Dataset Information

Relationship between social cognitive theory constructs and self-reported condom use: assessment of behaviour in a subgroup of the Safe in the City trial.

ABSTRACT:

Objectives

Previous studies have found social cognitive theory (SCT)-framed interventions are successful for improving condom use and reducing sexually transmitted infections (STIs). We conducted a secondary analysis of behavioural data from the Safe in the City intervention trial (2003-2005) to investigate the influence of SCT constructs on study participants' self-reported use of condoms at last intercourse.

Methods

The main trial was conducted from 2003 to 2005 at three public US STI clinics. Patients (n=38,635) were either shown a 'safer sex' video in the waiting room, or received the standard waiting room experience, based on their visit date. A nested behavioural assessment was administered to a subsample of study participants following their index clinic visit and again at 3?months follow-up. We used multivariable modified Poisson regression models to examine the relationships among SCT constructs (sexual self-efficacy, self-control self-efficacy, self-efficacy with most recent partner, hedonistic outcome expectancies and partner expected outcomes) and self-reported condom use at last sex act at the 3-month follow-up study visit.

Results

Of 1252 participants included in analysis, 39% reported using a condom at last sex act. Male gender, homosexual orientation and single status were significant correlates of condom use. Both unadjusted and adjusted models indicate that sexual self-efficacy (adjusted relative risk (RRa)=1.50, 95% CI 1.23 to 1.84), self-control self-efficacy (RRa=1.67, 95% CI 1.37 to 2.04), self-efficacy with most recent partner (RRa=2.56, 95% CI 2.01 to 3.27), more favourable hedonistic outcome expectancies (RRa=1.83, 95% CI 1.54 to 2.17) and more favourable partner expected outcomes (RRa=9.74, 95% CI 3.21 to 29.57) were significantly associated with condom use at last sex act.

Conclusions

Social cognitive skills, such as self-efficacy and partner expected outcomes, are an important aspect of condom use behaviour.

Trial registration number

clinicaltrials.gov (NCT00137370).

SUBMITTER: Snead MC

PROVIDER: S-EPMC4281534 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Relationship between social cognitive theory constructs and self-reported condom use: assessment of behaviour in a subgroup of the Safe in the City trial.

Snead Margaret C MC O'Leary Ann M AM Mandel Michele G MG Kourtis Athena P AP Wiener Jeffrey J Jamieson Denise J DJ Warner Lee L Malotte C Kevin CK Klausner Jeffrey D JD O'Donnell Lydia L Rietmeijer Cornelis A CA Margolis Andrew D AD

BMJ open 20141230 12

<h4>Objectives</h4>Previous studies have found social cognitive theory (SCT)-framed interventions are successful for improving condom use and reducing sexually transmitted infections (STIs). We conducted a secondary analysis of behavioural data from the Safe in the City intervention trial (2003-2005) to investigate the influence of SCT constructs on study participants' self-reported use of condoms at last intercourse.<h4>Methods</h4>The main trial was conducted from 2003 to 2005 at three public ...[more]

PMID: 25550295

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Project description:BackgroundRegular engagement in physical activity has well-established physical and psychological health benefits. Despite this, over a quarter of the global adult population is insufficiently physically active. Physical activity interventions grounded in behaviour change theory, such as the social-cognitive theory, are widely considered to be more effective than non-theoretical approaches. Such interventions set out to intervene on the ultimate outcome (physical activity), but also influence intermediate factors (social-cognitive theory constructs) which in turn, are believed to influence physical activity behaviour. The primary aim of the study was to use mediation analysis to examine whether changes in the social-cognitive theory and related constructs, in particular self-efficacy, outcome expectations, intentions, barriers and goal setting, mediated the effects of a smartphone-based social networking physical activity intervention.MethodsMediation analyses were conducted using the PROCESS Macro in SPSS to (i) calculate the regression coefficients for the effect of the independent variable (group allocation) on the hypothesised mediators (social-cognitive theory constructs), (ii) calculate the regression coefficient for the effect of the hypothesised mediators (social-cognitive theory constructs) on the dependent variable (objectively measured physical activity or self-report physical activity), independent of group assignment and (iii) determine the total, direct and indirect intervention effects.ResultsData from 243 participants were included in the mediation analysis. There was no evidence of mediation for change in objectively measured MVPA or self-reported MVPA.ConclusionsThere was no conclusive evidence that any of the social-cognitive theory constructs mediated the relationship between an app-based intervention and change in physical activity. Ongoing efforts to develop and understand components that make physical activity app-based interventions effective are recommended.Trial registrationThis trial was registered with the Australian and New Zealand Clinical Trial Registry ( ACTRN12617000113358 , date of registration 23 January, 2017).

Project description:ObjectiveTo investigate whether rates of self-reported Woman's Condom (WC) clinical failure and semen exposure from a functionality study are comparable to results from a contraceptive efficacy substudy.Study designWe structured our comparative analysis to assess whether functionality studies might credibly supplant contraceptive efficacy studies when evaluating new female condom products. Couples not at risk of pregnancy in the functionality (breakage/slippage/invagination/penile misdirection) study and women in the contraceptive efficacy study completed condom self-reports and collected precoital and postcoital vaginal samples for up to four uses of the WC. Both studies used nearly identical self-report questions and the same self-sampling procedures and laboratory for prostatic specific antigen (PSA), a well-studied semen biomarker. We compared condom failure and semen exposure proportions using generalized estimating equations methods accounting for within-couple correlation.ResultsNinety-five (95) efficacy substudy participants used 334 WC and 408 functionality participants used 1572 WC. Based on self-report, 19.2% WC (64 condoms) clinically failed in the efficacy substudy compared to 12.3% WC (194 condoms) in the functionality study (p=.03). Of the 207 WC efficacy uses with evaluable postcoital PSA levels, 14.5% (30 uses) resulted in semen exposure compared to 14.2% (184 uses) of the 1293 evaluable WC functionality study uses.ConclusionsWhen evaluating the ability of an experimental condom to prevent semen exposure, the rate of clinical condom failure reported by participants risking pregnancy in an efficacy substudy was significantly higher than the rate reported by participants not risking pregnancy in a functionality study. The rate of semen exposure, assessed by an objective biomarker was nearly identical for the two studies.ImplicationsOur results suggest that an objective marker of semen exposure in functionality studies could provide a reasonable alternative to contraceptive efficacy studies in evaluating risk of unintended pregnancy and inferring protection from sexually transmitted infection than condom failure rates based on self-report.

Dataset Information

Relationship between social cognitive theory constructs and self-reported condom use: assessment of behaviour in a subgroup of the Safe in the City trial.

Objectives

Methods

Results

Conclusions

Trial registration number

Publications

Relationship between social cognitive theory constructs and self-reported condom use: assessment of behaviour in a subgroup of the Safe in the City trial.

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