Perceived Parental and Peer Disapproval Toward Substances: Influences on Adolescent Decision-Making

This study investigated the relative influence of perceived parent and peer disapproval for using drugs on youth intentions to use drugs. In a cross-sectional design, sixth and eighth grade students (N = 1,649) completed surveys that included measures of parent disapproval, peer disapproval, and intentions to use drugs in the future. Parent influences were more salient for sixth graders, whereas peer influences were predominant for eighth graders. Peer disapproval was significantly evident in the sixth grade sample, as was parent disapproval in the eighth grade sample. Additionally, girls’ drug use intentions were higher than were boys’. These findings suggest that parents can have a robust protective role over and above peer influences and that girls’ intentions to use substances deserve increased attention. Editors’ Strategic Implications: These findings, if replicated, should help practitioners develop developmentally appropriate strategies and programs for substance use prevention.     

Effects of peer-led AIDS education aimed at Turkish and Moroccan male immigrants in The Netherlands. A randomised controlled evaluation study.

BACKGROUND: An evaluation study was conducted in The Netherlands into acquired immune deficiency syndrome (AIDS) education for immigrants given in their native language by peers. Turkish and Moroccan men were trained to educate people from their own ethnic group. The effect of peer education on the perceived threat of AIDS and beliefs about condom use were studied. METHODS: Places where male immigrants met, i.e. coffee houses, mosques and bars, were matched and randomly assigned to experimental and control groups. The experimental group filled out a short questionnaire at the end of the education session (post-test), whereas the control group was pre-tested and had the opportunity of following the AIDS education after participation in the questionnaire. RESULTS: Using multilevel logistic regression analysis, an effect could be established on misunderstandings regarding human immunodeficiency virus (HIV) transmission (OR = 5.9 and 95% CI: 2.3-15.3) and risk appraisal for HIV infection (OR = 2.9 and 95% CI: 1.3-6.3). The perceived benefits of the protective effect of condom use were affected in men 30 years and older, the perceived barrier of diminished satisfaction if using condoms was changed among unmarried men, condom self-efficacy was affected in men who valued peer education as important and an effect on intention to use condoms was found among Moroccans. CONCLUSION: Continuation of peer-led AIDS education for immigrants and adaption of the message to the needs of specific target groups is recommended.     

Gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the information-motivation-behavior skills (IMB) model

PurposeTo validate the predictive value of the Information-Motivation-Behavioral Skills (IMB) model of human immunodeficiency virus (HIV) prevention for sexually active juvenile offenders and to explore gender differences in IMB model constructs for condom-protected vaginal intercourse.MethodsSelf-report measures of acquired immune deficiency syndrome (AIDS) knowledge, pro-condom peer influence, risk perception, condom attitudes, condom use self-efficacy, frequency of vaginal intercourse, and frequency condom-protected vaginal intercourse were collected from predominantly African-American adolescent detainees. Analysis consisted of structural equation models for the combined sample (N = 523) and for separate gender groups (328 males and 195 females).ResultsIn the combined model, condom use was significantly predicted by male gender, peer influence, positive condom attitudes, and condom self-efficacy. In separate gender analyses, condom use among adolescent males was predicted by peer influence (modestly) and by positive condom attitudes, whereas condom use among females was predicted by peer influence, self-efficacy, and condom attitudes. Compared with males, females reported significantly greater knowledge, less peer influence, higher perceived risk for infection, more positive condom attitudes, and more self-efficacy, but they reported less condom use.ConclusionsFemales may find it difficult to use condoms consistently despite their awareness of their efficacy. Power imbalances or other dynamics operating in their relationships with males need further exploration. Gender differences in the relationship between condom self-efficacy and condom use were masked in the analysis of the total sample, indicating the value of testing theories of HIV prevention separately by gender.     

Are peer and social influences important components to include in HIV-STD prevention models?: Results of a survey on young people at Lund University, Sweden

An anonymous self-administered questionnaire (SAQ) mail surveywas conducted on a random sample (n=659) of undergraduate studentsat Lund University (n=20,000). The objective was to analysethe relationship between KABP (knowledge, attitudes, behaviourand practice) and social-normative variables to consistent condomuse and to investigate current student attitudes towards HIVpublic health promotions and the mass media. Multiple variablesindicated a significant relationship between social-normativeinfluences and consistent condom use, including perceived socialnorms, between-partner communication barriers, others' locusof control and respondents' self-reported Justifications forInconsistent use. Of the KABP variables, objective HIV knowledgeand perceived risk were predictors of inconsistent use. Highsubjective knowledge and a strong opinion that one should alwaysuse a condom with a new partner were predictors of consistentcondom use. This latter opinion was significantly related topositive perceived social norms, low communication barriersand satisfaction with one's knowledge of safer sex. The surveyalso revealed that over one-third of students doubted the trustworthinessof HIV health authorities and the mass media and an equal proportionfelt that national campaigns lacked personal relevancy. Theseresults suggest that social and peer influences are importantcomponents to include in HIV health promotion and that thereis a need to assist, empower and evaluate local community interventions.     

河池市2011—2015年女性性工作者安全套使用的影响因素

目的了解河池市女性性工作者安全套使用情况及其影响因素,为制定艾滋病防控策略和措施提供依据。方法对河池市辖区内不同场所档次女性性工作者进行匿名问卷调查,采用卡方检验和Kruskal Wallis H检验推断安全套使用情况,用logisitic回归分析对安全套使用状况的影响因素进行分析。结果共调查2011—2015年河池市女性性工作者10 867人,艾滋病相关知识总知晓率95.69%,2011—2015年艾滋病知识知晓率随场所档次提高而增大（趋势χ2=53.72,P<0.01）。安全套使用频率影响因素分析显示,来自高档场所（OR=3.034,95.0%CI=2.410~3.818）和中档场所（OR=1.807,95.0%CI=1.639~1.992）者较低档场所者坚持使用安全套的可能性较大,文化程度为高中及以上者（OR=1.403,95.0%CI=1.183~1.665）较初中及以下者坚持使用安全套的可能性较大。另外,艾滋病知识作答全对（OR=2.521,95.0%CI=2.291~2.773）、接受过安全套宣传和发放/艾滋病咨询与检测服务（OR=2.019,95.0%CI=1.568~2.599）、接受过同伴教育（OR=1.538,95.0%CI=1.365~1.733）均为安全套使用的促进因素。而年龄在40岁以上（OR=0.835,95.0%CI=0.737~0.945）则为影响安全套使用的危险因素。 结论安全套的使用主要受调查对象自身文化程度及其对艾滋病相关知识知晓程度等因素的影响,加强针对低档场所以及中年女性性工作者艾滋病知识宣传教育和行为干预,有利于提高安全套的使用率。     

A study of body weight concerns and weight control practices of 4th and 7th grade adolescents

Objective. The purpose of this study was to assess grade, race, socioeconomic status and gender differences in perceptions of body size, weight concerns, and weight control practices between 4th and 7th grade students in South Carolina. Design. Two random samples, consisting of a total of 1,597 children (53.1% white, 51.97% female, 44.9% 4th graders) participated in two questionnaire surveys. Both surveys included a series of seven female and seven male body size drawings, body image and weight concern questions, and questions pertaining to weight control practices. Responses to the questionnaire were analyzed using chi-square analysis and the General Linear Model. Results. Using socioeconomic status (SES), race, gender, and grade as independent variables, differences in ideal adult body size, opposite gender ideal adult body size, weight concerns, perceptions of family/peer weight concerns, perceptions of own body size and weight control practices were studied. Analyses revealed that 4th grade males select a larger ideal adult body size and opposite gender ideal adult body size when compared to 7th grade males ( p < 0.0001 and p = 0.0078, respectively). Fourth grade females indicated less personal concern about their weight than 7th grade females ( p = 0.0009). Fourth graders also perceived less family/peer concern about weight than 7th graders ( p = 0.0027) and 7th graders described themselves as being more overweight than 4th graders ( p = 0.0039). Blacks selected a significantly larger body size than white children for ideal adult ( p = 0.0287) and ideal opposite gender adult body size ( p < 0.0001 for males, p = 0.0030 for females). Blacks also perceived less personal and family/peer concern about weight when compared to whites ( p = 0.0083). More whites reported that they were trying to lose weight, as compared to blacks ( p = 0.0010). Males also selected significantly larger body size silhouettes than females for ideal adult body size ( p = 0.0012). Males expressed less personal concern about weight ( p < 0.0001), perceived less family/peer concern about weight ( p < 0.0001), and were less likely than females to be engaged in weight loss ( p < 0.0001). Females in the high SES category selected a significantly smaller ideal male adult body size than females in the low SES group ( p = 0.0124) and more females in the high SES category were trying to lose weight when compared to females in the low SES group ( p = 0.0055).) Conclusion. This study indicates that early in a child's sociocultural development, grade level, gender, race, and SES are influential in the perception of ideal adult body size and opposite gender ideal adult body size. These factors are also influential in determining concerns about weight and weight control practices. The findings of this study support the need to begin health and wellness education efforts early in childhood while taking into account racial, gender, age, and SES disparities. This knowledge can also be useful in targeting interventions for both obesity and eating disorders.     

Perceived legitimacy of parental authority and tobacco and alcohol use during early adolescence.

PURPOSE: To assess the likelihood that young adolescents perceive that parents have legitimate authority regarding cigarette smoking and alcohol consumption; to test whether perceived parental authority predicts adolescents' use of tobacco and alcohol, and to test the association between parenting style and the legitimacy of parental authority regarding tobacco and alcohol. METHODS: Survey data were obtained in 1997 from 1220 sixth and eighth grade adolescents enrolled in a central North Carolina school district. The sample comprised 72.3% of 1687 eligible students and 92.3% of 1321 students with parental consent; 83.8% of the sample was European-American and 16.2% African-American. Students completed self-report questionnaires administered in classrooms. Logistic regression models were used to test the study hypotheses. RESULTS: Adolescents were significantly more likely to legitimize parental authority regarding tobacco and alcohol than parental authority regarding conventional or contemporary issues. Failure to legitimize parental authority was associated with significantly greater odds of current smoking (OR = 4.06; p <.000) or drinking (OR = 3.81; p <.000) among all respondents, and significantly greater odds of intending to smoke (OR = 3.38; p <.000) or drink (OR = 3.38; p <.000) among abstinent respondents. Adolescents' perceptions of parental authority regarding tobacco and alcohol varied significantly by parenting style. CONCLUSIONS: The results discredit the myth that adolescents uniformly disregard parental values and rules regarding tobacco and alcohol. The results also showed that general parenting style covaried strongly with adolescents' perceptions of parental authority regarding substance use. Additional research is warranted to test for causal relations between general parenting style, adolescents' perceptions of parental authority regarding substance use, and adolescents' risk of substance use.     

Male heterosexual crack smokers with multiple sex partners: between- and within-person predictors of condom use intention

Little research has examined predictors of condom intention within concurrent partnerships. This study examined predictors of intention among 259 male African-American crack smokers with multiple partners. Each participant reported personal condom intention at next sex, condom use self-efficacy, responsibility and outcome expectances for himself and his perceptions for his last two sex partners. Stepwise logistic regressions showed that for both partners one and two, condom use at last sex and personal responsibility for condom use were predictors of intention to use condoms at next sex. Perceived partner responsibility was an additional positive predictor with Partner 2. Hierarchical generalized linear model analyses showed that positive intention was associated negatively with perceived partner responsibility and intimacy, while positively related to situational self-efficacy. Personal responsibility interacted with intimacy such that only men who indicated the highest levels of intimacy were more likely to intend to use condoms. Overall, the findings in this study support the need for examining additional social cognitive constructs that capture the interpersonal aspects of sexual relationships such as personal and perceived responsibility, intimacy and how beliefs may change between multiple partners and across time. Finally, the differences in the valence of perceived partner responsibility across analyses and the interaction of personal responsibility with intimacy suggest the need for studies that include measure of power within the relationship.     

Predictors of Intention to Practice Safer Sex Among Korean College Students

This study examined the efficacy of the Theory of Planned Behavior (TpB) among Korean college students on intentions of condom use. A cross-sectional, correlational design was conducted with an exploratory survey method. Young men and women aged 18-25 were recruited from a university in Seoul, Korea using a flyer and self-referral. Students completed a background and sexual behavior questionnaire, a parent-adolescent communication scale, and instruments derived from the TpB. Age, parent-adolescent communication, and perceived risk of sexual behavior were added to the model as potential determinants of intention of condom use. All the TpB components significantly predicted intention of condom use for young men, but only condom attitude and condom efficacy significantly predicted intention of condom use for young women. Age and quality of parent-adolescent communication indirectly affected the intention of condom use; however, perceived risk of sexual behavior did not predict intention of condom use, nor was it affected by age. Older students had a higher condom efficacy and a higher perceived peer norm of condom use. The quality of parent-adolescent communication significantly predicted a higher condom efficacy for young men, but not women.     

Correlates of Condom Use Among Male High School Students in Nairobi, Kenya

BACKGROUND: Correct and consistent condom use is an effective strategy to reduce the risk of sexually transmitted infections (STIs). This study examines sociodemographic, behavioral, and psychosocial characteristics of 3 groups of adolescent males: consistent, sporadic, and non-condom users.
METHODS: The sample consisted of 931 sexually experienced male high school students in Nairobi, Kenya. Cross tabulations and general linear models were used to test the relation between each explanatory variable and condom user group.
RESULTS: Fifty-three percent of respondents reported having used condoms. Compared with nonusers and sporadic users, consistent users engaged in sexual intercourse for the first time at an older age and reported higher condom use self-efficacy, more positive peer attitudes toward safe sex, and stronger attitudes toward condom use. Compared with sporadic and consistent users, nonusers reported fewer sexual partners, less substance use, and more frequent intercourse with non-romantic partners. Sporadic users, compared with the other 2 groups, had more sexual partners and stronger attitudes that support that males and females have separate roles. The 3 groups did not differ in HIV/AIDS knowledge. On average, respondents responded correctly to two thirds of the questions. All groups perceived their risk of contracting an STI as low, and this perception did not differ by condom use. Differences in participants' age by group were minimal.
CONCLUSIONS: The study supports the need for interventions that target specific condom use groups.     

Multiple Correlates of Cigarette Use Among High School Students

A cross-sectional survey research design measured factors related to cigarette use among 2,212 senior high school students. Results showed 14.3% of the sample smoked cigarettes at least occasionally, with 5.3% reporting they were daily smokers. About 12.8% indicated they were ex-smokers. Males and females smoked at almost equal rates, and the percentage of 10th grade student smokers was slightly higher (16.4%) than the percentage of juniors and seniors who smoked. Approximately 22% of Hispanic students, 15% of Caucasian students, and 4.5% of African-American students reported smoking cigarettes at least occasionally. An initial regression analysis used 21 variables to predict cigarette smoking. A more parsimonious regression model (R2 = .28), using variables from the initial regression analysis with significance levels of .01 or less, indicated the most important predictors of cigarette use were ethnic group, attitude toward females who smoke, close friends' use of cigarettes, personal use of marijuana, best friend's use of cigarettes, personal use of alcohol, and school self-esteem. Implications for school health programs are addressed.     

芜湖市镜湖区2011年暗娼人群艾滋病知识及相关行为调查报告

目的了解芜湖市镜湖区暗娼人群艾滋病相关知识的知晓情况、行为特征及其在商业性性行为中的安全套使用情况,为在公共娱乐场所性服务工作者中全面推广正确使用安全套、加强艾滋病的健康教育以及预防控制提供参考依据。方法采用暗娼人群哨点监测统一的调查问卷,对芜湖市镜湖区不同档次娱乐场所中暗娼人群进行行为学调查和血清学调查。结果共调查暗娼405人,HIV抗体检测均为阴性,梅毒感染率为9.63%,丙肝感染率为0.74%;中高档与低档暗娼艾滋病知晓率差异无统计学意义(P>0.05);中高档场所和低档场所暗娼最近一次安全套使用率和最近一个月安全套使用率差异有统计学意义(P<0.01);低档场所暗娼的梅毒感染率和中高档场暗娼梅毒感染率差异有统计学意义(P<0.01);多因素logisitic回归分析显示:娱乐场所的档次(P<0.01,OR=4.19)、文化程度(P<0.01,OR=1.82)、艾滋病知识知晓程度(P<0.01,OR=2.09)和接受同伴教育(P=0.01,OR=1.94)是安全套使用的影响因素。结论不同档次娱乐场所的暗娼艾滋病相关知识知晓率均较高,但每次性行为均使用安全套的比率仍然较低,低档场暗娼的安全套使用率更低,需要探索更有实效行为干预模式,提高安全套的全程正确使用率,以减少艾滋病经性行为传播。     

Psychosocial, school, and parent factors associated with recent smoking among early-adolescent boys and girls

BACKGROUND: Experimentation with smoking often begins during adolescence, but an adequate understanding of the factors associated with early initiation remains elusive. METHODS: Sixth- to eighth-grade students (n = 4,263, 67.1% white, 23.5% black, 7.2% other) from seven middle schools were surveyed. RESULTS: The overall prevalence of recent smoking (past 30 days) of 10.4% was similar for boys and girls and by race, but increased from 3.7% in sixth to 17.8% in eighth grade. In multiple logistic regression analyses positive outcome expectations, high perceived prevalence, deviance acceptance, and trouble at school were independently associated with smoking for both boys and girls. Among boys, problem-behaving friends, peer pressure, authoritative parenting, and mother's education and among girls, self-control problems, knowledgeable parents, and grade were independently associated with smoking. CONCLUSIONS: This is one of the few studies to report an independent association between smoking and outcome expectations, the first study to report an independent effect for peer influences among boys only, and one of several to find a negative association between smoking and positive parenting behavior. These findings suggest that the effectiveness of preventive interventions might be improved by targeting parent, school, and student outcomes, including outcome expectations, deviance acceptance, and social norms for both boys and girls, peer influences among boys, and self-control among girls.     

初中生性与生殖健康同伴教育过程评价

目的对初中生性与生殖健康同伴教育过程进行评价,为初中生性健康教育的实施提供依据.方法从上海市徐汇区3所中学的初一年级抽取145人和133人,分别接受本班同伴和本校初二年级学生的教育.利用小组活动形式,运用问卷、观察、专题小组讨论和个人深入访谈进行评价.结果项目组织良好,学生学习热情高,大多数学生骨干和教师对本次同伴教育给予了肯定评价.同班同学与高年级同学的同伴教育各有利弊.小组活动形式和教育流程受到师生欢迎.结论性同伴教育可接受性强,过程评价为其进一步实施提供了经验.     

Examining gender, racial, and age differences in weight concern among third, fifth, eighth, and eleventh graders

Weight management and concern, body weight beliefs, and perceptions of friend's and family's weight concerns were examined in this study by race, grade, and gender. A stratified random sample was used to select schools within nine districts in South Carolina and an anonymous self-report paper-pencil questionnaire was completed by the students. The final sample included 3151 African American (42.3%) and White (57.7%) children (51.7% female) in the third (n=599), fifth (n=686), eighth (n=1168), and eleventh (n=698) grades. White girls were more likely to report being overweight (P=.0042), having higher personal weight concerns (P<.0001), and perceiving higher friend (P<.0001) and family weight concerns (P<.0001) than the African American girls. Using multiple regression, 29.8% of the variance in the children's personal weight concern scores was explained by perceptions of family's weight concerns (R(2)=.1659), gender (R(2)=.0762), perceptions of friend's weight concerns (R(2)=.0392), grade (R(2)=.0094), a Race x Gender interaction (R(2)=.0042), and race (R(2)=.003). Most of the children, particularly the white girls, have personal weight concerns and dieting practices which place them at risk for possible health problems. These results support the need for nutrition interventions and education in early childhood. Programs to prevent obesity and eating disorders should be tailored for differences by gender, grade, and race.     

两种艾滋病预防教育方式效果的比较

目的为改进大学生艾滋病教育模式,对大学生艾滋病教育的两种方式———专题讲座和同伴教育进行比较分析。方法以问卷调查和随机访谈的形式对非医学专业的大学生进行两种教育方式效果的调查。结果在授课时间(2学时/12学时)、教育成本(600元/5000元)、教育效果、技能的掌握等方面两者存在差异,如对同学婚前性行为不介意两组差异显著(专题讲座为78.4%,同伴教育为55.0%,P<0.01),安全套的使用技能两组差异显著(专题讲座正确率为4.3%,同伴教育正确率为87.5%,P<0.01)。结论对非医学专业大学生来说,两种教育方式各有所长及不足,在知识积累与时间之比,大课的专题讲座优于同伴教育模式。     

HIV/AIDS prevention among the male population: results of a peer education program for taxicab and tricycle drivers in the Philippines.

This study assesses the results of a 2-year community-based peer education program aimed at increasing HIV/AIDS knowledge, attitudes toward condoms, and condom use behavior among taxicab and tricycle drivers in the Philippines. Pretest, posttest, and follow-up data were collected throughout the educational intervention program. The results of the repeated measures analysis of variance (ANOVA) indicate a significant change on knowledge about HIV/AIDS from baseline to posttest and from posttest to follow-up (F=449.27, df=2, p<.001). There was also a significant change on attitudes about condom use from baseline to posttest and from posttest to follow-up (F=425.19, df=2, p=0.001), and a significant effect on condom use behavior with commercial sex workers from baseline to posttest and follow-up (F=428.31, df=2, p=.001). The peer-mediated intervention was found to be an effective means of HIV/AIDS prevention among taxi and tricycle drivers in the Philippines.     

A Group Randomized Trial Evaluating High School FLASH,a Comprehensive Sexual Health Curriculum

PurposeTo evaluate the effectiveness of a school-based comprehensive sexual health curriculum (FLASH) on high-school students’ sexual behavior and related outcomes.MethodsA cohort of 1,597 9th and 10th grade students representing 20 schools from two regions in the U.S. (Midwest and South) were enrolled and completed the baseline survey. Following baseline, the 20 schools were randomly assigned to receive FLASH (n = 10 schools, five per region) or a knowledge-based sexual health curriculum (n = 10 schools, five per region). Follow-up surveys were administered at 3 months and 12 months after the instruction period.ResultsThere were no statistically significant differences between conditions for the overall sample on rates of vaginal sex in the past 3 months or the rates of vaginal sex without a condom or other birth control. In supplementary subgroup analyses of students who were not sexually experienced at baseline, FLASH showed a statistically significant protective impact at the 3-month follow-up on vaginal sex without a condom or birth control (p = .04). FLASH also showed statistically significant gains in psychosocial outcomes, such as refusal and condom use self-efficacy, attitudes toward birth control and condoms, and perceived norms.ConclusionsFLASH demonstrated consistent short-term and long-term impacts on key behavioral determinants. It also showed a significant impact on vaginal sex without a condom or other birth control for the subgroup of students who were not sexually experienced at baseline. Behavioral impacts were not evident for the entire study population.     

The Role of Risk and Protective Factors in Substance Use Across Adolescence

PURPOSE: To compare the relative influence of risk and protective factors across several domains on adolescent substance use in a large sample of youth. METHODS: Cross-sectional survey data were collected from students in grades 6, 8, 10, and 12 in Pennsylvania (N = 91,778). Generalized linear mixed models were estimated for each grade level to examine associations among indices of three risk factors (individual, peer, and family) and three protective factors (family, school, and community) and both recent and lifetime substance use. RESULTS: The risk factors were stronger predictors of substance use outcomes compared with the protective factors, regardless of grade level or substance use type. In particular, the individual and peer risk factors were strongly related to lifetime and recent use of cigarettes, alcohol, and marijuana. Among the protective factors, the strongest associations with substance use were found in the community domain. Several age-related differences in the associations were also found, suggesting that family and community factors were more salient among younger adolescents whereas peer and school factors were stronger among older adolescents. CONCLUSIONS: These findings provide support for the social development model (SDM), which proposes that adolescent substance use is associated with factors across multiple spheres of influence. Age-related differences in these associations suggest that effective interventions to reduce adolescent substance use may need to emphasize different domains of risk and protective factors at different stages of adolescent development.     

The relationship of adolescent perceptions of peer norms and parent involvement to cigarette and alcohol use

This investigation assessed the relative influence of peer norms and parental involvement on adolescent cigarette and alcohol use. An anonymous questionnaire was administered to 2,017 seventh- to 12th-grade students in two Ohio public school districts. Cigarette and alcohol use rates in the sample were comparable to those found in national probability surveys. Results indicated that the relative balance of peer-parent influences did not differ across grade level. At all grade levels, perceived peer norms had substantially greater correlations with cigarette and alcohol use than did measures of perceived parental involvement. The findings are interpreted from an efficiency perspective. Optimal use of prevention resources suggest that programming for seventh- to 12th-graders should focus on shaping the perceptions of peer smoking and drinking practices rather than on parent interventions. Social norms marketing or other forms of normative education should be tested in this population.