PubMed Health⌕ Search

Biomedical subjects

J B Jemmott

Publications and source records attributed to J B Jemmott.

At least 19 recordsLinked to original sources
PubMed2001

The theory of planned behavior as a model of intentions for fighting among African American and Latino adolescents.

OBJECTIVES: To test the theory of planned behavior as a model for predicting and understanding behavioral intentions for fighting among inner-city adolescents and to determine whether its predictive power differs as a function of ethnicity (African American versus Latino). METHODS: Participants were 956 (511 females, 445 males) African American (n = 702) and Latino (n = 254) adolescents (mean age = 12.72 years; SD = 1.12) recruited from sixth, seventh, and eighth grade classes in public middle schools serving two inner-city communities in New Jersey who completed self-administered, confidential questionnaires. RESULTS: Consistent with the theory of planned behavior, hierarchical multiple regression analyses revealed that attitudes, subjective norms, and perceived behavioral control predicted intentions for fighting. Although the theory of planned behavior accounted for substantial variance in intentions to fight in both ethnic groups, it accounted for greater variance among Latinos than among African Americans. The strength of the relations of subjective norms and perceived behavioral control to intentions was similar in the two groups. but the relation of attitudes to intentions to fight was significantly stronger among Latinos. CONCLUSIONS: The findings strongly suggest that the theory of planned behavior provides a potentially useful conceptual framework for guiding the creation of interventions for African American and Latino adolescents that are designed to reduce violent behavior and the tragedies that such behavior leaves in its wake.

Adolescent↗
PubMed2000

Economic evaluation of HIV risk reduction intervention in African-American male adolescents.

PURPOSE: To evaluate the cost-effectiveness of a cognitive-behavioral HIV risk reduction intervention for African-American male adolescents that has previously been shown to be effective at reducing sexual risk taking. METHODS: Standard techniques of cost-utility analysis were employed. A societal perspective and a 3% discount rate were used in the main analysis. Program costs were ascertained retrospectively. A mathematical model of HIV transmission was used to translate observed changes in sexual behavior into an estimate of the number of HIV infections the intervention averted. Intervention effects were assumed to last for 1 year. For each infection averted, the corresponding savings in future HIV-related medical care costs and quality-adjusted life years (QALYs) were estimated. The overall net cost per QALY saved (cost-utility ratio) was then calculated. Sensitivity analyses were performed to assess the robustness of the main results. RESULTS: The cost-utility ratio was approximately $57,000 U.S. per QALY saved when training costs were included, and $41,000 U.S. per QALY saved when they were excluded. The intervention appeared substantially more cost-effective when the analysis was restricted to the subgroup of participants who reported being sexually active at baseline. Assumptions about the prevalence of HIV infection and the duration of intervention effectiveness also greatly affected the cost-utility ratio. CONCLUSIONS: The HIV prevention intervention was moderately cost-effective in comparison with other health care programs. Selectively implementing the intervention in high-HIV prevalence communities and with sexually active youth can enhance cost-effectiveness.

Adolescent↗
PubMed2000

HIV risk reduction behavioral interventions with heterosexual adolescents.

This article provides a comprehensive review of research on the effects of behavioral interventions on heterosexual adolescents' HIV sexual-risk behavior. It details adolescents' risk of sexually transmitted HIV infection and describes challenges associated with adolescent intervention research, including obtaining school and parent approval and the validity of self-reported measures. It describes central characteristics of 36 controlled intervention studies assessing the HIV sexual-risk behavior of over 30,000 male and female adolescents 11-21 years of age. It summarizes the participants' race/ethnicity and age, the theoretical framework, and the intervention setting, duration and outcome. This review reveals that the most commonly assessed behavioral outcomes were condom use and abstinence, and the largest effects sized were on condom use and condom acquisition. Effect sizes for abstinence and number of sexual partners were the smallest. Perceived self-efficacy and behavioral interventions were the most commonly assessed theoretical mediators. Key questions this research engaged in included whether behavioral skills can be increased, whether intervention-induced behavior change can be sustained, whether matching the race/ethnicity and gender of facilitators and participants enhances the effectiveness of culturally sensitive interventions, whether classroom teachers can effectively facilitate interventions, whether the behavior of high-risk populations can be changed, and which kinds of interventions are most effective. This review concludes that carefully designed theory-based interventions that take into account the characteristics of the particular population or culture can cause positive changes in adolescents' HIV sexual-risk behavior, but boundary conditions for their effectiveness still need to be identified. Several suggestions for additional research are proffered.

Adolescent↗
PubMed1999

Reducing HIV risk-associated sexual behavior among African American adolescents: testing the generality of intervention effects.

This randomized controlled trial tested the effects of a theory-based culture-sensitive HIV risk-reduction intervention among 496 inner-city African American adolescents (mean age = 13 years) and examined the generality of its effects as a function of the facilitator's race and gender and the gender composition of the intervention group. Adolescents who received the HIV risk-reduction intervention expressed more favorable behavioral beliefs about condoms, greater self-efficacy, and stronger condom-use intentions postintervention than did those who received a control intervention on other health issues. Six-month follow-up data collected on 93% of the adolescents revealed that those who received the HIV risk-reduction intervention reported less HIV risk-associated sexual behavior, including unprotected coitus, than did their counterparts in the control condition. Self-reported sexual behavior and changes in self-reported behavior were unrelated to scores on a standard measure of social desirability response bias. There was strong evidence for the generality of intervention effects. Moderator analyses testing eight specific interaction hypotheses and correlational analyses indicated that the effects of the HIV risk-reduction intervention did not vary as a function of the facilitator's race or gender, participant's gender, or the gender composition of the intervention group.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Abstinence and safer sex HIV risk-reduction interventions for African American adolescents: a randomized controlled trial.

CONTEXT: African American adolescents are at high risk of contracting sexually transmitted infection with human immunodeficiency virus (HIV), but which behavioral interventions to reduce risk are most effective and who should conduct them is not known. OBJECTIVE: To evaluate the effects of abstinence and safer-sex HIV risk-reduction interventions on young inner-city African American adolescents' HIV sexual risk behaviors when implemented by adult facilitators as compared with peer cofacilitators. DESIGN: Randomized controlled trial with 3-, 6-, and 12-month follow-up. SETTING: Three middle schools serving low-income African American communities in Philadelphia, Pa. PARTICIPANTS: A total of 659 African American adolescents recruited for a Saturday program. INTERVENTIONS: Based on cognitive-behavioral theories and elicitation research, interventions involved 8 1-hour modules implemented by adult facilitators or peer cofacilitators. Abstinence intervention stressed delaying sexual intercourse or reducing its frequency; safer-sex intervention stressed condom use; control intervention concerned health issues unrelated to sexual behavior. MAIN OUTCOME MEASURES: Self-reported sexual intercourse, condom use, and unprotected sexual intercourse. RESULTS: Mean age of the enrollees was 11.8 years; 53% were female and 92.6% were still enrolled at 12 months. Abstinence intervention participants were less likely to report having sexual intercourse in the 3 months after intervention than were control group participants (12.5% vs 21.5%, P=.02), but not at 6- or 12-month follow-up (17.2% vs 22.7%, P=.14; 20.0% vs 23.1%, P=.42, respectively). Safer-sex intervention participants reported significantly more consistent condom use than did control group participants at 3 months (odds ratio [OR]=3.38; 95% confidence interval [CI], 1.25-9.16) and higher frequency of condom use at all follow-ups. Among adolescents who reported sexual experience at baseline, the safer-sex intervention group reported less sexual intercourse in the previous 3 months at 6- and 12-month follow-up than did control and abstinence intervention (adjusted mean days over prior 3 months, 1.34 vs 3.77 and 3.03, respectively; P< or =.01 at 12- month follow-up) and less unprotected intercourse at all follow-ups than did control group (adjusted mean days, 0.04 vs 1.85, respectively, P<.001, at 12-month follow-up). There were no differences in intervention effects with adult facilitators as compared with peer cofacilitators. CONCLUSION: Both abstinence and safer-sex interventions can reduce HIV sexual risk behaviors, but safer-sex interventions may be especially effective with sexually experienced adolescents and may have longer-lasting effects.

Adolescent↗
PubMed1998

Effects of an HIV risk reduction project on sexual risk behavior of low-income STD patients.

A 10-hour small-group informational and skill-building intervention was tested among patients (N = 472) attending publicly funded sexually transmitted disease clinics in Maryland, Georgia, and New Jersey. After completing a 90-minute interview concerning HIV risk behaviors, condom use self-efficacy and condom outcome expectancies, participants were randomized to either an intervention or a control condition. Participants in both conditions displayed significant reductions in unprotected encounters and number of partners and increases in condom use. No differences between treatment conditions were observed, indicating that the motivational effects of the interview may have been stronger than the effects of the intervention in this population.

Adolescent↗
PubMed1992

Perceived risk of infection and attitudes toward risk groups: determinants of nurses' behavioral intentions regarding AIDS patients.

The relationship of perceived occupational risk of AIDS and attitudes toward AIDS risk groups to behavioral intentions regarding the care of AIDS patients was examined among nurses (N = 496) residing in a selected area of New Jersey, a state with a relatively high number of reported AIDS cases. Hierarchical multiple regression analyses on anonymous mail survey responses revealed that, controlling for AIDS knowledge and years of education, nurses who perceived that caring for AIDS patients increased their risk of HIV infection scored higher on an index of intentions to avoid AIDS patient care. In addition, nurses who expressed more negative attitudes toward intravenous drug users or homosexuals were more likely to report similar intentions to avoid AIDS patient care. The implications of these findings for efforts to increase nurses' ability and willingness to provide quality care to persons with AIDS are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Self-efficacy, hedonistic expectancies, and condom-use intentions among inner-city black adolescent women: a social cognitive approach to AIDS risk behavior.

The effects on condom-use intentions of an acquired immune deficiency syndrome (AIDS) prevention intervention based on social cognitive theory were investigated among 19 sexually active black adolescent women recruited from an inner-city family planning clinic. The women received the social cognitive intervention designed to increase perceived self-efficacy and favorable outcome expectancies about the hedonistic consequences of using condoms or one of two control interventions: An information-alone intervention designed to increase AIDS knowledge or a general health-promotion intervention designed to provide information about important health problems other than AIDS. All interventions lasted 105 min and involved films and small-group exercises. Participants' evaluations did not differ among conditions. As hypothesized, analysis of covariance indicated that participants in the social cognitive condition reported greater intentions to use condoms than did those in the two control conditions. In addition, participants in the social cognitive condition scored higher in perceived self-efficacy and favorable hedonistic expectancies--the two hypothesized mediators of the intervention effect. Although participants who received the information-alone intervention subsequently had greater AIDS knowledge than did those in the health promotion condition, they did not express greater intentions to use condoms. These results highlight the value of a social cognitive approach to AIDS risk behavior: outcome expectancies regarding the effects of precautionary practices on sexual enjoyment and perceived self-efficacy to implement such practices play an important role in decisions about condom use.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention.

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.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Predicting intentions to use condoms among African-American adolescents: the theory of planned behavior as a model of HIV risk-associated behavior.

The relation of attitudes, subjective norms, and perceived behavioral control to intentions to use condoms was examined among 179 adolescents who completed a confidential self-administered questionnaire prior to participating in a minority youth health conference. Approximately 72% of the adolescents were African Americans. Hierarchical multiple regression analyses revealed that attitudes and subjective norms predicted intentions to use condoms and that, consistent with the theory of planned behavior, perceived behavioral control added a significant increment to the squared multiple correlation. Although adolescents' perceptions of their friends' approval of condom use was unrelated to their condom-use intentions, adolescents' behavioral beliefs about the effects of condoms on sexual enjoyment, normative beliefs regarding partners' and mothers' approval, and control beliefs regarding technical skill at using condoms were associated with such intentions. These results suggest the utility of the theory of planned behavior as a model of condom use among adolescents. Implications for HIV risk-reduction interventions are discussed.

Adolescent↗
PubMed1990

Motivational syndromes associated with natural killer cell activity.

This article reports three studies that taken together support two hypotheses: (a) that the stressed power motivation syndrome is associated with relatively low natural killer cell activity (NKCA) and (b) that the unstressed affiliation motivation syndrome is associated with higher NKCA. In Study 1, college students who were relatively high in stressed power motivation had significantly lower NKCA than did their peers. In addition, students high in unstressed affiliation motivation had significantly greater NKCA than did those showing less evidence of this syndrome. Study 2 replicated these findings on a sample of middle-class men. In Study 3, which tested the hypotheses among adult patients from a Health Maintenance Organization, results were in the same direction but less significant. Meta-analyses clearly indicate that the combined evidence from the three studies reliably supports both hypotheses.

Adult↗
PubMed1989

From rarity to evaluative extremity: effects of prevalence information on evaluations of positive and negative characteristics.

Experiments showed a scarcity principle in evaluative judgments such that the identical characteristic is evaluated more extremely the lower its perceived prevalence. In Study 1, Ss evaluated a fictitious medical condition that was described as either beneficial or detrimental to health and as occurring in either 30% or in one half of 1% of a test population. The condition was evaluated more extremely--as as a more positive health asset or a more negative health liability--in the low-prevalence than in the high-prevalence conditions. Study 2 demonstrated the same effect in self-evaluations and with a different manipulation of perceived prevalence. Ss were told that they actually had the fictitious medical condition, that it was either beneficial or detrimental to their health, and either that they were the only 1 of 5 Ss who had it or that 4 of the 5 did. Low-prevalence Ss exhibited more extreme evaluative, affective, and behavioral reactions to the medical condition than did high-prevalence Ss. The origins and validity of the scarcity principle are discussed, as are its implications for uniqueness theory, reactance theory, and social evaluation theories.

Adult↗
PubMed1989

Secretory IgA as a measure of resistance to infectious disease: comments on Stone, Cox, Valdimarsdottir, and Neale.

We examined recent assertions of Stone, Cox, Valdimarsdottir, and Neale regarding the use of S-IgA concentrations in whole saliva as a measure of mucosal immune competence. Our conclusions are markedly different from theirs. In this article, we report the results of a meta-analysis that reveals a significant relation between psychosocial variables and salivary S-IgA concentrations. Second, we note that an inverse relation between salivary flow and S-IgA would not preclude studying salivary S-IgA concentration. Third, we present a different perspective on the assertion of Stone et al that IgA proteases in whole saliva potentially lead to erroneous results from the radial immunodiffusion assay. Fourth, we report a meta-analysis suggesting a statistically significant relation between S-IgA salivary concentrations and the incidence of acute upper respiratory illnesses. We conclude that there is no empirical or logical reason to prefer the measurement of another aspect of immunity to total S-IgA concentration in whole saliva.

Communicable Diseases↗
PubMed1988

Academic stress, social support, and secretory immunoglobulin A.

We examined the relation of academic stress and social support to salivary concentrations of secretory immunoglobulin A (S-IgA), an antibody class that plays an important role in mucosal defense against acute upper respiratory tract infections. We assayed whole, unstimulated saliva samples collected from 15 healthy undergraduates 5 days before their final exam period, during their exam period, and 14 days after their last final exam for S-IgA concentrations by single radial immunodiffusion. The students rated the university's general psychological climate as being more stressful during the exam period compared with the two other periods. Paralleling this, their salivary concentrations of S-IgA were lower during the exam period. Students who reported more adequate social support at the preexam period had consistently higher S-IgA levels than did their peers reporting less adequate social support. This latter finding is consonant with the social support direct effects hypothesis, which states that social support enhances health outcomes irrespective of whether the individual is exposed to stressful experiences.

Achievement↗
PubMed1988

Common sense epidemiology: self-based judgments from laypersons and physicians.

This article reports two studies on a neglected aspect of common sense epidemiology: subjective estimates of the prevalence of symptoms and diseases. Based on social-psychological research on the false-consensus effect, it was hypothesized that subjects who had a history of a condition would estimate its prevalence to be greater than would subjects who did not have a history of that condition. This hypothesis was supported across several different symptoms and diseases. Expertise did not confer protection from the effect. It occurred among 110 college students in Study 1 as well as among 65 practicing physicians in Study 2. In addition, college students who estimated the prevalence of a condition as relatively high rated that condition as less life-threatening than did other students, and students who had a history of a condition rated it as less life-threatening than did their counterparts without such a history. The discussion focuses on (a) explanations of differences in prevalence estimates as a function of personal health history, (b) implications for laypersons' judgments of seriousness, their emotional reactions to illness threats, and their illness behavior, and (c) implications for physicians' diagnostic behavior.

Adolescent↗
PubMed1988

Appraising the threat of illness: a mental representational approach.

This article (a) describes a mental model underlying initial evaluations of illness signs and (b) reports an experiment demonstrating the model's utility by showing how the model represents evidence of defensiveness among people who test positively for a sign of illness. The model consists of a set of cognitive elements that people consider to evaluate the threat represented by a sign of possible illness. Seventy-two undergraduates were led to believe that they tested positively or negatively on a saliva test for a fictitious risk factor for a disease. In addition, half the participants were told about the existence of a simple preventive treatment for the disease, whereas the others were not. Subsequently the participants answered questions about elements of the threat-appraisal model. Analysis of their responses reveals evidence of defensiveness on several elements of the model. Those testing positively for the risk factor, especially those uninformed about its treatment, minimized threat by (a) increasing their estimates of the false-positive rate of the test, (b) decreasing their estimates of the seriousness of the risk factor, and (c) decreasing their estimates of the extent to which the disease itself is life-threatening. Applications of the model to actual illness threats and the relation between threat-related judgments and health-related behavior are discussed.

Attitude to Health↗