Health Behavior Research and Training Institute, Steve Hicks School of Social Work, University of Texas at Austin.
Diana R. Garland School of Social Work, Baylor University.
J Consult Clin Psychol. 2023 May;91(5):301-312. doi: 10.1037/ccp0000793. Epub 2023 Jan 19.
Further test mechanisms of the CHOICES intervention by replicating analyses of the experiential and behavioral processes of change (POC) for alcohol and for contraception as mediators of the intervention for reducing risk of alcohol-exposed pregnancy (AEP) using data from a more recent trial, CHOICES Plus (CP).
As in the prior study, replication models examined indirect paths from intervention to experiential POC for alcohol at 3 months, to behavioral POC at 9 months, to risky drinking and risk of AEP at 9 months and experiential POC for contraception at 3 months, to behavioral POC at 9 months, and to ineffective contraception and risk of AEP at 9 months. To test the temporal relationship, additional models examined the indirect path from behavioral POC for alcohol and POC for contraception at 3 months, to the experiential POC at 9 months, and to risk of AEP at 9 months. A final model tested the mediation of experiential and behavioral POC assessed at 3 months.
There was an indirect effect of the intervention on risky drinking (total indirect effect = -.13, 95% confidence interval [CI] [-.32, -.02]) but not AEP via the alcohol POC. There was an indirect effect of the intervention on ineffective contraception (total indirect effect = -.27, 95% CI [-.55, -.07]) and AEP (total indirect effect = -.22, 95% CI [-.46, -.06]) via the contraception POC.
This study completely replicated the prior indirect effects of the CHOICES intervention on the targeted risk behaviors through the experiential and behavioral POC for each behavior. Findings support the utility of the POC for informing health behavior change interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
通过复制经验和行为变化过程（POC）的分析，进一步检验 CHOICES 干预措施的机制，这些分析是针对酒精和避孕的，作为减少酒精暴露性妊娠（AEP）风险的干预措施的中介，使用来自最近一项试验（CHOICES Plus，CP）的数据。
与之前的研究一样，复制模型检验了从干预到酒精的 3 个月体验性 POC，到 9 个月的行为性 POC，再到 9 个月的危险饮酒和 AEP 风险，以及 3 个月的避孕体验性 POC，到 9 个月的行为性 POC，再到无效避孕和 9 个月的 AEP 风险的间接途径。为了检验时间关系，额外的模型检验了 3 个月时的酒精行为 POC 和避孕 POC 到 9 个月时的体验性 POC ，以及 9 个月时的 AEP 风险的间接途径。最后一个模型检验了在 3 个月时评估的体验性和行为性 POC 的中介作用。
干预对危险饮酒（总间接效应=-.13，95%置信区间[CI] [-.32，-.02]）有间接影响，但对 AEP 没有影响，通过酒精 POC。干预对避孕无效（总间接效应=-.27，95%置信区间[CI] [-.55，-.07]）和 AEP（总间接效应=-.22，95%置信区间[CI] [-.46，-.06]）有间接影响，通过避孕 POC。
这项研究完全复制了之前 CHOICES 干预对每个行为的目标风险行为的间接效应，通过经验和行为 POC。研究结果支持 POC 为健康行为改变干预措施提供信息的效用。（PsycInfo 数据库记录（c）2023 APA，保留所有权利）。
