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Mediation and moderation of an efficacious theory-based abstinence-only intervention for African American adolescents.

ABSTRACT: This secondary data analysis sought to determine what mediated reductions in self-reported sexual initiation over the 24-month postintervention period in early adolescents who received "Promoting Health among Teens," a theory-based, abstinence-only intervention (Jemmott, Jemmott, & Fong, 2010).African American Grade 6 and 7 students at inner-city public middle schools were randomized to 1 of 5 interventions grounded in social-cognitive theory and the theory of reasoned action: 8-hr abstinence-only targeting reduced sexual intercourse; 8-hr safer-sex-only targeting increased condom use; 8-hr and 12-hr comprehensive interventions targeting sexual intercourse and condom use; 8-hr control intervention targeting physical activity and diet. Primary outcome was self-report of vaginal intercourse by 24 months postintervention. Potential mediators, assessed immediately postintervention, were theory-of-reasoned-action variables, including behavioral beliefs about positive consequences of abstinence and negative consequences of sex, intention to have sex, normative beliefs about sex, and HIV and sexually transmitted infection (STI) knowledge. We tested single and serial mediation models using the product-of-coefficients approach.Of 509 students reporting never having vaginal intercourse at baseline (324 girls and 185 boys; mean age = 11.8 years, SD = 0.8), 500 or 98.2% were included in serial mediation analyses. Consistent with the theory of reasoned action, the abstinence-only intervention increased positive behavioral beliefs about abstinence, which reduced intention to have sex, which in turn reduced sexual initiation. Negative behavioral beliefs about sex, normative beliefs about sex, and HIV/STI knowledge were not mediators.Abstinence-only interventions should stress the gains to be realized from abstinence rather than the deleterious consequences of sexual involvement.

SUBMITTER: Zhang J

PROVIDER: S-EPMC5862040 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Mediation and moderation of an efficacious theory-based abstinence-only intervention for African American adolescents.

Zhang Jingwen J Jemmott John B JB Jemmott Loretta Sweet LS

Health psychology : official journal of the Division of Health Psychology, American Psychological Association 20150727 12

<h4>Objective</h4>This secondary data analysis sought to determine what mediated reductions in self-reported sexual initiation over the 24-month postintervention period in early adolescents who received "Promoting Health among Teens," a theory-based, abstinence-only intervention (Jemmott, Jemmott, & Fong, 2010).<h4>Method</h4>African American Grade 6 and 7 students at inner-city public middle schools were randomized to 1 of 5 interventions grounded in social-cognitive theory and the theory of re ...[more]

PMID: 26214076

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Project description:African Americans are subject to health disparities in smoking and chronic pain. Given that nicotine has analgesic properties, increases in acute pain may be an expression of the tobacco abstinence syndrome, particularly among African American smokers with chronic pain. This report is a secondary analysis of data from an ongoing study of individual differences in laboratory-derived tobacco abstinence phenotypes in African American smokers. We tested whether overnight smoking abstinence increased acute pain and whether abstinence-induced changes in acute pain were correlated with other expressions of tobacco abstinence and amplified among smokers with chronic pain. African American smokers (N = 214; 10+ cig/day) attended a baseline visit (when chronic pain was reported), and two counterbalanced experimental sessions (ad libitum smoking vs. 16-hr smoking abstinence). At both experimental sessions, measures of self-reported acute pain and other tobacco abstinence symptoms were administered. Smoking abstinence significantly increased acute pain (d = .17, p = .01). Correlations between abstinence-induced changes in acute pain and abstinence-induced changes in negative affect, r = .15, p = .02, smoking urges, r = .13, p = .05, and composite nicotine withdrawal symptoms, r = .13, p = .06, were small and nonsignificant after correction for multiple tests, indicating that phenotypic variation in abstinence-provoked changes in acute pain and other tobacco abstinence expressions were largely independent. Baseline levels of chronic pain predicted greater abstinence-induced pain amplification at experimental sessions (βs = .29-.31; ps < .001). Acute pain is greater following overnight tobacco abstinence (vs. satiation) among African American smokers, predominantly among those with chronic pain. Addressing pain in tobacco addiction science, treatment, and health equity programming warrants consideration. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Project description:PURPOSE:The current study was intended to assess the effect of a facilitated behavioral intervention based on the extended theory of planned behavior (TPB) on psychological constructs and physical activity among adolescents over a period of eight weeks. METHODS:Students (n = 51, 12 ± 0.3 years of age) in the seventh grade at a junior middle school in China were randomly assigned to two groups: the intervention group (n = 24) and the control group (n = 27). Both groups were pre- and post-tested with the related psychological constructs of the extended TPB, along with behavioral measures of the Physical Activity Scale and ActiGraph accelerometer (model wGT3X-BT). The intervention group took part in 45 min classes once per week for 8 weeks, including five indoor theoretical courses and three outdoor basketball matches. The control group was not required to make any change to their normal school day. Also, 2 × 2 repeated measures analysis of variance (ANOVA) was conducted to compare the differences between the two groups, and then t-test was employed to compare the independent and paired differences. RESULTS:Significant increases in pre-post subjective norms (SN) (p = 0.041, Cohen's d = 0.62), perceived behavior control (PBC) (p = 0.023, Cohen's d = 0.72), exercise intention (EI) (p = 0.043, Cohen's d = 0.61), and self-efficacy (SE) (p = 0.035, Cohen's d = 1.36) were observed in the intervention group. In addition, participants in the intervention group increased their exercise frequency (p < 0.001, Cohen's d = 1.25) and intensity (p = 0.028, Cohen's d = 0.68), especially their time spent on light intensity physical activity (light-PA%; p = 0.031, Cohen's d = 0.68), and their percentage of sedentary time (SB%) was also reduced (from 68% ± 10% to 58% ± 7%, p < 0.001, Cohen's d = 1.17). Furthermore, the intervention group showed significantly better performance in PBC (p = 0.032, Cohen's d = 0.62), EI (p < 0.001, Cohen's d = 1.32), SE (p < 0.001, Cohen's d = 1.15), SB% (p < 0.001, Cohen's d = 1.22), light-PA% (p < 0.001, Cohen's d = 1.12), and total physical activity (TPA) (p = 0.015, Cohen's d = 0.72) compared to the control group at the post-test. No significant pre post differences were observed for any psychological or behavioral variables in the control group, except for exercise frequency, but the values were still lower than those in the intervention group after the 8-week intervention (3.70 ± 0.72 versus 3.92 ± 0.83). CONCLUSION:The combined theory-based intervention was effective at improving psychological constructs and physical activity among seventh-grade adolescents in 8 weeks.

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Mediation and moderation of an efficacious theory-based abstinence-only intervention for African American adolescents.

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Mediation and moderation of an efficacious theory-based abstinence-only intervention for African American adolescents.

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