Redding Colleen A, Prochaska James O, Armstrong Kay, Rossi Joseph S, Hoeppner Bettina B, Sun Xiaowu, Kobayashi Hisanori, Yin Hui-Qing, Coviello Donna, Evers Kerry, Velicer Wayne F
Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA
Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881 and Family Planning Council of Pennsylvania, Philadelphia, PA 19103, USA.
Health Educ Res. 2015 Feb;30(1):162-78. doi: 10.1093/her/cyu015. Epub 2014 May 2.
Smoking and sexual risk behaviors in urban adolescent females are prevalent and problematic. Family planning clinics reach those who are at most risk. This randomized effectiveness trial evaluated a transtheoretical model (TTM)-tailored intervention to increase condom use and decrease smoking. At baseline, a total of 828 14- to 17-year-old females were recruited and randomized within four urban family planning clinics. Participants received TTM or standard care (SC) computerized feedback and stage-targeted or SC counseling at baseline, 3, 6 and 9 months. Blinded follow-up telephone surveys were conducted at 12 and 18 months. Analyses revealed significantly more consistent condom use in the TTM compared with the SC group at 6 and 12, but not at 18 months. In baseline consistent condom users (40%), significantly less relapse was found in the TTM compared with the SC group at 6 and 12, but not at 18 months. No significant effects for smoking prevention or cessation were found, although cessation rates matched those found previously. This TTM-tailored intervention demonstrated effectiveness for increasing consistent condom use at 6 and 12 months, but not at 18 months, in urban adolescent females. This intervention, if replicated, could be disseminated to promote consistent condom use and additional health behaviors in youth at risk.
城市青春期女性中的吸烟和性风险行为普遍存在且问题严重。计划生育诊所接触到的是风险最高的人群。这项随机有效性试验评估了一种基于跨理论模型（TTM）的定制干预措施，以增加避孕套的使用并减少吸烟。在基线时，共招募了828名14至17岁的女性，并在四个城市计划生育诊所内进行随机分组。参与者在基线、3个月、6个月和9个月时接受TTM或标准护理（SC）的计算机化反馈以及分阶段针对性或SC咨询。在12个月和18个月时进行了盲法随访电话调查。分析显示，在6个月和12个月时，TTM组使用避孕套的一致性明显高于SC组，但在18个月时并非如此。在基线时使用避孕套情况一致的使用者（40%）中，在6个月和12个月时，TTM组的复吸率明显低于SC组，但在18个月时并非如此。尽管戒烟率与之前的研究结果相当，但未发现预防或戒烟的显著效果。这种基于TTM的定制干预措施在城市青春期女性中，在6个月和12个月时显示出增加避孕套使用一致性的有效性，但在18个月时未显示出有效性。如果重复这项干预措施，可以进行推广，以促进处于风险中的青少年持续使用避孕套以及采取其他健康行为。
