Kim Soojong, Kelly Terri-Ann, Icard Larry D, Zhang Jingwen, Jemmott Loretta S, Jemmott John B
Department of Communication, University of California Davis, 1 Shields Ave, Kerr Hall 469, Davis, CA, 95616, USA.
School of Nursing, Rutgers University - Camden, Camden, USA.
J Racial Ethn Health Disparities. 2025 May 7. doi: 10.1007/s40615-025-02446-1.
African American youth face disproportionate risks for human immunodeficiency virus (HIV) and other sexually transmitted infections, highlighting the need for culturally tailored, evidence-based interventions. This research reports a secondary, exploratory analysis examining the mediation effects of theoretical constructs on the efficacy of sexual risk-reduction interventions promoting abstinence for African American adolescents in church-based settings. The participants are African American adolescents aged 11-14 from 14 churches in Philadelphia, PA (N = 613) who participated in a randomized controlled trial of parent-child faith-based and non-faith-based sexual risk-reduction interventions. Data were collected at baseline, immediate post-intervention, and 3-, 6-, 12-, and 18-month post-intervention. We examined whether the interventions' effects on the frequency of sexual intercourse in the past 3 months were mediated through theoretical constructs, including outcome expectancies, subjective norms, self-efficacy, and intention, using a product-of-coefficients approach. We also explored potential moderation effects of sexual experience, church membership, child gender, and parent gender. We found that self-efficacy mediated the effect of the faith-based intervention (α × β × γ product = - 0.028, 95% ACI [- 0.064, - 0.002]). However, no significant mediators were identified for the non-faith-based intervention. Neither intervention had significant moderators, indicating no differences in efficacy among adolescents differing in sexual experience, church membership, gender, and parent's gender. These findings suggest that parent-child faith-based sexual risk-reduction interventions among African American adolescents in church-based settings could benefit from focusing on boosting self-efficacy.
非裔美国青少年面临感染人类免疫缺陷病毒（HIV）和其他性传播感染的风险更高，这凸显了开展针对特定文化、基于证据的干预措施的必要性。本研究报告了一项二级探索性分析，该分析考察了理论构念对在教会环境中促进非裔美国青少年禁欲的性风险降低干预措施效果的中介作用。参与者是来自宾夕法尼亚州费城14所教堂的11至14岁非裔美国青少年（N = 613），他们参与了一项基于亲子信仰和非信仰的性风险降低干预措施的随机对照试验。在基线、干预后即刻以及干预后3个月、6个月、12个月和18个月收集数据。我们使用系数乘积法检验了干预措施对过去3个月性交频率的影响是否通过包括结果期望、主观规范、自我效能感和意图在内的理论构念进行中介。我们还探讨了性经验、教会成员身份、儿童性别和父母性别的潜在调节作用。我们发现自我效能感中介了基于信仰的干预措施的效果（α×β×γ乘积 = -0.028，95% ACI [-0.064，-0.002]）。然而，未发现非基于信仰的干预措施有显著的中介因素。两种干预措施均无显著的调节因素，这表明在性经验、教会成员身份、性别和父母性别不同的青少年中，干预措施的效果没有差异。这些发现表明，在教会环境中针对非裔美国青少年的基于亲子信仰的性风险降低干预措施可能受益于专注于提高自我效能感。
