Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States.
School of Community & Global Health, Claremont Graduate University, Claremont, CA, United States.
Soc Sci Med. 2017 Jul;185:102-109. doi: 10.1016/j.socscimed.2017.05.035. Epub 2017 May 18.
Implementation intentions are situation-linked action plans that increase health behaviors such as condom use. Few studies have measured the strength of implementation intentions, especially regarding condom use. Non-injection drug users are at high risk for HIV due to risky sexual practices. Substance use before sex may increase risky sexual behaviors, and implementation intentions are a promising, practical route for HIV prevention.
This prospective study assessed the measurement properties of the newly developed Strength of Implementation Intentions Scale (SIIS) for condom use and investigated whether the SIIS predicted condom use one-year later. The study evaluated whether behavioral intentions and alcohol or methamphetamine use before sex modified the relationship between the SIIS and condom use.
Participants were 590 non-injection drug users convicted of nonviolent drug offenses in court-mandated outpatient drug diversion programs. They completed self-directed computer assessments at baseline and at one-year follow-up. Measures included demographics, behavioral intentions to use condoms, the SIIS for condom use, alcohol and methamphetamine use before or during sex, and condom use. Psychometric properties, direct, and interaction effects of the SIIS were evaluated using structural equation modeling and general linear regressions.
The SIIS, behavioral intentions, and condom use were positively correlated and there was discriminant validity between all three constructs. In addition, the SIIS predicted condom use one-year later in this high-risk population. No significant interactions were detected.
The SIIS is predictive of condom use behavior, is psychometrically sound and distinct from behavioral intentions, and can be incorporated into HIV prevention interventions and used as a mediator variable. In addition, it can be used as an outcome measure where a follow-up is not feasible. The SIIS can also be tailored for additional HIV-related behaviors such as HIV-testing, adhering to antiretroviral medication, prescribing and adhering to pre-exposure prophylaxis, and other health behaviors.
实施意向是与情境相关的行动计划，可增加性行为（如使用避孕套）等健康行为。目前很少有研究测量实施意向的强度，特别是针对避孕套使用的情况。由于存在危险的性行为，非注射吸毒者感染艾滋病毒的风险较高。性行为前使用药物可能会增加危险行为，而实施意向是预防艾滋病毒的一种有前途且实用的方法。
本前瞻性研究评估了新开发的避孕套使用实施意向强度量表（SIIS）的测量特性，并调查了 SIIS 是否可以预测一年后的避孕套使用情况。该研究评估了性行为前的行为意向和酒精或冰毒使用是否会改变 SIIS 与避孕套使用之间的关系。
参与者是 590 名因非暴力毒品犯罪而被法院判处缓刑的非注射吸毒者，他们在门诊药物戒毒计划中完成了自我指导的计算机评估。他们在基线和一年后随访时完成了评估，评估内容包括人口统计学数据、使用避孕套的行为意向、避孕套使用 SIIS、性行为前或期间使用酒精和冰毒的情况以及避孕套使用情况。使用结构方程模型和一般线性回归评估 SIIS 的心理测量特性、直接和交互效应。
SIIS、行为意向和避孕套使用呈正相关，并且这三个构念之间存在区分效度。此外，SIIS 可以预测该高风险人群一年后的避孕套使用情况。未发现显著的交互作用。
SIIS 可预测避孕套使用行为，具有良好的心理测量学特性，且与行为意向不同，可以纳入 HIV 预防干预措施，并作为中介变量使用。此外，在无法进行随访的情况下，它也可以用作结果测量指标。SIIS 还可以针对其他与 HIV 相关的行为进行定制，如 HIV 检测、坚持使用抗逆转录病毒药物、开出处方并坚持使用暴露前预防以及其他健康行为。
