violence or injury if no...

42 CFR 483.352 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... resident's behavior in a way that reduces the safety risk to the resident or others; (2) Has the temporary... unanticipated resident behavior that places the resident or others at serious threat of violence or injury if no...

42 CFR 483.352 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS... resident's behavior in a way that reduces the safety risk to the resident or others; (2) Has the temporary... unanticipated resident behavior that places the resident or others at serious threat of violence or injury if no...

Behavioral Decision Research Intervention Reduces Risky Sexual Behavior.

PubMed

Downs, Julie S; Bruine de Bruin, Wändi; Fischhoff, Baruch; Murray, Pamela J

2015-01-01

Although adolescents are at disproportionate risk for sexually transmitted infections, most sex education programs have shown little effect on sexual behavior. An interactive video intervention developed by our team has been identified as one of a few programs that have been documented to reduce sexually transmitted infections in this population. Building on behavioral decision research, we used a mental models approach to interview young women about their sexual decisions, finding, among other things, the strong role of perceived social norms. We based our intervention on these results, aiming to help young women identify and implement personally and socially acceptable decision strategies. A randomized controlled trial found that the video reduced risky sexual behavior and the acquisition of chlamydia infection. We recently revised the video to suit more diverse audiences, and upgraded it to modern standards of cinematography and interactivity. It is now in field trial.

Behavioral Decision Research Intervention Reduces Risky Sexual Behavior Accepted for publication in Current HIV Research

PubMed Central

Downs, Julie S.; de Bruin, Wändi Bruine; Fischhoff, Baruch; Murray, Pamela J.

2017-01-01

Although adolescents are at disproportionate risk for sexually transmitted infections, most sex education programs have shown little effect on sexual behavior. An interactive video intervention developed by our team has been identified as one of a few programs that have been documented to reduce sexually transmitted infections in this population. Building on behavioral decision research, we used a mental models approach to interview young women about their sexual decisions, finding, among other things, the strong role of perceived social norms. We based our intervention on these results, aiming to help young women identify and implement personally and socially acceptable decision strategies. A randomized controlled trial found that the video reduced risky sexual behavior and the acquisition of chlamydia infection. We recently revised the video to suit more diverse audiences, and upgraded it to modern standards of cinematography and interactivity. It is now in field trial. PMID:26149165

The dynamics of injection drug users' personal networks and HIV risk behaviors.

PubMed

Costenbader, Elizabeth C; Astone, Nan M; Latkin, Carl A

2006-07-01

While studies of the social networks of injection drug users (IDUs) have provided insight into how the structures of interpersonal relationships among IDUs affect HIV risk behaviors, the majority of these studies have been cross-sectional. The present study examined the dynamics of IDUs' social networks and HIV risk behaviors over time. Using data from a longitudinal HIV-intervention study conducted in Baltimore, MD, this study assessed changes in the composition of the personal networks of 409 IDUs. We used a multi-nomial logistic regression analysis to assess the association between changes in network composition and simultaneous changes in levels of injection HIV risk behaviors. Using the regression parameters generated by the multi-nomial model, we estimated the predicted probability of being in each of four HIV risk behavior change groups. Compared to the base case, individuals who reported an entirely new set of drug-using network contacts at follow-up were more than three times as likely to be in the increasing risk group. In contrast, reporting all new non-drug-using contacts at follow-up increased the likelihood of being in the stable low-risk group by almost 50% and decreased the probability of being in the consistently high-risk group by more than 70%. The findings from this study show that, over and above IDUs' baseline characteristics, changes in their personal networks are associated with changes in individuals' risky injection behaviors. They also suggest that interventions aimed at reducing HIV risk among IDUs might benefit from increasing IDUs' social contacts with individuals who are not drug users.

Number of Psychosocial Strengths Predicts Reduced HIV Sexual Risk Behaviors Above and Beyond Syndemic Problems Among Gay and Bisexual Men.

PubMed

Hart, Trevor A; Noor, Syed W; Adam, Barry D; Vernon, Julia R G; Brennan, David J; Gardner, Sandra; Husbands, Winston; Myers, Ted

2017-10-01

Syndemics research shows the additive effect of psychosocial problems on high-risk sexual behavior among gay and bisexual men (GBM). Psychosocial strengths may predict less engagement in high-risk sexual behavior. In a study of 470 ethnically diverse HIV-negative GBM, regression models were computed using number of syndemic psychosocial problems, number of psychosocial strengths, and serodiscordant condomless anal sex (CAS). The number of syndemic psychosocial problems correlated with serodiscordant CAS (RR = 1.51, 95% CI 1.18-1.92; p = 0.001). When adding the number of psychosocial strengths to the model, the effect of syndemic psychosocial problems became non-significant, but the number of strengths-based factors remained significant (RR = 0.67, 95% CI 0.53-0.86; p = 0.002). Psychosocial strengths may operate additively in the same way as syndemic psychosocial problems, but in the opposite direction. Consistent with theories of resilience, psychosocial strengths may be an important set of variables predicting sexual risk behavior that is largely missing from the current HIV behavioral literature.

An idiographic and nomothetic approach to the study of Mexican-origin adolescent mothers' socio-cultural stressors and adjustment.

PubMed

Zeiders, Katharine H; Umaña-Taylor, Adriana J; Updegraff, Kimberly A; Jahromi, Laudan B

2015-04-01

The current study examined the longitudinal relations of socio-cultural stressors (i.e., acculturative stressors, enculturative stressors, ethnic discrimination) and Mexican-origin adolescent mothers' depressive symptoms and risk-taking behaviors. Utilizing an idiographic and nomothetic approach, we conducted lagged analyses to examine how individuals' fluctuations in stressors predicted subsequent adjustment. Further, we investigated potential threshold effects by examining if the impact of fluctuations in stressors differed at varying levels of stressors. Mexican-origin adolescent females (N = 184) participated in yearly in-home assessments across 5 years and reported on their experiences of acculturative and enculturative stressors, ethnic discrimination, depressive symptoms, and risk-taking behaviors. Findings revealed that within-person fluctuations in acculturative stressors and, to a lesser extent, perceived discrimination related to youths' depressive symptoms. For risk-taking behaviors, however, only within-person fluctuations in enculturative stressors emerged as significant. Further, a threshold effect emerged in the link between enculturative stressors and risk-taking behaviors, suggesting that fluctuations in enculturative stressors predicted changes in risk-taking behaviors at high levels of enculturative stressors but not low levels. Our findings highlight the differential relations between socio-cultural stressors and adolescent females' adjustment and suggest that prevention programs aimed at reducing depressive symptoms should attend to any degree of change in socio-cultural stressors, whereas programs focused on risk-taking behaviors should be especially attuned to levels of enculturative stress.

Teaching primary prevention of Alzheimer's disease: does it make a difference?

PubMed

Clevenger, Carolyn K; Cantey, Shileah; Quinn, Mary Ellen

2010-07-01

Alzheimer's disease (AD) is one of the most feared illnesses among older adults. Although no cure exists, an emerging body of literature has outlined potentially risk-reducing behaviors. As evidence has become available on risk reduction, community organizations and advocacy groups have developed health education courses on the topic. This study examines the impact of one educational program on the audience's efficacy expectations and outcome expectations for behavior change. Participants included 53 older adults residing in a continuing care retirement community. The study used a pretest-posttest design with an experimental group (n = 33) and a control group (n = 20). Topics on weekly classes included the relationship between cardiovascular factors and AD, dietary factors implicated in AD, and mental stimulation to reduce AD risk. Class sessions consisted of lecture, discussion, and demonstration. Between-group differences were found for both efficacy (P = .016) and outcome expectations (P = .000). Within-group differences were only significant for increased outcome expectations related to literature-derived behaviors (P = .000). Future work should focus on action and prevention and on replication of the educational program's evaluation in a more diverse population.

Screening for Drug and Alcohol Use Disorders and Their Association with HIV-Related Sexual Risk Behaviors among Men Who Have Sex with Men in Peru

PubMed Central

Ludford, Kaysia T.; Vagenas, Panagiotis; Lama, Javier R.; Peinado, Jesus; Gonzales, Pedro; Leiva, Rene; Pun, Monica; Sanchez, Jorge; Altice, Frederick L.

2013-01-01

Background Peru's HIV epidemic is concentrated among men who have sex with men (MSM). The contribution of alcohol use disorders (AUDs) to known high-risk behaviors associated with HIV transmission in this context has not been well characterized. Methods Between June and October 2011, 5,148 sexually active MSM were recruited using convenience sampling in five cities to participate in a cross-sectional bio-behavioral survey. Five high-risk sexual criteria previously associated with incident HIV infection in this setting were selected a priori as the dependent outcomes. Screening for AUDs used the validated Alcohol Use Disorders Identification Test (AUDIT) and AUDS were stratified by severity. Unadjusted and adjusted odds ratios (AOR) were computed to establish the independent correlates of the five dependent outcomes. Results The majority (62.8%) of participants met screening criteria for having an AUD, which were independently correlated with each of the following high-risk sexual risk behaviors in the previous 6 months: 1) >5 sexual partners [AOR = 1.76; (1.54–2.02)]; 2) sex with an HIV-infected partner [AOR = 1.29; (1.03–1.62)]; 3) having a sexually transmitted infection [AOR = 1.38; (1.13–1.68)]; 4) being a sex worker [AOR = 1.61; (1.40–1.87)]; and 5) unprotected sex during last encounter [AOR = 1.22; (1.09–1.38)]. Recent drug use was also correlated with having >5 sexual partners [AOR = 1.42 (1.19–1.71)], sex work [AOR = 1.97 (1.63–2.39)] and unprotected sex during last encounter [AOR = 1.31 (1.11–1.54)]. For each dependent variable, the association with AUDs significantly increased with increasing AUD severity. Conclusions AUDs are highly prevalent among MSM in Peru and are associated with increased HIV risk-taking behaviors that are associated with HIV transmission. Strategies that target problematic drinking such as medication-assisted therapy, behavioral counseling and structural interventions could potentially reduce risky behaviors and ultimately reduce HIV transmission among MSM in Peru. PMID:23936364

Screening for drug and alcohol use disorders and their association with HIV-related sexual risk behaviors among men who have sex with men in Peru.

PubMed

Ludford, Kaysia T; Vagenas, Panagiotis; Lama, Javier R; Peinado, Jesus; Gonzales, Pedro; Leiva, Rene; Pun, Monica; Sanchez, Jorge; Altice, Frederick L

2013-01-01

Peru's HIV epidemic is concentrated among men who have sex with men (MSM). The contribution of alcohol use disorders (AUDs) to known high-risk behaviors associated with HIV transmission in this context has not been well characterized. Between June and October 2011, 5,148 sexually active MSM were recruited using convenience sampling in five cities to participate in a cross-sectional bio-behavioral survey. Five high-risk sexual criteria previously associated with incident HIV infection in this setting were selected a priori as the dependent outcomes. Screening for AUDs used the validated Alcohol Use Disorders Identification Test (AUDIT) and AUDS were stratified by severity. Unadjusted and adjusted odds ratios (AOR) were computed to establish the independent correlates of the five dependent outcomes. The majority (62.8%) of participants met screening criteria for having an AUD, which were independently correlated with each of the following high-risk sexual risk behaviors in the previous 6 months: 1) >5 sexual partners [AOR = 1.76; (1.54-2.02)]; 2) sex with an HIV-infected partner [AOR = 1.29; (1.03-1.62)]; 3) having a sexually transmitted infection [AOR = 1.38; (1.13-1.68)]; 4) being a sex worker [AOR = 1.61; (1.40-1.87)]; and 5) unprotected sex during last encounter [AOR = 1.22; (1.09-1.38)]. Recent drug use was also correlated with having >5 sexual partners [AOR = 1.42 (1.19-1.71)], sex work [AOR = 1.97 (1.63-2.39)] and unprotected sex during last encounter [AOR = 1.31 (1.11-1.54)]. For each dependent variable, the association with AUDs significantly increased with increasing AUD severity. AUDs are highly prevalent among MSM in Peru and are associated with increased HIV risk-taking behaviors that are associated with HIV transmission. Strategies that target problematic drinking such as medication-assisted therapy, behavioral counseling and structural interventions could potentially reduce risky behaviors and ultimately reduce HIV transmission among MSM in Peru.

Sexual health risk reduction interventions for people with severe mental illness: a systematic review.

PubMed

Pandor, Abdullah; Kaltenthaler, Eva; Higgins, Agnes; Lorimer, Karen; Smith, Shubulade; Wylie, Kevan; Wong, Ruth

2015-02-12

Despite variability in sexual activity among people with severe mental illness, high-risk sexual behavior (e.g. unprotected intercourse, multiple partners, sex trade and illicit drug use) is common. Sexual health risk reduction interventions (such as educational and behavioral interventions, motivational exercises, counselling and service delivery), developed and implemented for people with severe mental illness, may improve participants' knowledge, attitudes, beliefs behaviors or practices (including assertiveness skills) and could lead to a reduction in risky sexual behavior. This systematic review evaluates the effectiveness of sexual health risk reduction interventions for people with severe mental illness. Thirteen electronic databases (including MEDLINE, EMBASE and PsycINFO) were searched to August 2014, and supplemented by hand-searching relevant articles and contacting experts. All controlled trials (randomized or non-randomized) comparing the effectiveness of sexual health risk reduction interventions with usual care for individuals living in the community with severe mental illness were included. Outcomes included a range of biological, behavioral and proxy endpoints. Narrative synthesis was used to combine the evidence. Thirteen controlled trials (all from the USA) were included. Although there was no clear and consistent evidence that interventions reduce the total number of sex partners or improved behavioral intentions in sexual risk behavior, positive effects were generally observed in condom use, condom protected intercourse and on measures of HIV knowledge, attitudes to condom use and sexual behaviors and practices. However, the robustness of these findings is low due to the large between study variability, small sample sizes and low-to-moderate quality of included studies. There is insufficient evidence at present to fully support or reject the identified sexual health risk reduction interventions for people with severe mental illness. Given the serious consequences of high-risk sexual behaviors, there is an urgent need for well-designed UK based trials, as well as training and support for staff implementing sexual health risk reduction interventions. PROSPERO CRD42013003674 .

28 CFR 115.341 - Obtaining information from residents.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ACT NATIONAL STANDARDS Standards for Juvenile Facilities Screening for Risk of Sexual Victimization... use information about each resident's personal history and behavior to reduce the risk of sexual abuse... instrument. (c) At a minimum, the agency shall attempt to ascertain information about: (1) Prior sexual...

28 CFR 115.341 - Obtaining information from residents.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ACT NATIONAL STANDARDS Standards for Juvenile Facilities Screening for Risk of Sexual Victimization... use information about each resident's personal history and behavior to reduce the risk of sexual abuse... instrument. (c) At a minimum, the agency shall attempt to ascertain information about: (1) Prior sexual...

28 CFR 115.341 - Obtaining information from residents.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ACT NATIONAL STANDARDS Standards for Juvenile Facilities Screening for Risk of Sexual Victimization... use information about each resident's personal history and behavior to reduce the risk of sexual abuse... instrument. (c) At a minimum, the agency shall attempt to ascertain information about: (1) Prior sexual...

Convergence of Humans, Bats, Trees, and Culture in Nipah Virus Transmission, Bangladesh

PubMed Central

Hegde, Sonia T.; Hossain, Kamal; Sazzad, Hossain M.S.; Hossain, M. Jahangir; Rahman, Mahmudur; Sharker, M.A. Yushuf; Salje, Henrik; Islam, M. Saiful; Epstein, Jonathan H.; Khan, Salah U.; Kilpatrick, A. Marm; Daszak, Peter; Luby, Stephen P.

2017-01-01

Preventing emergence of new zoonotic viruses depends on understanding determinants for human risk. Nipah virus (NiV) is a lethal zoonotic pathogen that has spilled over from bats into human populations, with limited person-to-person transmission. We examined ecologic and human behavioral drivers of geographic variation for risk of NiV infection in Bangladesh. We visited 60 villages during 2011–2013 where cases of infection with NiV were identified and 147 control villages. We compared case villages with control villages for most likely drivers for risk of infection, including number of bats, persons, and date palm sap trees, and human date palm sap consumption behavior. Case villages were similar to control villages in many ways, including number of bats, persons, and date palm sap trees, but had a higher proportion of households in which someone drank sap. Reducing human consumption of sap could reduce virus transmission and risk for emergence of a more highly transmissible NiV strain. PMID:28820130

Convergence of Humans, Bats, Trees, and Culture in Nipah Virus Transmission, Bangladesh.

PubMed

Gurley, Emily S; Hegde, Sonia T; Hossain, Kamal; Sazzad, Hossain M S; Hossain, M Jahangir; Rahman, Mahmudur; Sharker, M A Yushuf; Salje, Henrik; Islam, M Saiful; Epstein, Jonathan H; Khan, Salah U; Kilpatrick, A Marm; Daszak, Peter; Luby, Stephen P

2017-09-01

Preventing emergence of new zoonotic viruses depends on understanding determinants for human risk. Nipah virus (NiV) is a lethal zoonotic pathogen that has spilled over from bats into human populations, with limited person-to-person transmission. We examined ecologic and human behavioral drivers of geographic variation for risk of NiV infection in Bangladesh. We visited 60 villages during 2011-2013 where cases of infection with NiV were identified and 147 control villages. We compared case villages with control villages for most likely drivers for risk of infection, including number of bats, persons, and date palm sap trees, and human date palm sap consumption behavior. Case villages were similar to control villages in many ways, including number of bats, persons, and date palm sap trees, but had a higher proportion of households in which someone drank sap. Reducing human consumption of sap could reduce virus transmission and risk for emergence of a more highly transmissible NiV strain.

The interplay of stressful life events and coping skills on risk for suicidal behavior among youth students in contemporary China: a large scale cross-sectional study.

PubMed

Tang, Fang; Xue, Fuzhong; Qin, Ping

2015-07-31

Stressful life events are common among youth students and may induce psychological problems and even suicidal behaviors in those with poor coping skills. This study aims to assess the influence of stressful life events and coping skills on risk for suicidal behavior and to elucidate the underlying mechanism using a large sample of university students in China. 5972 students, randomly selected from 6 universities, completed the questionnaire survey. Logistic regression analysis was performed to estimate the effect of stressful life events and coping skills on risk for suicidal behavior. Bayesian network was further adopted to probe their probabilistic relationships. Of the 5972 students, 7.64% reported the presence of suicidal behavior (attempt or ideation) within the past one year period. Stressful life events such as strong conflicts with classmates and a failure in study exam constituted strong risk factors for suicidal behavior. The influence of coping skills varied according to the strategies adapted toward problems with a high score of approach coping skills significantly associated with a reduced risk of suicidal behavior. The Bayesian network indicated that the probability of suicidal behavior associated with specific life events was to a large extent conditional on coping skills. For instance, a stressful experience of having strong conflicts with classmates could result in a probability of suicidal behavior of 21.25% and 15.36% respectively, for female and male students with the score of approach coping skills under the average. Stressful life events and deficient coping skills are strong risk factors for suicidal behavior among youth students. The results underscore the importance of prevention efforts to improve coping skills towards stressful life events.

Does Age Matter Among Young Black Men Who Have Sex With Men? A Comparison of Risk Behaviors Stratified by Age Category.

PubMed

Chamberlain, Nicholas; Mena, Leandro; Geter, Angelica; Crosby, Richard A

2016-06-01

The purpose of this study is to assess whether different sexual risk behavior exists among young Black men who have sex with men (YBMSM) as a function of age. A total of 382 YBMSM completed a computer-assisted self-interview at a sexual health clinic. The frequency/prevalence of fifteen sexual risk behaviors was compared between three groups (ages 16-19, 20-25, and 26-29, respectively) in the 90 days prior to enrollment in the study. Regression models were used to control for the confounding influence of Human Immunodeficiency Virus (HIV) status. One hundred seven participants were HIV-infected at study enrollment. Of the 15 measures assessed, none significantly differed among the groups. These null findings did not change in multivariate analyses. Our findings suggest that there is no differential sexual risk based on age among YBMSM and that this group should be considered a homogenous population with regards to intervention strategies that aim to reduce the sexual risk behaviors of YBMSM.

Neighborhoods and Race/Ethnic Disparities in Adolescent Sexual Risk Behavior

PubMed Central

Carlson, Daniel L.; McNulty, Thomas L.; Bellair, Paul E.; Watts, Stephen

2013-01-01

Understanding the determinants of racial/ethnic disparities in adolescent sexual risk behavior is important given its links to the differential risk of teen pregnancy, childbearing, and sexually transmitted infections. This article tests a contextual model that emphasizes the concentration of neighborhood disadvantage in shaping racial/ethnic disparities in sexual risk behavior. We focus on two risk behaviors that are prevalent among Black and Hispanic youth: the initiation of sexual activity in adolescence and the number of sex partners. Using data from the 1997 National Longitudinal Study of Youth (N = 6,985; 48% female; 57% non-Hispanic White) evidence indicates that neighborhood disadvantage – measured by concentrated poverty, unemployment rates, and the proportion of female-headed households – partially explains Black and Hispanic disparities from Whites in the odds of adolescent sexual debut, although the prevalence of female-headed households in neighborhoods appears to be the main driver in this domain. Likewise, accounting for neighborhood disadvantage reduces the Black-White and Hispanic-White disparity in the number of sexual partners, although less so relative to sexual debut. We discuss theoretical and practical implications of these findings. PMID:24214727

Opportunities for Skin Cancer Prevention Education among Individuals Attending a Community Skin Cancer Screening in a High-Risk Catchment Area.

PubMed

Parsons, Bridget Grahmann; Gren, Lisa H; Simonsen, Sara E; Harding, Garrett; Grossman, Douglas; Wu, Yelena P

2018-04-01

Despite the highly preventable nature of skin cancer, it remains the most commonly diagnosed form of cancer in the United States. Recommendations for a complete skin cancer prevention regimen include engaging in photoprotection (e.g., sunscreen use), avoiding skin cancer risk behaviors (e.g., tanning), and receiving total body skin exams from a health care provider. The current study examined reported engagement in these behaviors among participants attending a community skin cancer screening (N = 319) in a high-risk catchment area to assess the need for increased health education on skin cancer prevention. Participants' responses indicate a history of suboptimal avoidance of skin cancer risk behaviors. Over half of participants (52%) reported four or more blistering sunburns before age 20, and 46% reported indoor tanning at least one during their lifetime. There is a need among this population for education regarding a complete skin cancer prevention regimen, which could improve adherence to photoprotection and avoidance of skin cancer risk behaviors, thereby reducing morbidity and mortality due to skin cancer.

Theoretical framework to study exercise motivation for breast cancer risk reduction.

PubMed

Wood, Maureen E

2008-01-01

To identify an appropriate theoretical framework to study exercise motivation for breast cancer risk reduction among high-risk women. An extensive review of the literature was conducted to gather relevant information pertaining to the Health Promotion Model, self-determination theory, social cognitive theory, Health Belief Model, Transtheoretical Model, theory of planned behavior, and protection motivation theory. An iterative approach was used to summarize the literature related to exercise motivation within each theoretical framework. Protection motivation theory could be used to examine the effects of perceived risk and self-efficacy in motivating women to exercise to facilitate health-related behavioral change. Evidence-based research within a chosen theoretical model can aid practitioners when making practical recommendations to reduce breast cancer risk.

Age of alcohol use initiation, suicidal behavior, and peer and dating violence victimization and perpetration among high-risk, seventh-grade adolescents.

PubMed

Swahn, Monica H; Bossarte, Robert M; Sullivent, Ernest E

2008-02-01

We examined the cross-sectional associations between reports of an early age of alcohol use initiation and suicidal ideation, suicide attempts, and peer and dating violence victimization and perpetration among high-risk adolescents. Data were obtained from the Youth Violence Survey conducted in 2004 and administered to all public school students enrolled in grades 7, 9, and 11/12 (N = 4131) in a high-risk school district in the United States. Our analyses were limited to seventh-grade students who either began drinking before the age of 13 or were nondrinkers, with complete information on all covariates (n = 856). Cross-sectional logistic and multinomial logistic regression analyses were conducted to determine the associations between early alcohol use and each of the 6 outcome behaviors (dating violence victimization and perpetration, peer violence victimization and perpetration, suicidal ideation, and suicide attempts) while controlling for demographic characteristics and other potential confounders (ie, heavy episodic drinking, substance use, peer drinking, depression, impulsivity, peer delinquency, and parental monitoring). In our study, 35% of students reported alcohol use initiation before 13 years of age (preteen alcohol use initiators). Students who reported preteen alcohol use initiation reported involvement in significantly more types of violent behaviors (mean: 2.8 behaviors), compared with nondrinkers (mean: 1.8 behaviors). Preteen alcohol use initiation was associated significantly with suicide attempts, relative to nondrinkers, controlling for demographic characteristics and all other potential confounders. Early alcohol use is an important risk factor for involvement in violent behaviors and suicide attempts among youths. Increased efforts to delay and to reduce early alcohol use among youths are needed and may reduce both violence and suicide attempts.

The Influence of Substance Use, Social Sexual Environment, Psychosocial Factors, and Partner Characteristics on High-Risk Sexual Behavior Among Young Black and Latino Men Who Have Sex with Men Living with HIV: A Qualitative Study

PubMed Central

Duncan, Alexandra; Burrell-Piggott, Tiphani; Bleakley, Amy; Birnbaum, Jeffrey; Siegel, Karolynn; Lekas, Helen-Marie; Schrimshaw, Eric; Cohall, Alwyn; Ramjohn, Destiny

2011-01-01

Abstract Understanding the sexual risk behaviors of youths living with HIV/AIDS is critical to secondary prevention of HIV. As part of a larger qualitative study of youths living with HIV, in-depth interviews were conducted with 27 African American and Latino, HIV-infected young men who have sex with men, aged 16–24 years, living in New York City. The study explored the role of substance use, the social-sexual-environmental, and psychological contexts in which sexual risk behaviors occurred. Since learning of their HIV infection, the majority of participants had reduced their risky sexual behaviors; however, a subset (26%) of participants continued to have unprotected sex, in most cases with multiple partners. Substance use, the social environmental context of the sexual encounter, the psychological impact of HIV on sexual behavior, and partner characteristics were associated with high-risk sexual behaviors in this group. Among high-risk participants, factors associated with risky sexual behaviors clustered, with 57% reporting two or more factors. More intensive interventions are needed for this subset of youths living with HIV, including assessment and treatment for substance use and mental health issues, strategies for stress reduction, and partner interventions. PMID:21235387

Using Immersive Virtual Reality to Reduce Work Accidents in Developing Countries.

PubMed

Nedel, Luciana; de Souza, Vinicius Costa; Menin, Aline; Sebben, Lucia; Oliveira, Jackson; Faria, Frederico; Maciel, Anderson

2016-01-01

Thousands of people die or are injured in work accidents every year. Although the lack of safety equipment is one of the causes, especially in developing countries, behavioral issues caused by psychosocial factors are also to blame. This article introduces the use of immersive VR simulators to preventively reduce accidents in the workplace by detecting behavioral patterns that may lead to an increased predisposition to risk exposure. The system simulates day-to-day situations, analyzes user reactions, and classifies the behaviors according to four psychosocial groups. The results of a user study support the effectiveness of this approach.

Break in Sedentary Behavior Reduces the Risk of Noncommunicable Diseases and Cardiometabolic Risk Factors among Workers in a Petroleum Company

PubMed Central

Jalayondeja, Chutima; Jalayondeja, Wattana; Mekhora, Keerin; Bhuanantanondh, Petcharatana; Dusadi-Isariyavong, Asadang; Upiriyasakul, Rujiret

2017-01-01

Although prolonged sitting appears as a novel risk factor related to health outcomes for all ages, its association needs to be replicated in occupational conditions. This study explored the associations between sedentary behavior and four noncommunicable diseases (NCDs) as well as two cardiometabolic risk factors (CMRFs) among workers in a petroleum company, Thailand. All workers were invited to complete the online self-report questionnaire. Sedentary behavior was measured as the amount of time sitting at work, during recreation, and while commuting. Out of 3365 workers contacted, 1133 (34%) participated. Prevalence of NCDs and CMRFs was 36% and was positively associated with sedentary behavior. After adjusting for age, BMI, and exercise, the risk of NCDs and CMRFs for sedentary office work was 40% greater compared with more active field work. Those who took a break without sitting more than twice a day and commuted by walking or cycling had less risk of NCDs and CMRFs. The total duration of sedentary behavior was 10 h/day, and two-thirds of that total was workplace sitting. This was significantly associated with NCDs and CMRFs (p < 0.001). Day-and-night rotating shiftwork was negatively associated with NCDs and CMRFs (p < 0.001). Sedentary behavior should be considered a health risk among workers. Hence, to promote a healthy lifestyle and safe workplace, organizations should encourage standing activities during break and physically active commutes, and have workers avoid prolonged sitting. PMID:28486414

Break in Sedentary Behavior Reduces the Risk of Noncommunicable Diseases and Cardiometabolic Risk Factors among Workers in a Petroleum Company.

PubMed

Jalayondeja, Chutima; Jalayondeja, Wattana; Mekhora, Keerin; Bhuanantanondh, Petcharatana; Dusadi-Isariyavong, Asadang; Upiriyasakul, Rujiret

2017-05-09

Although prolonged sitting appears as a novel risk factor related to health outcomes for all ages, its association needs to be replicated in occupational conditions. This study explored the associations between sedentary behavior and four noncommunicable diseases (NCDs) as well as two cardiometabolic risk factors (CMRFs) among workers in a petroleum company, Thailand. All workers were invited to complete the online self-report questionnaire. Sedentary behavior was measured as the amount of time sitting at work, during recreation, and while commuting. Out of 3365 workers contacted, 1133 (34%) participated. Prevalence of NCDs and CMRFs was 36% and was positively associated with sedentary behavior. After adjusting for age, BMI, and exercise, the risk of NCDs and CMRFs for sedentary office work was 40% greater compared with more active field work. Those who took a break without sitting more than twice a day and commuted by walking or cycling had less risk of NCDs and CMRFs. The total duration of sedentary behavior was 10 h/day, and two-thirds of that total was workplace sitting. This was significantly associated with NCDs and CMRFs ( p < 0.001). Day-and-night rotating shiftwork was negatively associated with NCDs and CMRFs ( p < 0.001). Sedentary behavior should be considered a health risk among workers. Hence, to promote a healthy lifestyle and safe workplace, organizations should encourage standing activities during break and physically active commutes, and have workers avoid prolonged sitting.

Reducing sexual risk behavior among steady heterosexual serodiscordant couples in a testing and counseling program.

PubMed

Hernando, Victoria; del Romero, Jorge; García, Soledad; Rodríguez, Carmen; del Amo, Julia; Castilla, Jesús

2009-10-01

To assess the effect of an HIV counseling and testing program targeting steady heterosexual serodiscordant couples. We studied 564 couples who attended a sexually transmitted infections/HIV clinic in Madrid in the period 1989 to 2007 and participated in couples counseling and testing. Sociodemographic, epidemiologic, clinical, and behavioral information of both partners was obtained before testing the nonindex partner. Sexual practices reported in the first (preintervention) and second visit were compared, as well those reported in 4 additional visits. Among the 399 couples who returned for a second visit (71%), the median number of sexual risk practices in the previous 6 months decreased (26.9-0; P <0.001) and the percentage of couples who had not engaged in sexual risk behavior increased (46.1-66.7; P <0.001). This reduction was maintained by the 143 couples who had 4 return visits. The diagnosis of HIV-infection in the index case previous to entering the program was associated with a lower frequency of sexual risk behavior. Independent predictors of postintervention risky sexual behavior included preintervention sexual risk behavior (odds ratio [OR]: 2.8, 95% confidence interval: 1.7-4.4), index case aged over 35 (OR: 2.0, 1.2-3.3), and a recent pregnancy (OR: 3.1, 1.6-6.3). The incidence of HIV seroconversion was 3.9 per 1000 couple-years (1.4-9.7). The diagnosis of HIV-infection and counseling appears to provide complementary reductions in sexual risk behaviors among serodiscordant steady heterosexual couples at follow-up, but the risk of transmission was not totally eliminated.

Sexually Transmitted Infections: Recommendations from the U.S. Preventive Services Task Force.

PubMed

Lee, Karen C; Ngo-Metzger, Quyen; Wolff, Tracy; Chowdhury, Joya; LeFevre, Michael L; Meyers, David S

2016-12-01

The U.S. Preventive Services Task Force (USPSTF) has issued recommendations on behavioral counseling to prevent sexually transmitted infections (STIs) and recommendations about screening for individual STIs. Clinicians should obtain a sexual history to assess for behaviors that increase a patient's risk. Community and population risk factors should also be considered. The USPSTF recommends intensive behavioral counseling for all sexually active adolescents and for adults whose history indicates an increased risk of STIs. These interventions can reduce STI acquisition and risky sexual behaviors, and increase condom use and other protective behaviors. The USPSTF recommends screening for chlamydia and gonorrhea in all sexually active women 24 years and younger, and in older women at increased risk. It recommends screening for human immunodeficiency virus (HIV) infection in all patients 15 to 65 years of age regardless of risk, as well as in younger and older patients at increased risk of HIV infection. The USPSTF also recommends screening for hepatitis B virus infection and syphilis in persons at increased risk. All pregnant women should be tested for hepatitis B virus infection, HIV infection, and syphilis. Pregnant women 24 years and younger, and older women with risk factors should be tested for gonorrhea and chlamydia. The USPSTF recommends against screening for asymptomatic herpes simplex virus infection. There is inadequate evidence to determine the optimal interval for repeat screening; clinicians should rescreen patients when their sexual history reveals new or persistent risk factors.

The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempt⋆

PubMed Central

Wilcox, Holly C.; Kellam, Sheppard G.; Brown, C. Hendricks; Poduska, Jeanne; Ialongo, Nicholas S.; Wang, Wei; Anthony, James C.

2008-01-01

Objective This paper reports the impact of two first- and second-grade classroom based universal preventive interventions on the risk of Suicide Ideation (SI) and Suicide Attempts (SA) by young adulthood. The Good Behavior Game (GBG) was directed at socializing children for the student role and reducing aggressive, disruptive behavior. Mastery Learning (ML) was aimed at improving academic achievement. Both were implemented by the teacher. Methods The design was epidemiologically based, with randomization at the school and classroom levels and balancing of children across classrooms. The trial involved a cohort of first-grade children in 19 schools and 41 classrooms with intervention at first and second grades. A replication was implemented with the next cohort of first grade children with the same teachers but with little mentoring or monitoring. Results In the first cohort, there was consistent and robust GBG-associated reduction of risk for suicide ideation by age 19–21 years compared to youths in standard setting (control) classrooms regardless of any type of covariate adjustment. A GBG-associated reduced risk for suicide attempt was found, though in some covariate-adjusted models the effect was not statistically robust. No statistically significant impact on these outcomes was found for ML. The impact of the GBG on suicide ideation and attempts was greatly reduced in the replication trial involving the second cohort. Conclusions A universal preventive intervention directed at socializing children and classroom behavior management to reduce aggressive, disruptive behavior may delay or prevent onset of suicide ideation and attempts. The GBG must be implemented with precision and continuing support of teachers. PMID:18329189

Assessing the Comprehensive Soldier Fitness Program: Measuring Startle Response and Prepulse Inhibition

DTIC Science & Technology

2011-04-01

increase PPI, but dopamine agonists can have the opposite effect by reducing PPI. Fortunately, caffeine appears to have no significant effect on PPI...violent behavior, and sexual risk behavior. Landis, C., & Hunt, W.A. (1939). The Startle Pattern. New York: Farrar. An example of early research on

Harm Reduction for Cannabis: Factor Analysis of a Protective Behavioral Strategies Survey

ERIC Educational Resources Information Center

Caffrey, Kathleen S.; Wright, Bruce R.; Maarhuis, Patricia L.

2018-01-01

Objective: To examine the psychometric properties of a measure of cannabis-specific Protective Behavioral Strategies (PBS), which assesses ways in which students may reduce cannabis-related risk. Participants: Respondents to the American College Health Association-National College Health Assessment II (N = 580) during Spring 2015. Methods:…

Universal Screening for Behavioral and Emotional Risk: A Promising Method for Reducing Disproportionate Placement in Special Education

ERIC Educational Resources Information Center

Raines, Tara C.; Dever, Bridget V.; Kamphaus, Randy W.; Roach, Andrew T.

2012-01-01

The overrepresentation of U.S. minority students identified for emotional and behavior disorders special education programs plagues schools and challenges researchers and practitioners. Arcane methods including teacher nomination continue to guide referral processes, despite compelling evidence of their influence on disproportionate special…

Antecedent-Based Interventions for Young Children at Risk for Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Park, Kristy L.; Scott, Terrance M.

2009-01-01

Following descriptive functional assessment procedures, a brief structural analysis was used to confirm the hypothesized antecedent conditions that preceded problem behavior across three children enrolled in Head Start classrooms. A withdrawal design investigated the effectiveness of antecedent-based interventions to reduce disruptive behaviors…

Effect of STOP technique on safety climate in a construction company.

PubMed

Darvishi, Ebrahim; Maleki, Afshin; Dehestaniathar, Saeed; Ebrahemzadih, Mehrzad

2015-01-01

Safety programs are a core part of safety management in workplaces that can reduce incidents and injuries. The aim of this study was to investigate the influence of Safety Training Observation Program (STOP) technique as a behavior modification program on safety climate in a construction company. This cross-sectional study was carried out on workers of the Petrochemical Construction Company, western Iran. In order to improve safety climate, an unsafe behavior modification program entitled STOP was launched among workers of project during 12 months from April 2013 and April 2014. The STOP technique effectiveness in creating a positive safety climate was evaluated using the Safety Climate Assessment Toolkit. 76.78% of total behaviors were unsafe. 54.76% of total unsafe acts/ at-risk behaviors were related to the fall hazard. The most cause of unsafe behaviors was associated with habit and unavailability of safety equipment. After 12 month of continuous implementation the STOP technique, 55.8% of unsafe behaviors reduced among workers. The average score of safety climate evaluated using of the Toolkit, before and after the implementation of the STOP technique was 5.77 and 7.24, respectively. The STOP technique can be considered as effective approach for eliminating at-risk behavior, reinforcing safe work practices, and creating a positive safety climate in order to reduction incidents/injuries.

Hunger and Behavioral Risk Factors for Noncommunicable Diseases in School-Going Adolescents in Bolivia, 2012.

PubMed

Romo, Matthew L

2016-04-21

Hunger may play a role in noncommunicable disease (NCD) risk. This study used the 2012 Global School-based Student Health Survey from Bolivia to determine the association between hunger and risk factors for NCDs among adolescents. Hunger was associated with increased odds of nondaily fruit and vegetable consumption (adjusted odds ratio [AOR] = 1.21; P < .001), inadequate physical activity (AOR = 1.21; P = .001), and current tobacco use (hunger sometimes [AOR = 1.83; P < .001] or most of the time/always [AOR = 2.12; P < .001]). Interventions to reduce the burden of NCDs in Bolivia should address hunger, in addition to traditional behavioral risk factors.

Hunger and Behavioral Risk Factors for Noncommunicable Diseases in School-Going Adolescents in Bolivia, 2012

PubMed Central

2016-01-01

Hunger may play a role in noncommunicable disease (NCD) risk. This study used the 2012 Global School-based Student Health Survey from Bolivia to determine the association between hunger and risk factors for NCDs among adolescents. Hunger was associated with increased odds of nondaily fruit and vegetable consumption (adjusted odds ratio [AOR] = 1.21; P < .001), inadequate physical activity (AOR = 1.21; P = .001), and current tobacco use (hunger sometimes [AOR = 1.83; P < .001] or most of the time/always [AOR = 2.12; P < .001]). Interventions to reduce the burden of NCDs in Bolivia should address hunger, in addition to traditional behavioral risk factors. PMID:27103264

Skip the Trip: Air Travelers' Behavioral Responses to Pandemic Influenza

PubMed Central

Fenichel, Eli P.; Kuminoff, Nicolai V.; Chowell, Gerardo

2013-01-01

Theory suggests that human behavior has implications for disease spread. We examine the hypothesis that individuals engage in voluntary defensive behavior during an epidemic. We estimate the number of passengers missing previously purchased flights as a function of concern for swine flu or A/H1N1 influenza using 1.7 million detailed flight records, Google Trends, and the World Health Organization's FluNet data. We estimate that concern over “swine flu,” as measured by Google Trends, accounted for 0.34% of missed flights during the epidemic. The Google Trends data correlates strongly with media attention, but poorly (at times negatively) with reported cases in FluNet. Passengers show no response to reported cases. Passengers skipping their purchased trips forwent at least $50 M in travel related benefits. Responding to actual cases would have cut this estimate in half. Thus, people appear to respond to an epidemic by voluntarily engaging in self-protection behavior, but this behavior may not be responsive to objective measures of risk. Clearer risk communication could substantially reduce epidemic costs. People undertaking costly risk reduction behavior, for example, forgoing nonrefundable flights, suggests they may also make less costly behavior adjustments to avoid infection. Accounting for defensive behaviors may be important for forecasting epidemics, but linking behavior with epidemics likely requires consideration of risk communication. PMID:23526970

Does life history predict risk-taking behavior of wintering dabbling ducks?

USGS Publications Warehouse

Ackerman, Joshua T.; Eadie, J.M.; Moore, T.G.

2006-01-01

Life-history theory predicts that longer-lived, less fecund species should take fewer risks when exposed to predation than shorter-lived, more fecund species. We tested this prediction for seven species of dabbling ducks (Anas) by measuring the approach behavior (behavior of ducks when approaching potential landing sites) of 1099 duck flocks during 37 hunting trials and 491 flocks during 13 trials conducted immediately after the 1999-2000 waterfowl hunting season in California, USA. We also experimentally manipulated the attractiveness of the study site by using two decoy treatments: (1) traditional, stationary decoys only, and (2) traditional decoys in conjunction with a mechanical spinning-wing decoy. Approach behavior of ducks was strongly correlated with their life history. Minimum approach distance was negatively correlated with reproductive output during each decoy treatment and trial type. Similarly, the proportion of flocks taking risk (approaching landing sites to within 45 m) was positively correlated with reproductive output. We found similar patterns of approach behavior in relation to other life-history parameters (i.e., adult female body mass and annual adult female survival rate). Thus, species characterized by a slower life-history strategy (e.g., Northern Pintail [A. acuta]) were more risk-averse than species with a faster life-history strategy (e.g., Cinnamon Teal [A. cyanoptera]). Furthermore, although we were able to reduce risk-averseness using the spinning-wing decoy, we were unable to override the influence of life history on risk-taking behavior. Alternative explanations did not account for the observed correlation between approach behavior and life-history parameters. These results suggest that life history influences the risk-taking behavior of dabbling ducks and provide an explanation for the differential vulnerability of waterfowl to harvest. ?? The Cooper Ornithological Society 2006.

Translating evidence based violence and drug use prevention to obesity prevention: development and construction of the pathways program.

PubMed

Sakuma, Kari-Lyn K; Riggs, Nathaniel R; Pentz, Mary Ann

2012-04-01

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health, a school-based obesity prevention program that was developed by translating from evidence-based violence and drug use prevention programs, Promoting Alternative THinking Strategies and the Midwestern Prevention Project STAR (STAR). We illustrate how a hypothesized underlying behavior change mechanism in two domains of risk behavior, violence and substance use, can be applied to obesity prevention. A 4-step translational process is provided and may be relevant for use in developing other curricula to address multiple health risk behaviors. Practical application and decision points are also provided.

Translating evidence based violence and drug use prevention to obesity prevention: development and construction of the Pathways program

PubMed Central

Sakuma, Kari-Lyn K.; Riggs, Nathaniel R.; Pentz, Mary Ann

2012-01-01

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health, a school-based obesity prevention program that was developed by translating from evidence-based violence and drug use prevention programs, Promoting Alternative THinking Strategies and the Midwestern Prevention Project STAR (STAR). We illustrate how a hypothesized underlying behavior change mechanism in two domains of risk behavior, violence and substance use, can be applied to obesity prevention. A 4-step translational process is provided and may be relevant for use in developing other curricula to address multiple health risk behaviors. Practical application and decision points are also provided. PMID:21987475

A qualitative study of lung cancer risk perceptions and smoking beliefs among national lung screening trial participants.

PubMed

Park, Elyse R; Streck, Joanna M; Gareen, Ilana F; Ostroff, Jamie S; Hyland, Kelly A; Rigotti, Nancy A; Pajolek, Hannah; Nichter, Mark

2014-02-01

The National Comprehensive Cancer Network and the American Cancer Society recently released lung screening guidelines that include smoking cessation counseling for smokers undergoing screening. Previous work indicates that smoking behaviors and risk perceptions of the National Lung Screening Trial (NLST) participants were relatively unchanged. We explored American College of Radiology Imaging Network (ACRIN)/NLST former and current smokers' risk perceptions specifically to (a) determine whether lung screening is a cue for behavior change, (b) elucidate risk perceptions for lung cancer and smoking-related diseases, and (c) explore postscreening behavioral intentions and changes. A random sample of 35 participants from 4 ACRIN sites were qualitatively interviewed 1-2 years postscreen. We used a structured interview guide based on Health Belief Model and Self-Regulation Model constructs. Content analyses were conducted with NVivo 8. Most participants endorsed high-risk perceptions for lung cancer and smoking-related diseases, but heightened concern about these risks did not appear to motivate participants to seek screening. Risk perceptions were mostly attributed to participants' heavy smoking histories; former smokers expressed greatly reduced risk. Lung cancer and smoking-related diseases were perceived as very severe although participants endorsed low worry. Current smokers had low confidence in their ability to quit, and none reported quitting following their initial screen. Lung screening did not appear to be a behavior change cue to action, and high-risk perceptions did not translate into quitting behaviors. Cognitive and emotional dissonance and avoidance strategies may deter engagement in smoking behavior change. Smoking cessation and prevention interventions during lung screening should explore risk perceptions, emotions, and quit confidence.

A Qualitative Study of Lung Cancer Risk Perceptions and Smoking Beliefs Among National Lung Screening Trial Participants

PubMed Central

2014-01-01

Introduction: The National Comprehensive Cancer Network and the American Cancer Society recently released lung screening guidelines that include smoking cessation counseling for smokers undergoing screening. Previous work indicates that smoking behaviors and risk perceptions of the National Lung Screening Trial (NLST) participants were relatively unchanged. We explored American College of Radiology Imaging Network (ACRIN)/NLST former and current smokers’ risk perceptions specifically to (a) determine whether lung screening is a cue for behavior change, (b) elucidate risk perceptions for lung cancer and smoking-related diseases, and (c) explore postscreening behavioral intentions and changes. Methods: A random sample of 35 participants from 4 ACRIN sites were qualitatively interviewed 1–2 years postscreen. We used a structured interview guide based on Health Belief Model and Self-Regulation Model constructs. Content analyses were conducted with NVivo 8. Results: Most participants endorsed high-risk perceptions for lung cancer and smoking-related diseases, but heightened concern about these risks did not appear to motivate participants to seek screening. Risk perceptions were mostly attributed to participants’ heavy smoking histories; former smokers expressed greatly reduced risk. Lung cancer and smoking-related diseases were perceived as very severe although participants endorsed low worry. Current smokers had low confidence in their ability to quit, and none reported quitting following their initial screen. Conclusions: Lung screening did not appear to be a behavior change cue to action, and high-risk perceptions did not translate into quitting behaviors. Cognitive and emotional dissonance and avoidance strategies may deter engagement in smoking behavior change. Smoking cessation and prevention interventions during lung screening should explore risk perceptions, emotions, and quit confidence. PMID:23999653

Personality Traits, Perceived Risk, and Risk-Reduction Behaviors: A Further Study of Smoking and Radon

PubMed Central

Hampson, Sarah E.; Andrews, Judy A.; Barckley, Maureen; Lichtenstein, Edward; Lee, Michael E.

2008-01-01

Personality traits and risk perceptions were examined as predictors of changes in smoking behavior. Participants (N = 697) were part of a randomized controlled trial of interventions to reduce exposure to the combined hazard of radon and cigarette smoke. Participants with higher perceived risk at baseline for the combination of smoking and radon were more likely to have a more restrictive household smoking ban in place at 12 months follow-up (p <. 05). Risk perceptions also predicted reductions in the total number of cigarettes smoked in the home for participants in the video intervention who had high or moderate levels of Extraversion (p <.001). Greater perceived risk predicted quitting for highly or moderately conscientious women (p <.05). The moderating effects of personality traits should be considered when evaluating risk-reduction interventions. PMID:16846328

A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru.

PubMed

Vagenas, Panagiotis; Brown, Shan-Estelle; Clark, Jesse L; Konda, Kelika A; Lama, Javier R; Sánchez, Jorge; Duerr, Ann C; Altice, Frederick L

2017-06-07

Peruvian men who have sex with men (MSM) and transgender women (TGW) experience the double burden of a highly concentrated HIV epidemic with a high prevalence of alcohol use disorders (AUDs). Recent research has associated both with risky sexual behaviors, including unprotected sex, having multiple sexual partners, engaging in sex work, having recent sexually transmitted infections, and having HIV-infected partners. AUDs have also been associated in MSM/TGW with being unaware of HIV+ status. This study aims to further examine issues associated with alcohol consumption, HIV infection, and risk behaviors in a qualitative analysis of focus groups conducted with MSM/TGW in Peru. A total of 26 MSM/TGW participants with AUDs participated in three semi-structured focus groups in Lima, Peru. Content analysis was facilitated by software, and specific themes were elucidated. Participants described their drinking patterns, including the types of alcoholic drinks they consumed. They depicted drinking frequently and over multiple-day sessions. Problematic drinking behaviors were described, as well as the perceived characteristics of alcohol dependence. Interestingly, HIV-infected participants who were prescribed antiretroviral therapy did not believe that their drinking affected their medication adherence. These insights can aid in the design of future interventions aiming to reduce problematic drinking as well as HIV-related risk behaviors and, subsequently, HIV incidence. Peruvian MSM/TGW exhibit problematic drinking, which may be associated with risky sexual behaviors and HIV transmission. Interest in reducing alcohol consumption was high, suggesting the need for targeted behavioral and pharmacological interventions.

Problem Behaviors among Israeli Undergraduate Students: Applying Jessor’s Problem Behavior Theory among Young Adult Students

PubMed Central

Korn, Liat; Shaked, Yael; Fogel-Grinvald, Haya

2014-01-01

Purpose: The current study tested the applicability of Jessor’s problem behavior theory (PBT) in Ariel University. Methods: A structured, self-reported, anonymous questionnaire was administered to undergraduate students. The final study sample included 1,360 participants (882 females and 478 males, mean age 25, SD = 2.9, range = 17). Results: Findings indicated that the PBT was replicated in this sample. As shown from the hierarchal linear regression model, religiosity and high-academic achievements were found to be strong and significant protective factors that reduce risk behaviors. Among young and religious students, the personal vulnerability has almost no impact on involvement in risk behaviors. Conclusion: The PBT finds empirical support in this young adult undergraduate Israeli sample. PMID:25566519

Effectiveness of HIV prevention social marketing with injecting drug users.

PubMed

Gibson, David R; Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M

2010-10-01

Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide.

Neighborhoods and HIV: A Social Ecological Approach to Prevention and Care

PubMed Central

Latkin, Carl A.; German, Danielle; Vlahov, David

2013-01-01

Neighborhood factors have been linked to HIV risk behaviors, HIV counseling and testing, and HIV medical care. However, the social–psychological mechanisms that connect neighborhood factors to HIV-related behaviors have not been fully determined. In this paper we review the research on neighborhood factors and HIV-related behaviors, approaches to measuring neighborhoods, and mechanism that may help to explain how the physical and social environment within neighborhoods may lead to HIV related behaviors. We then discuss organizational, geographic, and social network approaches to intervene in neighborhoods to reduce HIV transmission and facilitate HIV medical care with the goal of reducing morbidity and mortality and increasing social and psychological well-being. PMID:23688089

Bullying and HIV Risk Among High School Teenagers: The Mediating Role of Teen Dating Violence.

PubMed

Okumu, Moses; Mengo, Cecilia; Ombayo, Bernadette; Small, Eusebius

2017-10-01

Teen dating violence (TDV), bullying, and HIV risk behaviors are public health concerns that impact adolescents in the United States. National estimates reveal high rates of these risk behaviors among high school students. Based on theoretical and empirical evidence, we hypothesized that experiencing teen dating violence (sexual and physical) would mediate the impact of bullying on HIV risk. Data were from the 2013 National Youth Behavior Risk Surveillance Survey (YRBSS) among students who answered questions on bullying, TDV, and HIV risk (N = 13,571). The YRBSS is conducted biennially among 9th- to 12th-grade students nationally. We used multiple regression analysis and Hayes' SPSS process macro to examine the 2 study hypotheses. Findings from bivariate analysis suggest an association between bullying and HIV risk. The study also found associations between physical, sexual teen dating violence and HIV risk. Results also indicate that both physical and sexual teen dating violence mediate the association between bullying and HIV risk. Our findings suggest that multidimensional interventions should be developed to reduce the rate of teen dating violence and combat bullying as a preventative method for HIV risk among high school students. © 2017, American School Health Association.

Knowledge, attitudes, and practices regarding antiretroviral management, reproductive health, sexually transmitted infections, and sexual risk behavior among perinatally HIV-infected youth in Thailand.

PubMed

Lolekha, Rangsima; Boon-Yasidhi, Vitharon; Leowsrisook, Pimsiri; Naiwatanakul, Thananda; Durier, Yuitiang; Nuchanard, Wipada; Tarugsa, Jariya; Punpanich, Warunee; Pattanasin, Sarika; Chokephaibulkit, Kulkanya

2015-01-01

More than 30% of perinatally HIV-infected children in Thailand are 12 years and older. As these youth become sexually active, there is a risk that they will transmit HIV to their partners. Data on the knowledge, attitudes, and practices (KAP) of HIV-infected youth in Thailand are limited. Therefore, we assessed the KAP of perinatally HIV-infected youth and youth reporting sexual risk behaviors receiving care at two tertiary care hospitals in Bangkok, Thailand and living in an orphanage in Lopburi, Thailand. From October 2010 to July 2011, 197 HIV-infected youth completed an audio computer-assisted self-interview to assess their KAP regarding antiretroviral (ARV) management, reproductive health, sexual risk behaviors, and sexually transmitted infections (STIs). A majority of youth in this study correctly answered questions about HIV transmission and prevention and the importance of taking ARVs regularly. More than half of the youth in this study demonstrated a lack of family planning, reproductive health, and STI knowledge. Girls had more appropriate attitudes toward safe sex and risk behaviors than boys. Although only 5% of the youth reported that they had engaged in sexual intercourse, about a third reported sexual risk behaviors (e.g., having or kissing boy/girlfriend or consuming an alcoholic beverage). We found low condom use and other family planning practices, increasing the risk of HIV and/or STI transmission to sexual partners. Additional resources are needed to improve reproductive health knowledge and reduce risk behavior among HIV-infected youth in Thailand.

Family Financial Stress and Adolescent Sexual Risk-Taking: The Role of Self-Regulation.

PubMed

Crandall, AliceAnn; Magnusson, Brianna M; Novilla, M Lelinneth B; Novilla, Lynneth Kirsten B; Dyer, W Justin

2017-01-01

The ability to control one's emotions, thoughts, and behaviors is known as self-regulation. Family stress and low adolescent self-regulation have been linked with increased engagement in risky sexual behaviors, which peak in late adolescence and early adulthood. The purpose of this study was to assess whether adolescent self-regulation, measured by parent and adolescent self-report and respiratory sinus arrhythmia, mediates or moderates the relationship between family financial stress and risky sexual behaviors. We assessed these relationships in a 4-year longitudinal sample of 450 adolescents (52 % female; 70 % white) and their parents using structural equation modeling. Results indicated that high family financial stress predicts engagement in risky sexual behaviors as mediated, but not moderated, by adolescent self-regulation. The results suggest that adolescent self-regulatory capacities are a mechanism through which proximal external forces influence adolescent risk-taking. Promoting adolescent self-regulation, especially in the face of external stressors, may be an important method to reduce risk-taking behaviors as adolescents transition to adulthood.

Evidence-based HIV/STD prevention intervention for black men who have sex with men.

PubMed

Herbst, Jeffrey H; Painter, Thomas M; Tomlinson, Hank L; Alvarez, Maria E

2014-04-18

This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States. 3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs.

Evaluation of a Drowning Prevention Program Based on Testimonial Videos: A Randomized Controlled Trial

PubMed Central

Pang, Shulan; Schwebel, David C.

2016-01-01

Objective Unintentional drowning is the most common cause of childhood death in rural China. Global intervention efforts offer mixed results regarding the efficacy of educational programs. Methods Using a randomized controlled design, we evaluated a testimonial-based intervention to reduce drowning risk among 280 3rd- and 4th-grade rural Chinese children. Children were randomly assigned to view either testimonials on drowning risk (intervention) or dog-bite risk (control). Safety knowledge and perceived vulnerability were measured by self-report questionnaires, and simulated behaviors in and near water were assessed with a culturally appropriate dollhouse task. Results Children in the intervention group had improved children’s safety knowledge and simulated behaviors but not perceived vulnerability compared with controls. Conclusions The testimonial-based intervention’s efficacy appears promising, as it improved safety knowledge and simulated risk behaviors with water among rural Chinese children. PMID:26546476

Male Enchenopa treehoppers (Hemiptera: Membracidae) vary mate-searching behavior but not signaling behavior in response to spider silk

NASA Astrophysics Data System (ADS)

Fowler-Finn, Kasey D.; Al-Wathiqui, Nooria; Cruz, Daniel; Al-Wathiqui, Mishal; Rodríguez, Rafael L.

2014-03-01

Finding and attracting mates can impose costs on males in terms of increased encounters with, and attraction of, predators. To decrease the likelihood of predation, males may modify mate-acquisition efforts in two main ways: they may reduce mate-searching efforts or they may reduce mate-attraction efforts. The specific behavior that males change in the presence of predator cues should depend upon the nature of risk imposed by the type of predator present in the environment. For example, sit-and-wait predators impose greater costs to males moving in search of mates. Here, we test whether cues of the presence of a sit-and-wait predator lead to a reduction in mate-searching but not mate-acquisition behavior. We used a member of the Enchenopa binotata complex of treehoppers—a clade of vibrationally communicating insects in which males fly in search of mates and produce mate-attraction signals when they land on plant stems. We tested for changes in mate-searching and signaling behaviors when silk from a web-building spider was present or absent. We found that males delayed flight when spider silk was present but only if they were actively searching for mates. These results suggest that males have been selected to reduce predation risk by adjusting how they move about their environment according to the cues of sit-and-wait predators.

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

PubMed Central

El-Bassel, Nabila

2015-01-01

We conducted a systematic review of couple-based HIV biobehavioral (skills-building, VCT, and adherence) and biomedical (ART, circumcision) prevention and intervention studies designed to reduce sexual-and drug-risk behaviors and HIV transmission and acquisition. Of the 11,162 papers identified in the search, 93 peer-reviewed papers met the inclusion criteria and yielded a total of 33 studies conducted globally. Biobehavioral couple-based prevention and intervention studies have been efficacious in reducing sexual- and drug-risk behaviors, increasing access to HIV testing and care, and improving adherence. Biomedical couple-based studies were found to reduce HIV incidence among HIV-negative sex partners and viral load among HIV-positive partners. Despite much progress, couple-based HIV prevention and intervention studies remain limited; a number of methodological gaps exist and studies focusing on MSM, people who inject drugs, and sex workers are scarce. PMID:24980246

Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors?

PubMed

Shaw, William S; Linton, Steven J; Pransky, Glenn

2006-12-01

To assess, from the review literature, the extent to which effective strategies for reducing work absence after acute low back pain (LBP) match empirical risk factors. From 17 recent review articles (2000-2005), disability risk factors and interventions were cross-tabulated to assess levels of relative concordance. Potentially modifiable risk factors included 23 variables describing 3 workplace and 3 personal domains. Effective interventions included 25 strategies that were personal (physical or behavioral), engineering, or administrative in nature. There was a strong risk factor concordance for workplace technical and organizational interventions, graded activity exposure, and cognitive restructuring of pain beliefs. There was less risk factor concordance for exercise, back education, and RTW coordination. Few interventions focused on relieving emotional distress or improving job dissatisfaction, two well-supported risk factors. Gaps between the epidemiological and intervention research of back disability prevention could be reduced by testing mediators of intervention effects or by stratifying outcomes according to pre-intervention risk factors.

Exacerbated vulnerability of coupled socio-economic risk in complex networks

NASA Astrophysics Data System (ADS)

Zhang, Xin; Feng, Ling; Berman, Yonatan; Hu, Ning; Stanley, H. Eugene

2016-10-01

The study of risk contagion in economic networks has most often focused on the financial liquidities of institutions and assets. In practice the agents in a network affect each other through social contagion, i.e., through herd behavior and the tendency to follow leaders. We study the coupled risk between social and economic contagion and find it significantly more severe than when economic risk is considered alone. Using the empirical network from the China venture capital market we find that the system exhibits an extreme risk of abrupt phase transition and large-scale damage, which is in clear contrast to the smooth phase transition traditionally observed in economic contagion alone. We also find that network structure impacts market resilience and that the randomization of the social network of the market participants can reduce system fragility when there is herd behavior. Our work indicates that under coupled contagion mechanisms network resilience can exhibit a fundamentally different behavior, i.e., an abrupt transition. It also reveals the extreme risk when a system has coupled socio-economic risks, and this could be of interest to both policy makers and market practitioners.

Examining the Efficacy of HIV Risk-Reduction Counseling on the Sexual Risk Behaviors of a National Sample of Drug Abuse Treatment Clients: Analysis of Subgroups.

PubMed

Gooden, Lauren; Metsch, Lisa R; Pereyra, Margaret R; Malotte, C Kevin; Haynes, Louise F; Douaihy, Antoine; Chally, Jack; Mandler, Raul N; Feaster, Daniel J

2016-09-01

HIV counseling with testing has been part of HIV prevention in the U.S. since the 1980s. Despite the long-standing history of HIV testing with prevention counseling, the CDC released HIV testing recommendations for health care settings contesting benefits of prevention counseling with testing in reducing sexual risk behaviors among HIV-negatives in 2006. Efficacy of brief HIV risk-reduction counseling (RRC) in decreasing sexual risk among subgroups of substance use treatment clients was examined using multi-site RCT data. Interaction tests between RRC and subgroups were performed; multivariable regression evaluated the relationship between RRC (with rapid testing) and sex risk. Subgroups were defined by demographics, risk type and level, attitudes/perceptions, and behavioral history. There was an effect (p < .0028) of counseling on number of sex partners among some subgroups. Certain subgroups may benefit from HIV RRC; this should be examined in studies with larger sample sizes, designed to assess the specific subgroup(s).

Stages of Behavioral Change for Reducing Sodium Intake in Korean Consumers: Comparison of Characteristics Based on Social Cognitive Theory.

PubMed

Ahn, So-Hyun; Kwon, Jong Sook; Kim, Kyungmin; Kim, Hye-Kyeong

2017-07-27

High sodium intake increases the risk of cardiovascular disease. Given the importance of behavioral changes to reducing sodium intake, this study aims to investigate the stages of change and the differences in cognitive and behavioral characteristics by stage in Korean consumers. Adult participants ( N = 3892) completed a questionnaire on the stages of behavioral change, recognition of social efforts, outcome expectancy, barriers to practice, nutrition knowledge and dietary behaviors, and self-efficiency related to reduced sodium intake. The numbers of participants in each stage of behavioral change for reducing sodium intake was 29.5% in the maintenance stage, 19.5% in the action stage, and 51.0% in the preaction stage that included the precontemplation, contemplation, and preparation stages. Multiple logistic regression showed that the factors differentiating the three stages were recognizing a supportive social environment, perceived barriers to the practice of reducing sodium intake, and self-efficacy to be conscious of sodium content and to request less salt when eating out. Purchasing experience of sodium-reduced products for salty foods, knowledge of the recommended intake of salt and the difference between sodium and salt, and improving dietary habits of eating salted fish, processed food, and salty snacks were factors for being in the action stage versus the preaction stage. These findings suggest that tailored intervention according to the characteristics of each stage is helpful in reducing sodium intake.

From health as a rational choice to health as an affordable choice.

PubMed

Maziak, Wasim; Ward, Kenneth D

2009-12-01

Sedentary, consumption-based lifestyles are placing entire populations at serious health risks; obesity is a prime example. The individual approach to obesity, which targets those at risk, has largely failed because it ignores wider influences on behavior. Although the population-ecological approach is gaining support, it cannot disentangle clear targets for policy change. Consequently, health promotion has been relegated to the mass marketing of healthy behaviors, which is based on a rational notion that informed people tend to behave in their best interest. Creating environments that support behavior change and providing individuals incentives can be more effective to reduce lifestyle-related risks. A paradigm shift from trying to sell health to the public to creating the conditions whereby healthy choices become accessible and affordable is required.

From Health as a Rational Choice to Health as an Affordable Choice

PubMed Central

Ward, Kenneth D.

2009-01-01

Sedentary, consumption-based lifestyles are placing entire populations at serious health risks; obesity is a prime example. The individual approach to obesity, which targets those at risk, has largely failed because it ignores wider influences on behavior. Although the population–ecological approach is gaining support, it cannot disentangle clear targets for policy change. Consequently, health promotion has been relegated to the mass marketing of healthy behaviors, which is based on a rational notion that informed people tend to behave in their best interest. Creating environments that support behavior change and providing individuals incentives can be more effective to reduce lifestyle-related risks. A paradigm shift from trying to sell health to the public to creating the conditions whereby healthy choices become accessible and affordable is required. PMID:19833991

Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men

PubMed Central

Semple, Shirley J.; Strathdee, Steffanie A.; Zians, Jim; McQuaid, John R.; Patterson, Thomas L.

2011-01-01

Drug assertiveness skills have been demonstrated effective in reducing substance use behaviors among patients with alcohol- or heroin-use disorders. This study examined the association between drug assertiveness and methamphetamine use, psychological factors, and sexual risk behaviors in a sample of 250 HIV-positive men who have sex with men (MSM) enrolled in a safer sex intervention in San Diego, CA. Less assertiveness in turning down drugs was associated with greater frequency and larger amounts of methamphetamine use, lower self-esteem, higher scores on a measure of sexual sensation-seeking, and greater attendance at risky sexual venues. These data suggest that drug assertiveness training should be incorporated into drug abuse treatment programs and other risk reduction interventions for methamphetamine users. PMID:21550758

Wildfire risk in the wildland-urban interface: A simulation study in northwestern Wisconsin

Treesearch

Avi Bar Massada; Volker C. Radeloff; Susan I. Stewart; Todd J. Hawbaker

2009-01-01

The rapid growth of housing in and near the wildland-urban interface (WUI) increases wildfire risk to lives and structures. To reduce fire risk, it is necessary to identify WUI housing areas that are more susceptible to wildfire. This is challenging, because wildfire patterns depend on fire behavior and spread, which in turn depend on ignition locations, weather...

Risk Reduction Therapy for Adolescents: Targeting Substance Use and HIV/STI-Risk Behaviors

PubMed Central

McCart, Michael R.; Sheidow, Ashli J.; Letourneau, Elizabeth J.

2014-01-01

This paper describes a family-based intervention for addressing both substance use and unprotected sexual behavior in adolescents presenting for outpatient substance use treatment. The intervention combines contingency management (CM) for adolescent substance use, which is a behavioral intervention modeled on the Community Reinforcement Approach, with a sexual risk reduction protocol that mirrors aspects of the CM model. As a family-based intervention, caregivers attend every session and actively collaborate with the therapist to address their youth’s behavior problems. The treatment is criterion-based with treatment duration determined by the youth’s achievement of reduced substance use and unprotected sexual behavior goals. A case study describes the implementation of this treatment with an adolescent presenting a history of polysubstance use and unprotected sexual intercourse. Following the adolescent and caregiver’s participation in weekly sessions, the adolescent demonstrated improvements in substance use, unprotected sexual behavior, and other behavior problems. Clinical summary data from two outpatient clinics reveal similar positive outcomes for youth receiving the intervention. This paper illustrates the potential utility of an integrated treatment approach targeting substance use and unprotected sexual behavior in an adolescent population. PMID:25419101

Multidimensional family therapy HIV/STD risk-reduction intervention: an integrative family-based model for drug-involved juvenile offenders.

PubMed

Marvel, Francoise; Rowe, Cynthia L; Colon-Perez, Lissette; DiClemente, Ralph J; Liddle, Howard A

2009-03-01

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 Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies (www.cjdats.org). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/ STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.

"There's No Place Like Home": Perceptions of Home-Based HIV Testing in Lesotho

ERIC Educational Resources Information Center

Mantell, J. E.; DiCarlo, A. L.; Remien, R. H.; Zerbe, A.; Morris, D.; Pitt, B.; Nkonyana, J. P.; Abrams, E. J.; El-Sadr, W.

2014-01-01

HIV testing has the potential to reduce HIV transmission by identifying and counseling individuals with HIV, reducing risk behaviors, linking persons with HIV to care and earlier treatment, and reducing perinatal transmission. In Lesotho, a high HIV prevalence country in which a large proportion of the population has never tested for HIV,…

Examining links between sexual risk behaviors and dating violence involvement as a function of sexual orientation.

PubMed

Hipwell, A E; Stepp, S D; Keenan, K; Allen, A; Hoffmann, A; Rottingen, L; McAloon, R

2013-08-01

To examine the association between dating violence perpetration and victimization and sexually risky behaviors among sexual minority and heterosexual adolescent girls. Adolescent girls reported on sexual orientation, sexual behaviors, and risk-taking, and their use of, and experience with, dating violence in the past year. Data were analyzed using multinomial regression adjusted for race, poverty, living in a single parent household, and gender of current partner to examine (1) whether sexual minority status was associated with sexual risk behaviors after sociodemographic correlates of sexual risk were controlled; and (2) whether dating violence context accounted for elevated risk. Urban, population-based sample of girls interviewed in the home. 1,647 adolescent girls (38% European American, 57% African American, and 5% other) aged 17 years. Over one-third of the sample lived in poverty. None. Sexual risk-taking. Sexual minority status differentiated girls engaging in high sexual risk-taking from those reporting none, after controlling for sociodemographic and relationship characteristics. Dating violence perpetration and victimization made unique additional contributions to this model and did not account for the elevated risk conferred by sexual minority status. Sexual minority girls (SMGs) were more likely than heterosexual girls to report high sexual risk-taking and teen dating violence victimization. As with heterosexual girls, sexual risk-taking among SMGs was compounded by dating violence, which was not explained by partner gender. Adolescent girls' risky sexual behavior may be reduced by interventions for teen dating violence regardless of sexual minority status. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Examining links between sexual risk behaviors and dating violence involvement as a function of sexual orientation

PubMed Central

Hipwell, A.E.; Stepp, S.D.; Keenan, K.; Allen, A.; Hoffmann, A.; Rottingen, L.; McAloon, R.

2013-01-01

Study Objective To examine the association between dating violence perpetration and victimization and sexually risky behaviors among sexual minority and heterosexual adolescent girls. Design Adolescent girls reported on sexual orientation, sexual behaviors and risk-taking, and their use of and experience with dating violence in the past year. Data were analyzed using multinomial regression adjusted for race, poverty, living in a single parent household, and gender of current partner to examine (1) whether sexual minority status was associated with sexual risk behaviors after sociodemographic correlates of sexual risk were controlled; and (2) whether dating violence context accounted for elevated risk. Setting Urban, population-based sample of girls interviewed in the home. Participants 1,647 adolescent girls (38% European American, 57% African American, and 5% other) aged 17 years. Over one third of the sample lived in poverty. Interventions None. Main Outcome Measure Sexual risk-taking. Results Sexual minority status differentiated girls engaging in high sexual risk-taking from those reporting none, after controlling for sociodemographic and relationship characteristics. Dating violence perpetration and victimization made unique additional contributions to this model, and did not account for the elevated risk conferred by sexual minority status. Conclusions Sexual minority girls (SMGs) were more likely than heterosexual girls to report high sexual risk-taking and teen dating violence victimization. As with heterosexual girls, sexual risk-taking among SMGs was compounded by dating violence, which was not explained by partner gender. Adolescent girls’ risky sexual behavior may be reduced by interventions for teen dating violence regardless of sexual minority status. PMID:23726138

Reducing Adolescent Risk: Toward an Integrated Approach.

ERIC Educational Resources Information Center

Romer, David, Ed.

This collection of papers focuses on common influences that result in a number of interrelated risk behaviors, summarizing presentations and discussions from a recent conference at which a group of specialists from different health traditions synthesized current knowledge on the subject. There are 39 papers in four parts. Part 1, "Adolescents…

Teachers' Perceptions of School Connectedness and Risk-Taking in Adolescence

ERIC Educational Resources Information Center

Chapman, Rebekah L.; Buckley, Lisa; Sheehan, Mary; Shochet, Ian M.

2014-01-01

School connectedness has been shown to be an important protective factor in adolescent development, which is associated with reduced risk-taking behavior. Interventions to increase students' connectedness to school commonly incorporate aspects of teacher training. To date, however, research on connectedness has largely been based on student survey…

Reputationally Strong HIV Prevention Programs: Lessons from the Front Line

ERIC Educational Resources Information Center

Eke, Agatha N.; Mezoff, Jane S.; Duncan, Ted; Sogolow, Ellen D.

2006-01-01

Although HIV prevention researchers have conducted numerous controlled outcome studies to evaluate the effectiveness of theory-based interventions aimed at reducing HIV risk behaviors, many HIV risk reduction interventions are conducted not by researchers but by staff in local health departments or community-based organizations (CBOs). Despite…

Real and hypothetical monetary rewards modulate risk taking in the brain.

PubMed

Xu, Sihua; Pan, Yu; Wang, You; Spaeth, Andrea M; Qu, Zhe; Rao, Hengyi

2016-07-07

Both real and hypothetical monetary rewards are widely used as reinforcers in risk taking and decision making studies. However, whether real and hypothetical monetary rewards modulate risk taking and decision making in the same manner remains controversial. In this study, we used event-related potentials (ERP) with a balloon analogue risk task (BART) paradigm to examine the effects of real and hypothetical monetary rewards on risk taking in the brain. Behavioral data showed reduced risk taking after negative feedback (money loss) during the BART with real rewards compared to those with hypothetical rewards, suggesting increased loss aversion with real monetary rewards. The ERP data demonstrated a larger feedback-related negativity (FRN) in response to money loss during risk taking with real rewards compared to those with hypothetical rewards, which may reflect greater prediction error or regret emotion after real monetary losses. These findings demonstrate differential effects of real versus hypothetical monetary rewards on risk taking behavior and brain activity, suggesting a caution when drawing conclusions about real choices from hypothetical studies of intended behavior, especially when large rewards are used. The results have implications for future utility of real and hypothetical monetary rewards in studies of risk taking and decision making.

Socioeconomic and Behavioral Risk Factors for Mortality in a National 19-Year Prospective Study of U.S. Adults

PubMed Central

Lantz, Paula M.; Golberstein, Ezra; House, James S.; Morenoff, Jeffrey D.

2012-01-01

Many demographic, socioeconomic, and behavioral risk factors predict mortality in the United States. However, very few population-based longitudinal studies are able to investigate simultaneously the impact of a variety of social factors on mortality. We investigated the degree to which demographic characteristics, socioeconomic variables and major health risk factors were associated with mortality in a nationally-representative sample of 3,617 U.S. adults from 1986-2005, using data from the 4 waves of the Americans’ Changing Lives study. Cox proportional hazard models with time-varying covariates were employed to predict all-cause mortality verified through the National Death Index and death certificate review. The results revealed that low educational attainment was not associated with mortality when income and health risk behaviors were included in the model. The association of low-income with mortality remained after controlling for major behavioral risks. Compared to those in the “normal” weight category, neither overweight nor obesity was significantly associated with the risk of mortality. Among adults age 55 and older at baseline, the risk of mortality was actually reduced for those were overweight (hazard rate ratio=0.83, 95% C.I. = 0.71 – 0.98) and those who were obese (hazard rate ratio=0.68, 95% C.I. = 0.55 – 0.84), controlling for other health risk behaviors and health status. Having a low level of physical activity was a significant risk factor for mortality (hazard rate ratio=1.58, 95% C.I. = 1.20 – 2.07). The results from this national longitudinal study underscore the need for health policies and clinical interventions focusing on the social and behavioral determinants of health, with a particular focus on income security, smoking prevention/cessation, and physical activity. PMID:20226579

Integrated Assessment of Behavioral and Environmental Risk Factors for Lyme Disease Infection on Block Island, Rhode Island

PubMed Central

Krause, Peter J.; Niccolai, Linda; Steeves, Tanner; O’Keefe, Corrine Folsom; Diuk-Wasser, Maria A.

2014-01-01

Peridomestic exposure to Borrelia burgdorferi-infected Ixodes scapularis nymphs is considered the dominant means of infection with black-legged tick-borne pathogens in the eastern United States. Population level studies have detected a positive association between the density of infected nymphs and Lyme disease incidence. At a finer spatial scale within endemic communities, studies have focused on individual level risk behaviors, without accounting for differences in peridomestic nymphal density. This study simultaneously assessed the influence of peridomestic tick exposure risk and human behavior risk factors for Lyme disease infection on Block Island, Rhode Island. Tick exposure risk on Block Island properties was estimated using remotely sensed landscape metrics that strongly correlated with tick density at the individual property level. Behavioral risk factors and Lyme disease serology were assessed using a longitudinal serosurvey study. Significant factors associated with Lyme disease positive serology included one or more self-reported previous Lyme disease episodes, wearing protective clothing during outdoor activities, the average number of hours spent daily in tick habitat, the subject’s age and the density of shrub edges on the subject’s property. The best fit multivariate model included previous Lyme diagnoses and age. The strength of this association with previous Lyme disease suggests that the same sector of the population tends to be repeatedly infected. The second best multivariate model included a combination of environmental and behavioral factors, namely hours spent in vegetation, subject’s age, shrub edge density (increase risk) and wearing protective clothing (decrease risk). Our findings highlight the importance of concurrent evaluation of both environmental and behavioral factors to design interventions to reduce the risk of tick-borne infections. PMID:24416278

Integrated assessment of behavioral and environmental risk factors for Lyme disease infection on Block Island, Rhode Island.

PubMed

Finch, Casey; Al-Damluji, Mohammed Salim; Krause, Peter J; Niccolai, Linda; Steeves, Tanner; O'Keefe, Corrine Folsom; Diuk-Wasser, Maria A

2014-01-01

Peridomestic exposure to Borrelia burgdorferi-infected Ixodes scapularis nymphs is considered the dominant means of infection with black-legged tick-borne pathogens in the eastern United States. Population level studies have detected a positive association between the density of infected nymphs and Lyme disease incidence. At a finer spatial scale within endemic communities, studies have focused on individual level risk behaviors, without accounting for differences in peridomestic nymphal density. This study simultaneously assessed the influence of peridomestic tick exposure risk and human behavior risk factors for Lyme disease infection on Block Island, Rhode Island. Tick exposure risk on Block Island properties was estimated using remotely sensed landscape metrics that strongly correlated with tick density at the individual property level. Behavioral risk factors and Lyme disease serology were assessed using a longitudinal serosurvey study. Significant factors associated with Lyme disease positive serology included one or more self-reported previous Lyme disease episodes, wearing protective clothing during outdoor activities, the average number of hours spent daily in tick habitat, the subject's age and the density of shrub edges on the subject's property. The best fit multivariate model included previous Lyme diagnoses and age. The strength of this association with previous Lyme disease suggests that the same sector of the population tends to be repeatedly infected. The second best multivariate model included a combination of environmental and behavioral factors, namely hours spent in vegetation, subject's age, shrub edge density (increase risk) and wearing protective clothing (decrease risk). Our findings highlight the importance of concurrent evaluation of both environmental and behavioral factors to design interventions to reduce the risk of tick-borne infections.

A problem-solving intervention for cardiovascular disease risk reduction in veterans: Protocol for a randomized controlled trial.

PubMed

Nieuwsma, Jason A; Wray, Laura O; Voils, Corrine I; Gierisch, Jennifer M; Dundon, Margaret; Coffman, Cynthia J; Jackson, George L; Merwin, Rhonda; Vair, Christina; Juntilla, Karen; White-Clark, Courtney; Jeffreys, Amy S; Harris, Amy; Owings, Michael; Marr, Johnpatrick; Edelman, David

2017-09-01

Health behaviors related to diet, tobacco usage, physical activity, medication adherence, and alcohol use are highly determinative of risk for developing cardiovascular disease. This paper describes a study protocol to evaluate a problem-solving intervention that aims to help patients at risk for developing cardiovascular disease address barriers to adopting positive health behaviors in order to reduce cardiovascular risk. Eligible patients are adults enrolled in Veterans Affairs (VA) health care who have not experienced a cardiovascular event but are at elevated risk based on their Framingham Risk Score (FRS). Participants in this two-site study are randomized to either the intervention or care as usual, with a target of 400 participants. The study intervention, Healthy Living Problem-Solving (HELPS), consists of six group sessions conducted approximately monthly interspersed with individualized coaching calls to help participants apply problem-solving principles. The primary outcome is FRS, analyzed at the beginning and end of the study intervention (6months). Participants also complete measures of physical activity, caloric intake, self-efficacy, group cohesion, problem-solving capacities, and demographic characteristics. Results of this trial will inform behavioral interventions to change health behaviors in those at risk for cardiovascular disease and other health conditions. ClinicalTrials.gov identifier NCT01838226. Published by Elsevier Inc.

Does knowledge of coronary artery calcium affect cardiovascular risk perception, likelihood of taking action, and health-promoting behavior change?

PubMed

Johnson, Jennie E; Gulanick, Meg; Penckofer, Sue; Kouba, Joanne

2015-01-01

Evidence indicates that a healthy lifestyle can reduce cardiovascular disease risk, yet many people engage in unhealthy behaviors. New technologies such as coronary artery calcium (CAC) screening detect atherosclerosis before clinical disease is manifested. Knowledge of an abnormal finding could provide the "teachable moment" to enhance motivation for change. The aim of this study was to examine how knowledge of CAC score affects risk perception, likelihood of taking action, and health-promoting behavior change in persons at high risk for cardiovascular disease. This study used a descriptive prospective design with 174 high-risk adults (≥3 major risk factors) recruited at a radiology center offering CAC scans. Baseline self-report surveys using the Perception of Risk of Heart Disease Scale, the Benefits and Barriers Scale, the Quality of Life Index, and the Health-Promoting Lifestyle Profile II were completed immediately after a screening CAC scan but before results were known. Follow-up occurred 3 months later using mailed packets. Participants' mean age was 58 years; 62% were men, 89% were white, and most were well educated. There was no significant change in risk perception scores over time or between groups, except for a positive interaction in the moderate-risk group (CAC scores of 101-400) (P = .004). Quality of life remained unchanged. Health-promoting behavior changes increased in all groups over time (P < .001). McNemar χ² analysis indicated that risk reduction medication use increased in all groups, with a significant increase in statin (P < .001) and aspirin (P < .001) intake. Predictors of behavior change were perceived barriers (β = -.41; P < .001) and quality of life (β = .44; P < .001). Knowledge of CAC score does impact risk perception for some at-risk groups. This knowledge does enhance motivation for behavior change. Knowledge of CAC score does not impact quality of life. It is hoped that through improved understanding of the effect of CAC scoring on behavior change, nurses can better assist patients to modify behaviors during teachable moments.

Gender differences in pathways from child physical and sexual abuse to adolescent risky sexual behavior among high-risk youth.

PubMed

Yoon, Susan; Voith, Laura A; Kobulsky, Julia M

2018-04-01

This study investigated gender differences in the roles of internalizing and externalizing symptoms and substance use as pathways linking child physical and sexual abuse to risky sexual behavior among youth at risk of maltreatment. Path analysis was performed with 862 adolescents drawn from Longitudinal Studies of Child Abuse and Neglect. Four waves of data collected in the United States were used: childhood physical and sexual abuse experiences (from ages 0-12) were assessed by Child Protective Services reports, internalizing and externalizing symptoms were measured at age 14, substance use was measured at age 16, and risky sexual behavior was measured at age 18. Physical abuse was directly associated with risky sexual behavior in boys but not girls. For girls, physical abuse had a significant indirect effect on risky sexual behavior via externalizing symptoms. Gender-focused preventive intervention strategies may be effective in reducing risky sexual behavior among at-risk adolescents. Copyright © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Time perspective, optimistic bias, and self-control among different statuses of university smokers in China: a cross-sectional study.

PubMed

Xu, Ying; Yang, Yang; Ma, Xiao

2018-01-09

Risk behavior often seems 'self-defeating' to the observers. Most people understand the basic health-related knowledge, but some of them still choose to continue risk behaviors, especially for the young. This study aimed to examine time perspective, optimism bias and self control correlated with smoking behavior in Chinese college students. A cross-sectional survey enrolling 3016 university students in Chengdu City, Sichuan Province, China. Influence Factors were identified using multiple logistic regression analyses. Prevalence of current smoking was 20.92% (631 smokers), including 272 daily smokers (9.02%) and 359 non-daily smokers (11.90%). Future-oriented time perspective, general capacity for self-discipline, reliability and ethnicity were protective factors of smoking behavior. Possibility of self-suffering diseases and gender were risk factors of smoking behavior. Smoking in University of Chengdu, China is a severe problem. Results in this research have suggested that irrespective of the smoking level, improving health-related knowledge, time management awareness and self-control ability may contribute to reducing the prevalence of smoking behavior.

A Randomized Intervention Trial to Reduce the Lending of Used Injection Equipment Among Injection Drug Users Infected With Hepatitis C

PubMed Central

Latka, Mary H.; Hagan, Holly; Kapadia, Farzana; Golub, Elizabeth T.; Bonner, Sebastian; Campbell, Jennifer V.; Coady, Micaela H.; Garfein, Richard S.; Pu, Minya; Thomas, Dave L.; Thiel, Thelma K.; Strathdee, Steffanie A.

2008-01-01

Objectives. We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection. Methods. A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups. Results. Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention-group participants who had known their HCV-positive status for at least 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy. Conclusions. This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users. PMID:18382005

A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C.

PubMed

Latka, Mary H; Hagan, Holly; Kapadia, Farzana; Golub, Elizabeth T; Bonner, Sebastian; Campbell, Jennifer V; Coady, Micaela H; Garfein, Richard S; Pu, Minya; Thomas, Dave L; Thiel, Thelma K; Strathdee, Steffanie A

2008-05-01

We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection. A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups. Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention-group participants who had known their HCV-positive status for at least 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy. This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users.

Combination Social Protection for Reducing HIV-Risk Behavior Among Adolescents in South Africa.

PubMed

Cluver, Lucie D; Orkin, F Mark; Yakubovich, Alexa R; Sherr, Lorraine

2016-05-01

Social protection (ie, cash transfers, free schools, parental support) has potential for adolescent HIV prevention. We aimed to identify which social protection interventions are most effective and whether combined social protection has greater effects in South Africa. In this prospective longitudinal study, we interviewed 3516 adolescents aged 10-18 between 2009 and 2012. We sampled all homes with a resident adolescent in randomly selected census areas in 4 urban and rural sites in 2 South African provinces. We measured household receipt of 14 social protection interventions and incidence of HIV-risk behaviors. Using gender-disaggregated multivariate logistic regression and marginal effects analyses, we assessed respective contributions of interventions and potential combination effects. Child-focused grants, free schooling, school feeding, teacher support, and parental monitoring were independently associated with reduced HIV-risk behavior incidence (odds ratio: 0.10-0.69). Strong effects of combination social protection were shown, with cumulative reductions in HIV-risk behaviors. For example, girls' predicted past-year incidence of economically driven sex dropped from 11% with no interventions to 2% among those with a child grant, free school, and good parental monitoring. Similarly, girls' incidence of unprotected/casual sex or multiple partners dropped from 15% with no interventions to 10% with either parental monitoring or school feeding, and to 7% with both interventions. In real world, high-epidemic conditions, "combination social protection," shows strong HIV prevention effects for adolescents and may maximize prevention efforts.

Web-based intervention to change perceived norms of college student alcohol use and sexual behavior on spring break.

PubMed

Patrick, Megan E; Lee, Christine M; Neighbors, Clayton

2014-03-01

The purpose of the present study was to evaluate an adapted web-based multi-component personalized feedback intervention to reduce college student alcohol use and risky sexual behavior during Spring Break. This is one of the first interventions focused on Spring Break alcohol use and related sexual behavior. Personalized feedback intervention components addressed intentions, expected consequences, norms, motivations, protective behavioral strategies, and pacts with friends. Participants were college students (N=263; 55% women) between the ages of 18 and 21 who planned to go on a Spring Break trip with their friends. Effects were not significant in reducing alcohol use or sexual behavior during Spring Break or some of the proposed intervention mechanisms. However, consistent results showed that the intervention succeeded in reducing perceived social norms for Spring Break drinking and sexual behavior. Findings suggest that changing norms alone is not sufficient for changing risk behavior during this event and alternative strategies are needed to impact other putative mediators. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Impact of Gain- and Loss-Framed Messages on Young Adults’ Sexual Decision Making: An Experimental Study

PubMed Central

Macapagal, Kathryn; Janssen, Erick; Matson, Margaret; Finn, Peter R.; Heiman, Julia R.

2015-01-01

Messages that frame a target behavior in terms of its benefits (gain frame) or costs (loss frame) have been widely and successfully used for health promotion and risk reduction. However, the impact of framed messages on decisions to have sex and sexual risk, as well as moderators of these effects, has remained largely unexplored. We used a computerized laboratory task to test the effects of framed messages about condom use on young adults’ sexual decision making. Participants (N = 127) listened to both gain- and loss-framed messages and rated their intentions to have sex with partners who posed a high and low risk for sexually transmitted infections (STIs). The effects of message frame, partner risk, participant gender, ability to adopt the messages, and message presentation order on intentions to have sex were examined. Intentions to have sex with high-risk partners significantly decreased after the loss-framed message, but not after the gain-framed message, and intentions to have sex increased for participants who received the gain-framed message first. Yet, participants found it easier to adopt the gain-framed message. Results suggest that loss-framed messages may be particularly effective in reducing intentions to have sex with partners who might pose a higher risk for STIs, and that message presentation order may alter the relative effectiveness of gain- and loss-framed messages on sexual decision making. Future studies should examine the precise conditions under which gain- and loss-framed messages can promote healthy sexual behaviors and reduce sexual risk behaviors. PMID:26696408

The Impact of Gain- and Loss-Framed Messages on Young Adults' Sexual Decision Making: An Experimental Study.

PubMed

Macapagal, Kathryn; Janssen, Erick; Matson, Margaret; Finn, Peter R; Heiman, Julia R

2017-02-01

Messages that frame a target behavior in terms of its benefits (gain frame) or costs (loss frame) have been widely and successfully used for health promotion and risk reduction. However, the impact of framed messages on decisions to have sex and sexual risk, as well as moderators of these effects, has remained largely unexplored. We used a computerized laboratory task to test the effects of framed messages about condom use on young adults' sexual decision making. Participants (N = 127) listened to both gain- and loss-framed messages and rated their intentions to have sex with partners who posed a high and low risk for sexually transmitted infections (STIs). The effects of message frame, partner risk, participant gender, ability to adopt the messages, and message presentation order on intentions to have sex were examined. Intentions to have sex with high-risk partners significantly decreased after the loss-framed message, but not after the gain-framed message, and intentions to have sex increased for participants who received the gain-framed message first. Yet, participants found it easier to adopt the gain-framed message. Results suggest that loss-framed messages may be particularly effective in reducing intentions to have sex with partners who might pose a higher risk for STIs, and that message presentation order may alter the relative effectiveness of gain- and loss-framed messages on sexual decision making. Future studies should examine the precise conditions under which gain- and loss-framed messages can promote healthy sexual behaviors and reduce sexual risk behaviors.

Costs of fear: Behavioral and life-history responses to risk and their demographic consequences vary across species

USGS Publications Warehouse

LaManna, Joseph A.; Martin, Thomas E.

2016-01-01

Behavioural responses to reduce predation risk might cause demographic ‘costs of fear’. Costs differ among species, but a conceptual framework to understand this variation is lacking. We use a life-history framework to tie together diverse traits and life stages to better understand interspecific variation in responses and costs. We used natural and experimental variation in predation risk to test phenotypic responses and associated demographic costs for 10 songbird species. Responses such as increased parental attentiveness yielded reduced development time and created benefits such as reduced predation probability. Yet, responses to increased risk also created demographic costs by reducing offspring production in the absence of direct predation. This cost of fear varied widely across species, but predictably with the probability of repeat breeding. Use of a life-history framework can aid our understanding of potential demographic costs from predation, both from responses to perceived risk and from direct predation mortality.

Work-based predictors of mortality: a 20-year follow-up of healthy employees.

PubMed

Shirom, Arie; Toker, Sharon; Alkaly, Yasmin; Jacobson, Orit; Balicer, Ran

2011-05-01

This study investigated the effects of the Job-Demand-Control-Support (JDC-S) model's components, workload, control, peer and supervisor social support, on the risk of all-cause mortality. Also examined was the expectation that the above work-based components interact in predicting all-cause mortality. The study's hypotheses were tested after controlling for physiological variables and health behaviors known to be risk factors for mortality. The design used was prospective. Baseline data were obtained from healthy employees (N = 820) who underwent periodic health examinations in 1988. Follow-up data on all-cause mortality were obtained from the participants' computerized medical file, kept by their HMO, in 2008. The baseline data covered socioeconomic, behavioral, and biological risk factors in addition to the components of the JDC-S model. During the period of follow-up, 53 deaths were recorded. Data were analyzed using Cox regressions. Only one main effect was found: the risk of mortality was significantly lower for those reporting high levels of peer social support. The study found two significant interactions. Higher levels of control reduced the risk of mortality for the men and increased it for the women. The main effect of peer social support on mortality risk was significantly higher for those whose baseline age ranged from 38 to 43 but not for the older than 43 or the younger than 38 participants. Peer social support is a protective factor, reducing the risk of mortality, while perceived control reduces the risk of mortality among men but increases it among women. (c) 2011 APA, all rights reserved.

Binge-Eating Disorder in Adults

PubMed Central

Brownley, Kimberly A.; Berkman, Nancy D.; Peat, Christine M.; Lohr, Kathleen N.; Cullen, Katherine E.; Bann, Carla M.; Bulik, Cynthia M.

2017-01-01

Background The best treatment options for binge-eating disorder are unclear. Purpose To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. Data Sources English-language publications in EMBASE, the Cochrane Library, Academic OneFile, CINAHL, and ClinicalTrials.gov through 18 November 2015, and in MEDLINE through 12 May 2016. Study Selection 9 waitlist-controlled psychological trials and 25 placebo-controlled trials that evaluated pharmacologic (n = 19) or combination (n = 6) treatment. All were randomized trials with low or medium risk of bias. Data Extraction 2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence. Data Synthesis Therapist-led cognitive behavioral therapy, lisdexamfetamine, and second-generation antidepressants (SGAs) decreased binge-eating frequency and increased binge-eating abstinence (relative risk, 4.95 [95% CI, 3.06 to 8.00], 2.61 [CI, 2.04 to 3.33], and 1.67 [CI, 1.24 to 2.26], respectively). Lisdexamfetamine (mean difference [MD], −6.50 [CI, −8.82 to −4.18]) and SGAs (MD, −3.84 [CI, −6.55 to −1.13]) reduced binge-eating–related obsessions and compulsions, and SGAs reduced symptoms of depression (MD, −1.97 [CI, −3.67 to −0.28]). Headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal occurred more frequently with lisdexamfetamine than placebo (relative risk range, 1.63 to 4.28). Other forms of cognitive behavioral therapy and topiramate also increased abstinence and reduced binge-eating frequency and related psychopathology. Topiramate reduced weight and increased sympathetic nervous system arousal, and lisdexamfetamine reduced weight and appetite. Limitations Most study participants were overweight or obese white women aged 20 to 40 years. Many treatments were examined only in single studies. Outcomes were measured inconsistently across trials and rarely assessed beyond end of treatment. Conclusion Cognitive behavioral therapy, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related psychopathology, and lisdexamfetamine and topiramate reduced weight in adults with binge-eating disorder. Primary Funding Source Agency for Healthcare Research and Quality. PMID:27367316

Resistance to Extinction and Relapse in Combined Stimulus Contexts

ERIC Educational Resources Information Center

Podlesnik, Christopher A.; Bai, John Y. H.; Elliffe, Douglas

2012-01-01

Reinforcing an alternative response in the same context as a target response reduces the rate of occurrence but increases the persistence of that target response. Applied researchers who use such techniques to decrease the rate of a target problem behavior risk inadvertently increasing the persistence of the same problem behavior. Behavioral…

Reviewing Suicide in Native American Communities: Situating Risk and Protective Factors within a Transactional-Ecological Framework

ERIC Educational Resources Information Center

Alcantara, Carmela; Gone, Joseph P.

2007-01-01

The alarming prevalence of suicidal behaviors in Native American communities remains a major concern in the 21st-century United States. Recent reviews have demonstrated that prevention programs and intervention efforts using transactional-ecological models have effectively reduced suicidal behaviors in the American Indian and Alaska Native…

An Idiographic and Nomothetic Approach to the Study of Mexican-Origin Adolescent Mothers’ Socio-Cultural Stressors and Adjustment

PubMed Central

Zeiders, Katharine H.; Umaña-Taylor, Adriana J.; Updegraff, Kimberly A.; Jahromi, Laudan B.

2014-01-01

The current study examined the longitudinal relations of socio-cultural stressors (i.e., acculturative stressors, enculturative stressors, ethnic discrimination) and Mexican-origin adolescent mothers’ depressive symptoms and risk-taking behaviors. Utilizing an idiographic and nomothetic approach, we conducted lagged analyses to examine how individuals’ fluctuations in stressors predicted subsequent adjustment. Further, we investigated potential threshold effects by examining if the impact of fluctuations in stressors differed at varying levels of stressors. Mexican-origin adolescent females (N = 184) participated in yearly in-home assessments across 5 years and reported on their experiences of acculturative and enculturative stressors, ethnic discrimination, depressive symptoms, and risk-taking behaviors. Findings revealed that within-person fluctuations in acculturative stressors, and to a lesser extent, perceived discrimination, related to youths’ depressive symptoms. For risk-taking behaviors, however, only within-person fluctuations in enculturative stressors emerged as significant. Further, a threshold effect emerged in the link between enculturative stressors and risk-taking behaviors, suggesting that fluctuations in enculturative stressors predicted changes in risk-taking behaviors at high levels of enculturative stressors, but not low levels. Our findings highlight the differential relations between socio-cultural stressors and adolescent females’ adjustment, and suggest that prevention programs aimed at reducing depressive symptoms should attend to any degree of change in socio-cultural stressors, whereas programs focused on risk-taking behaviors should be especially attuned to levels of enculturative stress. PMID:25099084

Possession attachment predicts cell phone use while driving.

PubMed

Weller, Joshua A; Shackleford, Crystal; Dieckmann, Nathan; Slovic, Paul

2013-04-01

Distracted driving has become an important public health concern. However, little is known about the predictors of this health-risking behavior. One overlooked risk factor for distracted driving is the perceived attachment that one feels toward his or her phone. Prior research has suggested that individuals develop bonds toward objects, and qualitative research suggests that the bond between young drivers and their phones can be strong. It follows that individuals who perceive a strong attachment to their phone would be more likely to use it, even when driving. In a nationally representative sample of young drivers (17-28 years), participants (n = 1,006) completed a survey about driving behaviors and phone use. Risk perception surrounding cell phone use while driving and perceived attachment to one's phone were assessed by administering factor-analytically derived scales that were created as part of a larger project. Attachment toward one's phone predicted the proportion of trips in which a participant reported using their cell phone while driving, beyond that accounted for by risk perception and overall phone use. Further, attachment predicted self-reported distracted driving behaviors, such as the use of social media while driving. Attachment to one's phone may be an important but overlooked risk factor for the engagement of potentially health-risking driving behaviors. Understanding that phone attachment may adversely affect driving behaviors has the potential to inform prevention and intervention efforts designed to reduce distracted driving behaviors, especially in young drivers. 2013 APA, all rights reserved

Suicidal behavior and insight into illness among patients with schizophrenia spectrum disorders.

PubMed

Kao, Yu-Chen; Liu, Yia-Ping

2011-09-01

The purpose of the present study was to explore the relationship between suicidal behavior and socio-demographic and clinical factors, including insight into illness, in patients with schizophrenia spectrum disorders. We evaluated 104 inpatients using the Self-Appraisal of Illness Questionnaire (SAIQ) for insight assessment, several Beck-related symptoms rating scales, and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. These patients were also evaluated for suicidal behavior and risk using the critical items of the Scale for Suicide Ideation (SSI) and lifetime suicide attempts. Patients with suicidal behavior generally had greater insight into illness than those who were non-suicidal. After controlling for depressive symptoms, the association of insight into illness with current suicidal ideation remained significant, whereas the association between insight and lifetime suicide attempts was no longer significant. As predicted, the regression analyses revealed that those with greater suicide risk had significantly higher levels of depressive symptoms and hopelessness and more lifetime suicide attempts. Moreover, greater insight into illness appeared to have a close, independent connection to suicidal behavior. Our findings suggest that depression, hopelessness, and greater insight into illness are major risk factors for suicide in patients with schizophrenia. It is plausible that depression mediates the relationship between greater insight into illness and suicidal behavior. Aggressive improvement of insight without the risk of deteriorating depressive symptoms may be warranted to reduce the risk of suicide.

Breaking Down the Coercive Cycle: How Parent and Child Risk Factors Influence Real-Time Variability in Parental Responses to Child Misbehavior

PubMed Central

Lunkenheimer, Erika; Lichtwarck-Aschoff, Anna; Hollenstein, Tom; Kemp, Christine J.; Granic, Isabela

2016-01-01

Objective Parent-child coercive cycles have been associated with both rigidity and inconsistency in parenting behavior. To explain these mixed findings, we examined real-time variability in maternal responses to children's off-task behavior to determine whether this common trigger of the coercive cycle (responding to child misbehavior) is associated with rigidity or inconsistency in parenting. We also examined the effects of risk factors for coercion (maternal hostility, maternal depressive symptoms, child externalizing problems, and dyadic negativity) on patterns of parenting. Design Mother-child dyads (N = 96; M child age = 41 months) completed a difficult puzzle task, and observations were coded continuously for parent (e.g., directive, teaching) and child behavior (e.g., on-task, off-task). Results Multilevel continuous-time survival analyses revealed that parenting behavior is less variable when children are off-task. However, when risk factors are higher, a different profile emerges. Combined maternal and child risk is associated with markedly lower variability in parenting behavior overall (i.e., rigidity) paired with shifts towards higher variability specifically when children are off-task (i.e., inconsistency). Dyadic negativity (i.e., episodes when children are off-task and parents engage in negative behavior) are also associated with higher parenting variability. Conclusions Risk factors confer rigidity in parenting overall, but in moments when higher-risk parents must respond to child misbehavior, their parenting becomes more variable, suggesting inconsistency and ineffectiveness. This context-dependent shift in parenting behavior may help explain prior mixed findings and offer new directions for family interventions designed to reduce coercive processes. PMID:28190978

Early initiation of alcohol drinking, cigarette smoking, and sexual intercourse linked to suicidal ideation and attempts: findings from the 2006 Korean Youth Risk Behavior Survey.

PubMed

Kim, Dong-Sik; Kim, Hyun-Sun

2010-01-01

This study examined the association between early initiation of problem behaviors (alcohol drinking, cigarette smoking, and sexual intercourse) and suicidal behaviors (suicidal ideation and suicide attempts), and explored the effect of concurrent participation in these problem behaviors on suicidal behaviors among Korean adolescent males and females. Data were obtained from the 2006 Korean Youth Risk Behavior Survey, a nationally representative sample of middle and high school students (32,417 males and 31,467 females) in grades seven through twelve. Bivariate and multivariate logistic analyses were conducted. Several important covariates, such as age, family living structure, household economic status, academic performance, current alcohol drinking, current cigarette smoking, current butane gas or glue sniffing, perceived body weight, unhealthy weight control behaviors, subjective sleep evaluation, and depressed mood were included in the analyses. Both male and female preteen initiators of each problem behavior were at greater risk for suicidal behaviors than non-initiators, even after controlling for covariates. More numerous concurrent problematic behaviors were correlated with greater likelihood of seriously considering or attempting suicide among both males and females. This pattern was more clearly observed in preteen than in teen initiators although the former and latter were engaged in the same frequency of problem behavior. Early initiation of alcohol drinking, cigarette smoking, and sexual intercourse, particularly among preteens, represented an important predictor of later suicidal ideation and suicide attempts in both genders. Thus, early preventive intervention programs should be developed and may reduce the potential risks for subsequent suicidal behaviors.

Effect of adolescent substance use and antisocial behavior on the development of early adulthood depression.

PubMed

Choi, Tai Kiu; Worley, Matthew J; Trim, Ryan S; Howard, David; Brown, Sandra A; Hopfer, Christian J; Hewitt, John K; Wall, Tamara L

2016-04-30

Major depressive disorder (MDD) is a prevalent and frequently comorbid psychiatric disorder. This study evaluates the development of depressive symptoms, MDD diagnosis, and suicidal ideation in a high-risk sample (N=524) diagnosed with conduct disorder (CD) and substance use disorder (SUD) symptoms as youth and re-assessed approximately 6.5 years later. Dual trajectory classes of both alcohol and other drug use (AOD) and antisocial behavior (ASB), previously identified using latent class growth analyses (LCGA), were used to predict depression outcomes. The Dual Chronic, Increasing AOD/Persistent ASB, and Decreasing Drugs/Persistent ASB classes had higher past-week depression scores, more past-year MDD symptoms, and were more likely to have past-year MDD than the Resolved class. The Dual Chronic and Decreasing Drugs/Persistent ASB classes also had more past-year MDD symptoms than the Persistent AOD/Adolescent ASB class. Youth at highest risk for developing or maintaining depression in adulthood had the common characteristic of persistent antisocial behavior. This suggests young adulthood depression is associated more with persistent antisocial behavior than with persistent substance use in comorbid youth. As such, interventions targeting high-risk youth, particularly those with persistent antisocial behavior, are needed to help reduce the risk of severe psychosocial consequences (including risk for suicide) in adulthood. Published by Elsevier Ireland Ltd.

Youths and HIV/AIDS: Psychiatry’s Role in a Changing Epidemic

PubMed Central

DONENBERG, GERI R.; PAO, MARYLAND

2005-01-01

Objective To review the past 10 years of published research on human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the United States, including psychosocial and psychiatric risk factors, epidemiology, biology, neurocognitive and psychiatric sequelae, disclosure issues, prevention strategies, and biological and behavioral treatments. Method Researchers reviewed the English-language literature with a focus on child and adolescent risk factors associated with HIV/AIDS, prevention, and treatment. Results Substantial scientific advances have occurred over the past two decades leading to decreased morbidity and mortality in the United States from AIDS-related opportunistic infections. At the same time, rates of HIV infection are increasing in teenagers, young women, and minorities, and growing numbers of youths are living with an infected family member. Understanding HIV risk behavior requires a broad theoretical framework. Comprehensive HIV prevention programs have led to reduced risk behavior among HIV-affected youths and teens at risk of infection. Biological and behavioral treatments of HIV infection continue to evolve and have led to longer life span, improved quality of life, and fewer psychiatric problems. Conclusions HIV/AIDS has significant mental health implications, and psychiatry can play a critical role in curbing the epidemic. With minimal effort, mental health professionals can adapt and apply the strategies that they use to treat psychiatric symptoms to prevent HIV transmission behaviors. PMID:16034275

Sexual coercion and health-risk behaviors among urban Chinese high school students

PubMed Central

Song, Yi; Ji, Cheng-Ye; Agardh, Anette

2014-01-01

Objective To determine the association between health-risk behaviors and a history of sexual coercion among urban Chinese high school students. Design A cross-sectional study was performed among 109,754 high school students who participated in the 2005 Chinese Youth Risk Behavior Survey. Data were analyzed for 5,215 students who had experienced sexual intercourse (1,483 girls, 3,732 boys). Multivariate logistic regression was used to determine the relationship between sexual coercion and the related covariates, and data were stratified by gender. Results Of those students who had had sexual intercourse, 40.9% of the females and 29.6% of the males experienced sexual coercion (p<0.01). When analyses controlled for demographic characteristics, in the study sample, that is, students who had sexual intercourse, drug use (odds ratios [OR], 2.44), attempted suicide (OR, 2.30), physical abuse (OR, 1.74), binge drinking (OR, 1.62), verbal abuse (OR, 1.29), experience of being drunk (OR, 0.68), and smoking of cigarettes (OR, 0.52) were related to a history of sexual coercion. Patterns of health-risk behaviors also differed among female and male students who had experienced sexual coercion. Conclusions Sexual coercion is associated with health-risk behaviors. Initiatives to reduce the harm associated with sexual coercion among high school students are needed. PMID:24836445

Economic Context and HIV Vulnerability in Adolescents and Young Adults Living in Urban Slums in Kenya: A Qualitative Analysis Based on Scarcity Theory.

PubMed

Jennings, Larissa; Mathai, Muthoni; Linnemayr, Sebastian; Trujillo, Antonio; Mak'anyengo, Margaret; Montgomery, Brooke E E; Kerrigan, Deanna L

2017-09-01

Urban slum adolescents and young adults have disproportionately high rates of HIV compared to rural and non-slum urban youth. Yet, few studies have examined youth's perceptions of the economic drivers of HIV. Informed by traditional and behavioral economics, we applied a scarcity theoretical framework to qualitatively examine how poverty influences sexual risk behaviors among adolescents and young adults. Focus group discussions with one hundred twenty youth in Kenyan's urban slums were transcribed, coded, and analyzed using interpretive phenomenology. Results indicated that slum youth made many sexual decisions considered rational from a traditional economics perspective, such as acquiring more sex when resources were available, maximizing wealth through sex, being price-sensitive to costs of condoms or testing services, and taking more risks when protected from adverse sexual consequences. Youth's engagement in sexual risk behaviors was also motivated by scarcity phenomena explained by behavioral economics, such as compensating for sex lost during scarce periods (risk-seeking), valuing economic gains over HIV risks (tunneling, bandwidth tax), and transacting sex as an investment strategy (internal referencing). When scarcity was alleviated, young women additionally described reducing the number of sex partners to account for non-economic preferences (slack). Prevention strategies should address the traditional and behavioral economics of the HIV epidemic.

Exposure-Reducing Behaviors Among Residents Living Near a Coal Ash Storage Site.

PubMed

Zierold, Kristina M; Sears, Clara G; Brock, Guy N

2016-10-01

Coal ash, a waste product generated from burning coal for energy, is composed of highly respirable particles containing heavy metals, radioactive elements, and polycylic aromatic hydrocarbons. Coal ash is stored in landfills and surface impoundments frequently located near neighborhoods. Fugitive dust from the storage sites exposes neighborhoods, affecting the health and welfare of residents. The research questions of interest were (1) are community members concerned about coal ash exposure from the storage site; (2) what, if any, behaviors do community members engage in to reduce exposure; and (3) do exposure reducing behaviors differ by level of concern about coal ash. A community-based mixed-methods approach was used. Focus groups (n = 26) were conducted in 2012, and a cross-sectional survey was administered in 2013 (n = 231). The majority of survey respondents (62%) worried "a lot" about being exposed to coal ash; however, most did not engage in exposure-reducing behaviors, such as wearing protective equipment when doing chores. Compared with respondents who worry "some, very little, or none," or responded "I don't know," respondents who worried "a lot" about being exposed to coal ash did more exposure-reducing behaviors outdoors (p < .001) and indoors (p = .01). For people living near environmental hazards, reducing exposure is a priority. Although challenging because of the chronic nature of exposure, some behaviors can be useful in reducing exposure, such as wearing a particle-specific respirator when mowing the lawn. Communities at risk for chronic exposure to environmental toxins could benefit from education about exposure-reducing behaviors. © 2015 Society for Public Health Education.

Reduced Risk-Taking After Prior Losses in Pathological Gamblers Under Treatment and Healthy Control Group but not in Problem Gamblers.

PubMed

Bonini, Nicolao; Grecucci, Alessandro; Nicolè, Manuel; Savadori, Lucia

2018-06-01

A group of pathological gamblers and a group of problem gamblers (i.e., gamblers at risk of becoming pathological) were compared to healthy controls on their risk-taking propensity after prior losses. Each participant played both the Balloon Analogue Risk Taking task (BART) and a modified version of the same task, where individuals face five repeated predetermined early losses at the onset of the game. No significant difference in risk-taking was found between groups on the standard BART task, while significant differences emerged when comparing behaviors in the two tasks: both pathological gamblers and controls reduced their risk-taking tendency after prior losses in the modified BART compared to the standard BART, whereas problem gamblers showed no reduction in risk-taking after prior losses. We interpret these results as a sign of a reduced sensitivity to negative feedback in problem gamblers which might contribute to explain their loss-chasing tendency.

Application of the transtheoretical model: exercise behavior in Korean adults with metabolic syndrome.

PubMed

Kim, Chun-Ja; Kim, Bom-Taeck; Chae, Sun-Mi

2010-01-01

Although regular exercise has been recommended to reduce the risk of cardiovascular disease (CVD) among people with metabolic syndrome, little information is available about psychobehavioral strategies in this population. The purpose of this study was to identify the stages, processes of change, decisional balance, and self-efficacy of exercise behavior and to determine the significant predictors explaining regular exercise behavior in adults with metabolic syndrome. This descriptive, cross-sectional survey design enrolled a convenience sample of 210 people with metabolic syndrome at a university hospital in South Korea. Descriptive statistics were used to analyze demographic characteristics, metabolic syndrome risk factors, and transtheoretical model-related variables. A multivariate logistic regression analysis was used to determine the most important predictors of regular exercise stages. Action and maintenance stages comprised 51.9% of regular exercise stages, whereas 48.1% of non-regular exercise stages were precontemplation, contemplation, and preparation stages. Adults with regular exercise stages displayed increased high-density lipoprotein cholesterol level, were more likely to use consciousness raising, self-reevaluation, and self-liberation strategies, and were less likely to evaluate the merits/disadvantages of exercise, compared with those in non-regular exercise stages. In this study of regular exercise behavior and transtheoretical model-related variables, consciousness raising, self-reevaluation, and self-liberation were associated with a positive effect on regular exercise behavior in adults with metabolic syndrome. Our findings could be used to develop strategies and interventions to maintain regular exercise behavior directed at Korean adults with metabolic syndrome to reduce CVD risk. Further prospective intervention studies are needed to investigate the effect of regular exercise program on the prevention and/or reduction of CVD risk among this population. Health care providers, especially nurses, are optimally positioned to help their clients initiate and maintain regular exercise behavior in clinical and community settings.

Learning that circumcision is protective against HIV: risk compensation among men and women in Cape Town, South Africa.

PubMed

Maughan-Brown, Brendan; Venkataramani, Atheendar S

2012-01-01

We examined whether knowledge of the HIV-protective benefits of male circumcision (MC) led to risk compensating behavior in a traditionally circumcising population in South Africa. We extend the current literature by examining risk compensation among women, which has hitherto been unexplored. We used data on Xhosa men and women from the 2009 Cape Area Panel Study. Respondents were asked if they had heard that MC reduces a man's risk of contracting HIV, about their perceived risk of contracting HIV, and condom use. For each gender group we assessed whether risk perception and condom use differed by knowledge of the protective benefits of MC using bivariate and then multivariate models controlling for demographic characteristics, HIV knowledge/beliefs, and previous sexual behaviors. In a further check for confounding, we used data from the 2005 wave to assess whether individuals who would eventually become informed about the protective benefits of circumcision were already different in terms of HIV risk perception and condom use. 34% of men (n=453) and 27% of women (n=690) had heard that circumcision reduces a man's risk of HIV infection. Informed men perceived slightly higher risk of contracting HIV and were more likely to use condoms at last sex (p<0.10). Informed women perceived lower HIV risk (p<0.05), were less likely to use condoms both at last sex (p<0.10) and more generally (p<0.01), and more likely to forego condoms with partners of positive or unknown serostatus (p<0.01). The results were robust to covariate adjustment, excluding people living with HIV, and accounting for risk perceptions and condom use in 2005. We find evidence consistent with risk compensation among women but not men. Further attention should be paid to the role of new information regarding MC, and drivers of HIV risk more broadly, in modulating sexual behavior among women.

Disease dynamics in a stochastic network game: a little empathy goes a long way in averting outbreaks

PubMed Central

Eksin, Ceyhun; Shamma, Jeff S.; Weitz, Joshua S.

2017-01-01

Individuals change their behavior during an epidemic in response to whether they and/or those they interact with are healthy or sick. Healthy individuals may utilize protective measures to avoid contracting a disease. Sick individuals may utilize preemptive measures to avoid spreading a disease. Yet, in practice both protective and preemptive changes in behavior come with costs. This paper proposes a stochastic network disease game model that captures the self-interests of individuals during the spread of a susceptible-infected-susceptible disease. In this model, individuals strategically modify their behavior based on current disease conditions. These reactions influence disease spread. We show that there is a critical level of concern, i.e., empathy, by the sick individuals above which disease is eradicated rapidly. Furthermore, we find that risk averse behavior by the healthy individuals cannot eradicate the disease without the preemptive measures of the sick individuals. Empathy is more effective than risk-aversion because when infectious individuals change behavior, they reduce all of their potential infections, whereas when healthy individuals change behavior, they reduce only a small portion of potential infections. This imbalance in the role played by the response of the infected versus the susceptible individuals on disease eradication affords critical policy insights. PMID:28290504

Sexual Risk Behavior and Heavy Drinking Among Weekly Marijuana Users

PubMed Central

Metrik, Jane; Caswell, Amy J.; Magill, Molly; Monti, Peter M.; Kahler, Christopher W.

2016-01-01

Objective: Sexual behavior that incurs increased risk for sexually transmitted infections and HIV incidence is associated with both heavy alcohol and marijuana use. Whereas detrimental effects of alcohol on increased sexual risk have been documented in event-level and laboratory studies, less is known about the combined use of alcohol and marijuana and their relative impact on sexual risk behavior. We examined the degree to which both heavy drinking and marijuana use were associated with condomless sexual intercourse with casual versus main partners in a sample of weekly marijuana smokers. Method: Participants reported substance use and sexual activity using a 60-day Timeline Followback interview method (n = 112). Results: Results of generalized estimating equations indicated that both alcohol and marijuana use were independently associated with greater odds of having sexual intercourse but were not associated with greater odds of unprotected sex with a casual partner. Heavy drinking on a given day was associated with increased odds of having casual protected sex. Using both substances synergistically increased the likelihood of unprotected sex with a main partner. Conclusions: Findings suggest that behaviors posing higher sexual risk (condomless intercourse or sex with casual partners) occur on days when alcohol use exceeds moderate drinking guidelines. Interventions designed to reduce sexual risk behaviors may need to specifically target heavy drinking alone or when used with marijuana. PMID:26751360

Health risk perception and betel chewing behavior--the evidence from Taiwan.

PubMed

Chen, Chiang-Ming; Chang, Kuo-Liang; Lin, Lin; Lee, Jwo-Leun

2013-11-01

In this study, we provided an empirical examination of the interaction between people's health risk perception and betel chewing. We hypothesized that a better knowledge of possible health risks would reduce both the number of individuals who currently chew betel and the likelihood of those who do not yet chew betel to begin the habit. We constructed a simultaneous equation model with Bayesian two-stage approach to control the endogeneity between betel chewing and risk perception. Using a national survey of 26,684 observations in Taiwan, our study results indicated that better health knowledge reduced the possibility that people would become betel chewers. We also found that, in general, betel chewers have a poorer health risk perception than other population. Overall, the empirical evidence suggested that health authorities could reduce the odds of people becoming betel chewers by improving their knowledge of betel-chewing's harmful effects. © 2013 Elsevier Ltd. All rights reserved.

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment.

PubMed

Shrestha, Roman; Altice, Frederick L; Huedo-Medina, Tania B; Karki, Pramila; Copenhaver, Michael

2017-05-01

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the information-motivation-behavioral skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP.

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment

PubMed Central

Shrestha, Roman; Altice, Frederick L.; Huedo-Medina, Tania B.; Karki, Pramila; Copenhaver, Michael

2016-01-01

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the Information-Motivation-Behavioral Skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP. PMID:27990587

Patterns of Bullying and Sexual Harassment: Connections with Parents and Teachers as Direct Protective Factors.

PubMed

Doty, Jennifer L; Gower, Amy L; Rudi, Jessie H; McMorris, Barbara J; Borowsky, Iris W

2017-11-01

Involvement in bullying and sexual harassment in adolescence is associated with a variety of internalizing, externalizing, and health-risk behaviors. Yet, the two behaviors are often studied independently. The current study examined how bullying and sexual harassment co-occur and whether social connections protected youth from risk patterns. The data for this study come from the 2013 Minnesota Student Survey (N = 121,311; 50% female, 74% White, 26% received free or reduced-price lunch; M age  = 14.9, SD = 1.3). Students reported on bullying and sexual harassment victimization and perpetration. Using latent class analysis, youth were classified into five patterns: High-Risk of All Forms of Victimization and Perpetration (7%), Relational and Cyberbullying Victimization (17%), Sexual Harassment Victimization and Perpetration (8%), Physical Bullying Perpetration (6%), and Low-Risk (62%). Compared to the low-risk class, the four other classes had lower levels of social connections, particularly with teachers and parents. Older youth (9th and 11th grade students) were at greater risk for the sexual harassment pattern, while younger youth (8th grade students) were at greater risk for bullying patterns. The results indicate that efforts to reduce bullying should also address sexual harassment and social connections with adults.

Imagine HEALTH: results from a randomized pilot lifestyle intervention for obese Latino adolescents using Interactive Guided ImagerySM

PubMed Central

2014-01-01

Background There is an urgent need for innovative and developmentally appropriate lifestyle interventions to promote healthy lifestyle behaviors and to prevent the early onset of type 2 diabetes and cardiovascular disease risk in obese Latino adolescents. Guided imagery offers promise to reduce stress and promote lifestyle behavior change to reduce disease risk in obese adolescents. Our objectives were: 1) To pilot test a new 12-wk lifestyle intervention using a randomized trial design in obese Latino adolescents, in order to determine the effects of the mind-body modality of Interactive Guided ImagerySM (IGI), over and above those of a didactic lifestyle education, on insulin resistance, eating and physical activity behaviors, stress and stress biomarkers; and 2) To explore the role of intervention-related changes in stress and stress biomarkers on changes in metabolic outcomes, particularly insulin resistance. Methods Obese (BMI > 95th percentile), Latino adolescents (n = 35, age 14-17) were randomized to receive either 12 weekly sessions of a lifestyle education plus guided imagery program (GI), or lifestyle education plus a digital storytelling computer program (DS). Between-group differences in behavioral, biological, and psychological outcomes were assessed using unpaired T-tests and ANCOVA in the 29 subjects who completed the intervention. Results The GI group demonstrated significant reductions in leisure sedentary behavior (p < .05) and increases in moderate physical activity (p < .05) compared to DS group, and a trend toward reduced caloric intake in GI vs DS (p = .09). Salivary cortisol was acutely reduced by stress-reduction guided imagery (p < .01). There were no group differences in adiposity, insulin resistance, perceived stress, or stress biomarkers across the 12-week intervention, though decrease in serum cortisol over the course of the intervention was associated with improved insulin sensitivity (p = .03) independent of intervention group and other relevant co-variates. Conclusions The improvements in physical activity and stress biomarkers following this pilot intervention support the role of guided imagery in promoting healthy lifestyle behavior change and reducing metabolic disease risk in obese Latino adolescent populations. Future investigations will be needed to determine the full effects of the Imagine HEALTH intervention on insulin resistance, stress, and stress biomarkers. Trial registration Clinicaltrials.gov Registry #: NCT01895595 PMID:24433565

HIV prevalence and behavioral risk factors in the Sudan People's Liberation Army: Data from South Sudan.

PubMed

Courtney, Lauren P; Goco, Norman; Woja, John; Farris, Tonya; Cummiskey, Chris; Smith, Emily; Makuach, Lia; Chun, Helen M

2017-01-01

After two decades of civil war, South Sudan has limited published data on HIV prevalence and behavioral determinants of HIV infection risk. A surge in HIV/AIDS prevalence is a real concern for this new country with limited access to medical or HIV preventive services, and low education and literacy levels. We present findings from the first bio-behavioral surveillance survey conducted within the Sudan People's Liberation Army (SPLA). A cross-sectional survey of 1,149 randomly selected soldiers from thirteen SPLA bases was conducted in two phases: July to August 2010 and April to May 2012. Consenting participants received HIV rapid tests, pre- and post-test counseling, and a personal interview. Demographics, knowledge, attitudes, and behaviors, including sexual behavior, alcohol use, and mental health were assessed using computer-assisted interviews. The final sample included 1,063 survey participants (96.7% male). Education levels within the SPLA are low; only 16.4% attended school beyond the primary level. The overall HIV prevalence in the sample was 5.0% (95% confidence interval [CI]: 3.6-6.9). High-risk behaviors (e.g., multiple or concurrent sexual partners, heavy alcohol use, low condom use) were noted among SPLA members. High levels of HIV stigma were identified: 90.6% (n = 916) responded with one or more negative beliefs towards PLHIV, and 60.3% thought a healthy-looking person with HIV should not be allowed to remain in the SPLA. Results from this first evaluation of risk behaviors and HIV prevalence among the SPLA highlight high-risk behaviors that may contribute to the spread of HIV. Understanding potential comorbid conditions will be critical to designing strategies to reduce HIV risk. This survey represents the first steps in understanding the HIV epidemic within the SPLA context.

Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention.

PubMed Central

Jemmott, J B; Jemmott, L S; Fong, G T

1992-01-01

BACKGROUND. The number of reported cases of acquired immune deficiency syndrome (AIDS) is increasing disproportionately among Blacks in the United States. The relatively high incidence of sexually transmitted diseases among Black adolescents suggest the need for AIDS prevention programs to reduce their risk of sexually transmitted human immunodeficiency virus (HIV) infection. METHODS. Black male adolescents (n = 157) were randomly assigned to receive an AIDS risk reduction intervention aimed at increasing AIDS-related knowledge and weakening problematic attitudes toward risky sexual behavior, or to receive a control intervention on career opportunities. RESULTS. The adolescents who received the AIDS intervention subsequently had greater AIDS knowledge, less favorable attitudes toward risky sexual behavior, and lower intentions to engage in such behavior than did those in the control condition. Follow-up data collected 3 months later revealed that the adolescents who had received the AIDS intervention reported fewer occasions of coitus, fewer coital partners, greater use of condoms, and a lower incidence of heterosexual anal intercourse than did the other adolescents. CONCLUSIONS. These results suggest that interventions that increase knowledge about AIDS and change attitudes toward risky sexual behavior may have salutary effects on Black adolescents' risk of HIV infection. PMID:1536352

When self-reliance is not safe: associations between reduced help-seeking and subsequent mental health symptoms in suicidal adolescents.

PubMed

Labouliere, Christa D; Kleinman, Marjorie; Gould, Madelyn S

2015-04-01

The majority of suicidal adolescents have no contact with mental health services, and reduced help-seeking in this population further lessens the likelihood of accessing treatment. A commonly-reported reason for not seeking help is youths' perception that they should solve problems on their own. In this study, we explore associations between extreme self-reliance behavior (i.e., solving problems on your own all of the time), help-seeking behavior, and mental health symptoms in a community sample of adolescents. Approximately 2150 adolescents, across six schools, participated in a school-based suicide prevention screening program, and a subset of at-risk youth completed a follow-up interview two years later. Extreme self-reliance was associated with reduced help-seeking, clinically-significant depressive symptoms, and serious suicidal ideation at the baseline screening. Furthermore, in a subset of youth identified as at-risk at the baseline screening, extreme self-reliance predicted level of suicidal ideation and depressive symptoms two years later even after controlling for baseline symptoms. Given these findings, attitudes that reinforce extreme self-reliance behavior may be an important target for youth suicide prevention programs. Reducing extreme self-reliance in youth with suicidality may increase their likelihood of appropriate help-seeking and concomitant reductions in symptoms.

When Self-Reliance Is Not Safe: Associations between Reduced Help-Seeking and Subsequent Mental Health Symptoms in Suicidal Adolescents

PubMed Central

Labouliere, Christa D.; Kleinman, Marjorie; Gould, Madelyn S.

2015-01-01

The majority of suicidal adolescents have no contact with mental health services, and reduced help-seeking in this population further lessens the likelihood of accessing treatment. A commonly-reported reason for not seeking help is youths’ perception that they should solve problems on their own. In this study, we explore associations between extreme self-reliance behavior (i.e., solving problems on your own all of the time), help-seeking behavior, and mental health symptoms in a community sample of adolescents. Approximately 2150 adolescents, across six schools, participated in a school-based suicide prevention screening program, and a subset of at-risk youth completed a follow-up interview two years later. Extreme self-reliance was associated with reduced help-seeking, clinically-significant depressive symptoms, and serious suicidal ideation at the baseline screening. Furthermore, in a subset of youth identified as at-risk at the baseline screening, extreme self-reliance predicted level of suicidal ideation and depressive symptoms two years later even after controlling for baseline symptoms. Given these findings, attitudes that reinforce extreme self-reliance behavior may be an important target for youth suicide prevention programs. Reducing extreme self-reliance in youth with suicidality may increase their likelihood of appropriate help-seeking and concomitant reductions in symptoms. PMID:25837350

Pediatric Predispositional Genetic Risk Communication: Potential Utility for Prevention and Control of Melanoma Risk as an Exemplar.

PubMed

Wu, Yelena P; Mays, Darren; Kohlmann, Wendy; Tercyak, Kenneth P

2017-10-01

Predispositional genetic testing among minor children is intensely debated due to the potential benefits and harms of providing this type of genetic information to children and their families. Existing guidelines on pediatric genetic testing state that predispositional testing could be appropriate for minors if preventive services exist that mitigate children's risk for or severity of the health condition in question. We use the example of hereditary melanoma to illustrate the rationale for and potential application of genetic risk communication for an adult-onset cancer to a pediatric population where childhood behaviors may reduce risk of disease later in life. We draw from the adult melanoma genetic risk communication and pediatric health behavior change literatures to suggest ways in which genetic test reporting and complementary education could be delivered to children who carry a hereditary risk for melanoma and their families in order to foster children's engagement in melanoma preventive behaviors. Genetic discoveries will continue to yield new opportunities to provide predispositional genetic risk information to unaffected individuals, including children, and could be delivered within programs that provide personalized and translational approaches to cancer prevention.

Characteristics of high risk HIV-positive IDUs in Vietnam: implications for future interventions

PubMed Central

Go, Vivian F.; Frangakis, Constantine; Van Nam, Le; Sripaipan, Teerada; Bergenstrom, Anna; Latkin, Carl; Celentano, David D.; Quan, Vu Minh

2010-01-01

The HIV epidemic in Vietnam is concentrated primarily in injecting drug users (IDUs). To prevent HIV-1 super-infection and to develop effective HIV prevention programs, data are needed to understand the characteristics of high risk HIV-positive IDUs. In 2003, we conducted a community-based cross-sectional study among predominately male, out-of-treatment IDUs, aged 18–45, in Bac Ninh Province, Vietnam. Among 299 male participants, 42.8% were HIV-positive and among those, 96.9% did not know their status prior to the study. Thirty-two percent were HIV-positive and had high HIV behavioral risk (having unprotected sex or having shared injecting equipment in the past 6 months). Injecting for ≥ 3 years, younger age, and pooling money to buy drugs were independently associated with being at high risk for transmitting HIV. IDUs who purchased >1 syringe at a time were less likely to have high HIV behavioral risk. Structural interventions that increase syringe accessibility may be effective in reducing HIV risk behavior among HIV-positive IDUs. Study limitations are noted in the text. PMID:20735189

Effectiveness of HIV Prevention Social Marketing With Injecting Drug Users

PubMed Central

Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M.

2010-01-01

Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide. PMID:20724686

HIV Prevention Counseling Intervention Delivered During Routine Clinical Care Reduces HIV Risk Behavior in HIV-Infected South Africans Receiving Antiretroviral Therapy: The Izindlela Zokuphila/Options for Health Randomized Trial

PubMed Central

Fisher, Jeffrey D.; Cornman, Deborah H.; Shuper, Paul A.; Christie, Sarah; Pillay, Sandy; Macdonald, Susan; Ngcobo, Ntombenhle; Amico, K. Rivet; Lalloo, Umesh; Friedland, Gerald; Fisher, William A.

2014-01-01

Context Sustainable interventions are needed to minimize HIV risk behavior among people living with HIV (PLWH) in South Africa on antiretroviral therapy (ART), a significant proportion of whom do not achieve viral suppression. Objective To determine whether a brief lay counselor delivered intervention implemented during routine care can reduce risky sex among PLWH on ART. Design Cluster randomized 16 HIV clinical care sites in KwaZulu Natal, South Africa, to intervention or standard-of-care. Setting Publicly funded HIV clinical care sites. Patients 1891 PLWH on ART received the HIV prevention counseling intervention (n = 967) or standard-of-care counseling (n = 924). Intervention Lay counselors delivered a brief intervention using motivational interviewing strategies based on the Information—Motivation—Behavioral Skills (IMB) model during routine clinical care. Main Outcome Measures Number of sexual events without a condom in the past four weeks with partners of any HIV status, and with partners perceived to be HIV-negative or HIV-status unknown, assessed at baseline, 6, 12, and 18 months. Results Intervention participants reported significantly greater reductions in HIV risk behavior on both primary outcomes, compared to standard-of-care participants. Differences in STI incidence between arms were not observed. Conclusion Effective behavioral interventions, delivered by lay counselors within the clinical care setting, are consistent with the strategy of linking HIV care and HIV prevention and integrating biomedical and behavioral approaches to stemming the HIV epidemic. PMID:25230288

Preventive Care in Appalachia: Use of the Theory of Planned Behavior to Identify Barriers to Participation in Cholesterol Screenings among West Virginians

ERIC Educational Resources Information Center

Deskins, Shelli; Harris, Carole V.; Bradlyn, Andrew S.; Cottrell, Lesley; Coffman, Jessica W.; Olexa, Julie; Neal, William

2006-01-01

Context: West Virginians are at increased risk for heart disease. Given that the process of atherosclerosis begins in childhood, the Coronary Artery Risk Detection in Appalachian Communities Project was developed to reduce this risk by implementing a cholesterol screening program in the schools. However, participation rates have been less than…

Modeling individual movement decisions of brown hare (Lepus europaeus) as a key concept for realistic spatial behavior and exposure: A population model for landscape-level risk assessment.

PubMed

Kleinmann, Joachim U; Wang, Magnus

2017-09-01

Spatial behavior is of crucial importance for the risk assessment of pesticides and for the assessment of effects of agricultural practice or multiple stressors, because it determines field use, exposition, and recovery. Recently, population models have increasingly been used to understand the mechanisms driving risk and recovery or to conduct landscape-level risk assessments. To include spatial behavior appropriately in population models for use in risk assessments, a new method, "probabilistic walk," was developed, which simulates the detailed daily movement of individuals by taking into account food resources, vegetation cover, and the presence of conspecifics. At each movement step, animals decide where to move next based on probabilities being determined from this information. The model was parameterized to simulate populations of brown hares (Lepus europaeus). A detailed validation of the model demonstrated that it can realistically reproduce various natural patterns of brown hare ecology and behavior. Simulated proportions of time animals spent in fields (PT values) were also comparable to field observations. It is shown that these important parameters for the risk assessment may, however, vary in different landscapes. The results demonstrate the value of using population models to reduce uncertainties in risk assessment and to better understand which factors determine risk in a landscape context. Environ Toxicol Chem 2017;36:2299-2307. © 2017 SETAC. © 2017 SETAC.

Sex on the beach: the influence of social norms and trip companion on spring break sexual behavior.

PubMed

Lewis, Melissa A; Patrick, Megan E; Mittmann, Angela; Kaysen, Debra L

2014-06-01

Spring Break trips are associated with heavy drinking and with risky sexual behavior (e.g., unprotected sex, multiple partners, unwanted sexual contact), especially for those students who go on trips with friends. The present study adds to this growing event-specific risk literature by examining Spring Break-specific normative perceptions of sexual risk behavior and the role that these perceptions and taking a trip with a friend or with a romantic partner have on Spring Break sexual behavior. College students (N = 1,540; 53.9 % female) were asked to report descriptive normative perceptions of sex with casual partners, drinking prior to sex, number of drinks prior to sex, and condom use as well as their own Spring Break drinking and sexual behaviors. Students perceived the typical same-sex student to have engaged in more frequent sexual behavior for all outcomes than students' own self-reported sexual behavior. Furthermore, results revealed that these perceptions were positively associated with behavior. The choice of travel companion (friend(s) versus romantic partner) also differentially predicted sexual behaviors. Results suggested that intervention efforts aimed at reducing risks for Spring Break trip-takers may be strongest when they incorporate corrective normative information and target those traveling with friends.

Sex on the Beach: The Influence of Social Norms and Trip Companion on Spring Break Sexual Behavior

PubMed Central

Lewis, Melissa A.; Patrick, Megan E.; Mittmann, Angela; Kaysen, Debra L.

2014-01-01

Spring Break trips are associated with heavy drinking and with risky sexual behavior (e.g., unprotected sex, multiple partners, unwanted sexual contact), especially for those students who go on trips with friends. The present study adds to this growing event-specific risk literature by examining Spring Break-specific normative perceptions of sexual risk behavior and the role that these perceptions and taking a trip with a friend or with a romantic partner have on Spring Break sexual behavior. College students (N = 1,540; 53.9% female) were asked to report descriptive normative perceptions of sex with casual partners, drinking prior to sex, number of drinks prior to sex, and condom use as well as their own Spring Break drinking and sexual behaviors. Students perceived the typical same-sex student to have engaged in more frequent sexual behavior for all outcomes than students’ own self-reported sexual behavior. Furthermore, results revealed that these perceptions were positively associated with behavior. The choice of travel companion (friend(s) vs. romantic partner) also deferentially predicted sexual behaviors. Results suggested that intervention efforts aimed at reducing risks for Spring Break trip-takers may be strongest when they incorporate corrective normative information and target those traveling with friends. PMID:24464322

Structural equation modeling of pesticide poisoning, depression, safety, and injury.

PubMed

Beseler, Cheryl L; Stallones, Lorann

2013-01-01

The role of pesticide poisoning in risk of injuries may operate through a link between pesticide-induced depressive symptoms and reduced engagement in safety behaviors. The authors conducted structural equation modeling of cross-sectional data to examine the pattern of associations between pesticide poisoning, depressive symptoms, safety knowledge, safety behaviors, and injury. Interviews of 1637 Colorado farm operators and their spouses from 964 farms were conducted during 1993-1997. Pesticide poisoning was assessed based on a history of ever having been poisoned. The Center for Epidemiologic Studies-Depression scale was used to assess depressive symptoms. Safety knowledge and safety behaviors were assessed using ten items for each latent variable. Outcomes were safety behaviors and injuries. A total of 154 injuries occurred among 1604 individuals with complete data. Pesticide poisoning, financial problems, health, and age predicted negative affect/somatic depressive symptoms with similar effect sizes; sex did not. Depression was more strongly associated with safety behavior than was safety knowledge. Two safety behaviors were significantly associated with an increased risk of injury. This study emphasizes the importance of financial problems and health on depression, and provides further evidence for the link between neurological effects of past pesticide poisoning on risk-taking behaviors and injury.

Associations Between Antibullying Policies and Bullying in 25 States.

PubMed

Hatzenbuehler, Mark L; Schwab-Reese, Laura; Ranapurwala, Shabbar I; Hertz, Marci F; Ramirez, Marizen R

2015-10-01

Bullying is the most widespread form of peer aggression in schools. In an effort to address school bullying, 49 states have passed antibullying statutes. Despite the ubiquity of these policies, there has been limited empirical examination of their effectiveness in reducing students' risk of being bullied. To evaluate the effectiveness of antibullying legislation in reducing students' risk of being bullied and cyberbullied, using data from 25 states in the United States. A cross-sectional observational study was conducted using a population-based survey of 63 635 adolescents in grades 9 to 12 from 25 states participating in the 2011 Youth Risk Behavior Surveillance System study (September 2010-December 2011). Data on antibullying legislation were obtained from the US Department of Education (DOE), which commissioned a systematic review of state laws in 2011. The report identified 16 key components that were divided into the following 4 broad categories: purpose and definition of the law, district policy development and review, school district policy components (eg, responsibilities for reporting bullying incidents), and additional components (eg, how policies are communicated). Policy variables from 25 states were linked to individual-level data from the Youth Risk Behavior Surveillance System on experiencing bullying and cyberbullying. Analyses were conducted between March 1, 2014, and December 1, 2014. State antibullying legislation. Exposure to bullying and cyberbullying in the past 12 months. There was substantial variation in the rates of bullying and cyberbullying across states. After controlling for relevant state-level confounders, students in states with at least 1 DOE legislative component in the antibullying law had a 24% (95% CI, 15%-32%) reduced odds of reporting bullying and 20% (95% CI, 9%-29%) reduced odds of reporting cyberbullying compared with students in states whose laws had no DOE legislative components. Three individual components of antibullying legislation were consistently associated with decreased odds of exposure to both bullying and cyberbullying: statement of scope, description of prohibited behaviors, and requirements for school districts to develop and implement local policies. Antibullying policies may represent effective intervention strategies for reducing students' risk of being bullied and cyberbullied in schools.

Hypersexual behavior and HIV sex risk among young gay and bisexual men

PubMed Central

Yeagley, Emily; Hickok, Andrew; Bauermeister, José A.

2013-01-01

Hypersexual behavior has been identified as a sexual risk correlate among gay and bisexual men (GBM). The Hypersexual Behavior Inventory (HBI) has been shown to be a reliable and valid measure of hypersexual behavior in clinical populations, yet it has not been used to assess hypersexual behavior in non-clinical samples. We examined the psychometric properties of the HBI with survey data recorded between December 2009 and March 2010 in a sample of young men (N=366, M = 21.46 years old, SD = 1.95) who self-identified as gay (89%) or bisexual (11%), and assessed its association with unprotected receptive anal intercourse (URAI) partners and occasions. Using cross-sectional data of single, sexually active young GBM (YGBM), we used confirmatory factor analyses to test the HBI’s three-factor structure. Using negative binomial regressions, we then tested the association between the HBI subscales and sexual risk. After accounting for covariates, we found that sexual Control was a risk-factor for URAI partners and occasions, and Coping was found to be a protective factor for URAI occasions. In light of our findings, we discuss the importance of re-examining the theoretical assumptions of hypersexual behavior and propose HIV prevention strategies that may reduce young GBM’s vulnerability to HIV infection. PMID:24112113