社会认知理论构建与自我报告的避孕套使用之间的关系：对“城市安全”试验一个亚组中的行为评估
Relationship between social cognitive theory constructs and self-reported condom use: assessment of behaviour in a subgroup of the Safe in the City trial.
作者信息
Snead Margaret C, O'Leary Ann M, Mandel Michele G, Kourtis Athena P, Wiener Jeffrey, Jamieson Denise J, Warner Lee, Malotte C Kevin, Klausner Jeffrey D, O'Donnell Lydia, Rietmeijer Cornelis A, Margolis Andrew D
机构信息
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Division of HIV/AIDS, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
出版信息
BMJ Open. 2014 Dec 30;4(12):e006093. doi: 10.1136/bmjopen-2014-006093.
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).
目的
以往研究发现，以社会认知理论（SCT）为框架的干预措施在提高避孕套使用和减少性传播感染（STIs）方面是成功的。我们对“城市安全”干预试验（2003 - 2005年）的行为数据进行了二次分析，以研究SCT构建因素对研究参与者在最后一次性交时自我报告的避孕套使用情况的影响。
方法
主要试验于2003年至2005年在美国的三家公共性传播感染诊所进行。根据就诊日期，患者（n = 38,635）要么在候诊室观看一段“安全性行为”视频，要么接受标准的候诊室体验。在研究参与者首次就诊后及3个月随访时，对一个子样本进行了嵌套式行为评估。我们使用多变量修正泊松回归模型来检验SCT构建因素（性自我效能感、自我控制自我效能感、与最近性伴侣的自我效能感、享乐主义结果期望和伴侣期望结果）与在3个月随访研究就诊时最后一次性行为中自我报告的避孕套使用情况之间的关系。
结果
纳入分析的1252名参与者中，39%报告在最后一次性行为中使用了避孕套。男性、同性恋取向和单身状态是避孕套使用的显著相关因素。未调整和调整后的模型均表明，性自我效能感（调整后相对风险（RRa）= 1.50，95%可信区间1.23至1.84）、自我控制自我效能感（RRa = 1.67，95%可信区间1.37至2.04）、与最近性伴侣的自我效能感（RRa = 2.56，95%可信区间2.01至3.27）、更有利的享乐主义结果期望（RRa =
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