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Biomedical subjects

L S Jemmott

Publications and source records attributed to L S Jemmott.

At least 19 recordsLinked to original sources

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↗

Borrowed theories, shared theories, and the advancement of nursing knowledge.

Despite the continued use of borrowed theories in nursing, little attention has been given to determining whether theories developed in another discipline are empirically adequate descriptions, explanations, or predictions of nursing phenomena. In this article, we demonstrate how a borrowed theory can be placed within a nursing context by linking it with two different conceptual models of nursing. We present our plans for research focused on condom use behavior and discuss how results from these studies will be used to determine whether the borrowed theory can be considered a shared theory.

Condoms↗

African American grandmothers' perceptions of caregiver concerns associated with rearing adolescent grandchildren.

In 1996, grandparents were the sole providers of care for 269,000 grandchildren. Research findings indicate that grandmothers are usually the primary caretakers of grandchildren. Previous issues associated with raising grandchildren vary, but usually relate to the grandparents' health, financial concerns, or lack of social support. This qualitative descriptive study was designed to describe African American grandmothers' perceptions about the burdens of raising adolescent grandchildren. Using this approach, the researchers were able to study the richness and diversity of the grandmothers' perceptions. Data were collected from 35 grandmothers through a focus group (n = 7) and during a 4-day intervention research study (n = 28) entitled "Grandmother-Grandchild Health Promotion Program." Numerous concerns were voiced by both groups, but those stated most frequently were associated with the well-being of grandchildren (grandchildren's sexual behavior, potential drug use, and potential risk of encountering violence) and relational conflicts with adult children. Unexpected findings were the absence of stated concerns associated with the grandmothers' financial situation or health. Recommendations for intervention, clinical practice, and research are discussed.

Adolescent↗

HIV among people with mental illness: contributing factors, prevention needs, barriers, and strategies.

1. Findings suggest that PWMI, including those with serious mental illness, are sexually active although some individuals, including mental health professionals, perceive them to be asexual or not sexually active. 2. PWMI may be particularly susceptible to HIV risk-related behaviors due to poor judgment, limited impulse control, deficits in problem-solving skills, and suicidal intent and self-destructive behavior. 3. Nurses, due to their close interaction with PWMI, are in key positions to document HIV risk-related behaviors and to advocate for integrating HIV risk reduction strategies into the therapeutic milieu.

Acquired Immunodeficiency Syndrome↗

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↗

Saving our children: strategies to empower African-American adolescents to reduce their risk for HIV infection.

Adolescence is normally a healthy period of life. For some young people it is a period of experimentation with risky behavior. For others, it marks the development of habitual risk behaviors that persist into adulthood. Of special concern is adolescent involvement with sexual behaviors that increase the risk of infection with HIV and other sexually transmitted diseases (STDs). Nurses who work with adolescents are seeing an increase in STDs, including HIV infection occurring disproportionately among African-American adolescents. Although the use of condoms can reduce the risk of these sexually transmitted diseases, most sexually active adolescents do not consistently use condoms. This paper will discuss the scope of the problem of STDs, especially HIV infection among African-American adolescents. It will describe the Theory of Planned Behavior as a framework for designing interventions to reduce the sexual transmission of HIV and other STDs. Finally, it will provide strategies for nurses to intervene by empowering African-American adolescents to reduce their risk for sexually transmitted HIV infection.

Adolescent↗

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↗

Hearing our voices: assessing HIV prevention needs among Asian and Pacific Islander women.

The purpose of this study was to (a) assess the impact of HIV/AIDS on the Asian-Pacific Islander (API) community and changes in their behavior due to AIDS, (b) identify perception of risk, HIV risk behaviors, factors contributing to those behaviors, barriers to HIV prevention, and the types of prevention programs that would benefit their community, and (c) describe culturally appropriate considerations when designing HIV prevention strategies for API women. Thirty API adults participated in three different groups. Focus group interviewing methods were used, guided by the Health Belief Model. The women had numerous concerns about HIV that placed them at risk for infection, such as their inability to talk with their sexual partners about condom use due to the cultural and taboo nature of sexual topics. All groups concluded that for HIV prevention interventions to be successful, they must be tailored to the cultural and specific needs of API women.

Adolescent↗

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↗

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↗

Effects of an institutional AIDS prevention intervention: moderation by gender.

AIDS risk reduction programs are being conducted in many institutional settings, but rigorous evaluations of their effectiveness are lacking. This is particularly unfortunate in that these programs are expensive, and tend to be of lower intensity than those that have been shown to be effective. Further, risk reduction is generally regarded as entailing greater difficulty for women, who do not use condoms themselves but must negotiate their use with male partners. We used a quasi-experimental design to evaluate an institutional AIDS prevention program on a New Jersey college campus. Sexual behavior was assessed via linked, anonymous mailed surveys at the beginning and end of an academic year among 1st-year students on the campus and others on a nearby control campus. Responses from the spring survey indicated that intervention campus students had been exposed significantly more than control students to intervention components. While MANCOVA analyses indicated no main effect of treatment group on outcome variable, we obtained a significant group by gender interaction, indicating a significant effect on number of risky encounters for men but not for women. In fact, relative to women on the control campus, women on the intervention campus displayed reduced self-efficacy to perform safe sex at the end of the year. These results may indicate that although men can be effectively reached by low-intensity risk reduction programs, women may not be. In fact, interventions without adequate intensity to provide substantial and individualized negotiation skill training may cause women to experience failure in these efforts.

Adolescent↗

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↗

Predictors of safer sex on the college campus: a social cognitive theory analysis.

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N = 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjunction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.

Acquired Immunodeficiency Syndrome↗

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↗

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↗

AIDS risk among black male adolescents: implications for nursing interventions.

Acquired immunodeficiency syndrome (AIDS) is a devastating disease the incidence of which is increasing in the black heterosexual community. Only 12% of the nation's population is black, yet 28% of the people with AIDS are black. AIDS currently threatens black adolescents because of their high risk sexual behavior. No cure exists for AIDS nor is a vaccine available. However, AIDS is preventable. Presently, teaching people how to avoid becoming infected with the human immunodeficiency virus is the only strategy for reducing the spread of AIDS. Nurses can be an important link in the chain of AIDS prevention in this country. Minimal information is available to assist nurses in learning how to effectively intervene with adolescents, especially black male adolescents, regarding AIDS prevention. This article reviews research on AIDS knowledge, attitudes, and high risk sexual behavior among black male adolescents, suggests strategies for using the nursing process as an AIDS education model in working with black male adolescents, and provides guidelines for nurses to use when working with black male adolescents concerning the issue of sexuality education and AIDS prevention.

Acquired Immunodeficiency Syndrome↗

Building community partnerships to improve HIV prevention efforts: implications for nurses.

Acquired immune deficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), is a major and complex public health crisis. The Centers for Disease Control and Prevention (CDC) issued effective community-based HIV prevention planning in its 1993 "Supplemental Guidance on HIV Prevention Community Planning" through the formation of community planning groups (CPGs). These guidelines are reviewed along with behavioral and social science theories that are the crux of HIV prevention theory-based research and program development. Nurses' roles in community-based HIV prevention as community advocates, HIV prevention program planners, practitioners, and researchers are discussed. The article concludes with nursing implications for HIV prevention.

Attitude to Health↗