Department of Psychology, University of California-Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095-1563, USA.
Health Psychol. 2010 May;29(3):317-23. doi: 10.1037/a0019283.
Unprotected sexual behavior, needle sharing, and a prison history are major correlates of hepatitis B Virus (HBV). These risk factors are common among homeless people who also have elevated rates of HBV. We examine whether these behaviors were associated with completion or loss to follow-up of the most intensive and successful condition of a 3-arm HBV vaccination intervention. Significant results would imply that those most in need are the least compliant. Contributions of baseline demographics, physical health, psychosocial variables, and health beliefs were also assessed.
Three-hundred thirty-one adults from Los Angeles' Skid Row were assigned to nurse-case-managed sessions with hepatitis education, incentives, and tracking. Successive predictive structural equation models assessed the amount of variance accounted for by the risk variables, demographics, and the health-related variables.
(1) Completion of 3 injections by 6 months; and (2) loss to a 6-month follow-up questionnaire.
The 3 risk factors explained 2% of the variance in completion and 1% of the variance in loss. Adding the other variables increased the variance explained to 14% for completion and 13% for loss. African American ethnicity, positive coping, social support, poorer health, no prison history, and greater efficacy significantly predicted completion. White ethnicity, less social support, better health, and less intention to complete predicted participant loss.
The program was not strongly rejected differentially as a function of preexisting hepatitis B risk behaviors. Programs designed for homeless people should include malleable psychosocial and health belief model variables. These aspects of the lives of homeless people provide leverage points for future interventions.
无保护性行为、共用针头和监狱史是乙型肝炎病毒（HBV）的主要相关因素。这些风险因素在无家可归者中很常见，他们也有较高的 HBV 感染率。我们研究这些行为是否与 3 臂 HBV 疫苗接种干预中最密集和最成功的条件的完成或随访失败有关。如果这些行为与最需要的人的最低合规性有关，那么结果将具有重要意义。还评估了基线人口统计学、身体健康、心理社会变量和健康信念的贡献。
来自洛杉矶 Skid Row 的 331 名成年人被分配到接受护士管理的乙肝教育、激励和跟踪小组。连续的预测结构方程模型评估了风险变量、人口统计学和与健康相关的变量所解释的方差量。
（1）在 6 个月内完成 3 次注射；（2）在 6 个月的随访问卷中失去联系。
这 3 个风险因素解释了完成率的 2%和失访率的 1%的方差。添加其他变量将完成率的方差解释增加到 14%，失访率的方差解释增加到 13%。非裔美国人种族、积极应对、社会支持、健康状况较差、没有监狱史和更高的效能显著预测了完成情况。白种人种族、较少的社会支持、更好的健康状况和较低的完成意愿预测了参与者的失访。
该方案并没有因先前存在的乙型肝炎风险行为而被强烈拒绝。为无家可归者设计的方案应包括可塑的心理社会和健康信念模型变量。这些无家可归者生活的方面为未来的干预提供了着力点。
