RESUMEN
BACKGROUND: Sexual health concerns among young adults worldwide help to motivate preventative practices against sexually transmitted infections. To foster better sexual health, sexual health literacy must be enhanced. Little research has been conducted on the impact of gender power dynamics on sexual health, such as sexual coercion, even though the prevalence of sexual coercion remains high in China. OBJECTIVE: This study describes the development and systematic evaluation of a web-based sexual health literacy intervention called "Smart Girlfriend" for female Chinese university students. METHODS: A multicenter randomized controlled trial was conducted with 781 female university students at 5 universities with dormitories in Hong Kong. Inclusion criteria were used to select unmarried, female, Chinese university students who were ≥18 years old and had not received a sexual health intervention in the past 12 months. Participants were randomly assigned to 2 groups: one group received an interactive web-based sexual health literacy intervention and the other group received a single webpage of online information about condom use. The intervention content was based on the Health Belief Model and the Continuum of Conflict and Control theory. The primary outcome was self-reported consistency of condom use with every partner at 3-month and 6-month follow-up assessments, analyzed using zero/one inflated beta (ZOIB) regression. The secondary outcome was an appraisal of the knowledge, attitudes, norms, and self-efficacy of condom use using the 25-item Multidimensional Condom Attitudes Scale (MCAS). The intention to treat was applied in analyses. RESULTS: Of 1503 individuals that were screened, 781 (52%) were randomized into 2 groups. The retention rates at the 3-month and 6-month follow-ups were 92% and 91%, respectively. Most participants were born locally (536/746, 72%), and 18% (134/746) self-reported as a sexual minority. ZOIB results regarding the consistency of condom use were not significant [model 1: odds ratio (OR) 2.25 with a 95% credible interval (CrI) of 0.84-6.36; model 2: OR 8.03 (95% CrI 0.22-330.31); model 3: OR 1.21 (95% CrI 0.78-1.86)]. Consistency in the intervention group was 5% higher (95% CI -1.90 to 11.63) than the control group at the 3-month follow-up, and 1% higher (95% CI -5.81 to 8·02) at the 6-month follow-up. MCAS scores at the 3-month follow-up were significantly higher in the intervention group (mean 122.51, SD 15.97) than the control group (mean 119.86, SD 15.85; P=.02). CONCLUSIONS: An interactive web-based sexual health literacy program did not significantly increase the consistency of condom use compared to a single webpage of condom use information; however, it did temporarily improve knowledge, attitudes, norms, and self-efficacy regarding condom use. Future revisions of this intervention should be personalized and delivered with a proactive approach. TRIAL REGISTRATION: ClinicalTrials.gov NCT03695679; https://clinicaltrials.gov/ct2/show/NCT03695679.
Asunto(s)
Alfabetización en Salud , Intervención basada en la Internet , Sexo Seguro , Salud Sexual , Adolescente , Niño , China , Condones , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Internet , Masculino , Conducta Sexual , Estudiantes , Universidades , Adulto JovenRESUMEN
PURPOSE: Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health. METHODS: The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression). RESULTS: After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate -2.82, 95 % confidence interval (CI) -4.77 to -0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64-3.92, p < 0.0001), anxiety (estimate 1.84, 95 % CI 1.13-2.56, p < 0.0001) and depression levels (estimate 0.62, 95 % CI 0.05-1.2, p < 0.0001) were higher than in heterosexual people. Dating violence and sexual orientation concealment were mediators, with the models showing a good fit. CONCLUSION: Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health.
Asunto(s)
Trastornos de Ansiedad/psicología , Violencia de Pareja/psicología , Psicometría , Calidad de Vida , Conducta Sexual , Minorías Sexuales y de Género/psicología , China , Estudios Transversales , Femenino , Humanos , Masculino , Modelos Psicológicos , Factores Socioeconómicos , Adulto JovenRESUMEN
Dating applications (apps) on smartphones have become increasingly popular. The aim of this study was to explore the association between the use of dating apps and risky sexual behaviours. Data were collected in four university campuses in Hong Kong. Subjects completed a structured questionnaire asking about the use of dating apps, sexual behaviours, and sociodemographics. Multiple linear and logistics regressions were used to explore factors associated with sexual risk behaviours. Six hundred sixty-six subjects were included in the data analysis. Factors associated with having unprotected sexual intercourse with more lifetime sexual partners included use of dating apps (ß = 0.93, p<0.01), having one's first sexual intercourse before 16 years of age (ß = 1.74, p<0.01), being older (ß = 0.4, p<0.01), currently being in a relationship (= 0.69, p<0.05), having a monthly income at least HKD$5,000 (ß = 1.34, p<0.01), being a current smoker (ß = 1.52, p<0.01), and being a current drinker (ß = 0.7, p<0.01). The results of a multiple logistic regression analysis found that users of dating apps (adjust odds ratio: 0.52, p<0.05) and current drinkers (adjust odds ratio: 0.40, p<0.01) were less likely to have consistent condom use. Users of dating apps (adjust odds ratio: 1.93, p<0.05), bisexual/homosexual subjects (adjust odds ratio: 2.57, p<0.01) and female subjects (adjust odds ratio: 2.00, p<0.05) were more likely not to have used condoms the last time they had sexual intercourse. The present study found a robust association between using dating apps and sexual risk behaviours, suggesting that app users had greater sexual risks. Interventions that can target app users so that they can stay safe when seeking sexual partners through dating apps should be developed.
Asunto(s)
Condones/estadística & datos numéricos , Aplicaciones Móviles/estadística & datos numéricos , Asunción de Riesgos , Conducta Sexual/estadística & datos numéricos , Teléfono Inteligente/estadística & datos numéricos , Sexo Inseguro/estadística & datos numéricos , Adolescente , Consumo de Bebidas Alcohólicas/fisiopatología , Estudios Transversales , Femenino , Hong Kong , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Conducta Sexual/psicología , Parejas Sexuales/psicología , Fumar/fisiopatología , Estudiantes , Encuestas y Cuestionarios , Universidades , Sexo Inseguro/psicología , Adulto JovenRESUMEN
Integrating more than 40 years of studies on locus of control (LOC), this meta-analysis investigated whether (a) the magnitude of the relationship between LOC and psychological symptoms differed among cultures with distinct individualist orientations and (b) depression and anxiety symptoms yielded different patterns of cultural findings with LOC. We included studies that examined global self-ratings of LOC and at least 1 of the criterion variables in nonclinical samples (age range: 18-80 years). Data were analyzed on the basis of 152 independent samples, representing the testing of 33,224 adults across 18 cultural regions. Results revealed moderately strong relationships for external LOC with depression symptoms (k = 123, N = 28,490, r = .30, 95% confidence interval [CI] [.27, .32]) and anxiety symptoms (k = 65, N = 13,208, r = .30, 95% CI [.27, .33]). Individualism explained 20% of unique variance only in the external LOC-anxiety relationship: The link between external LOC and anxiety symptoms was weaker for collectivist societies (k = 8, N = 2,297, r = .20, 95% CI [.13, .28]) compared with individualist societies (k = 54, N = 9,887, r = .32, 95% CI [.29, .34]). Such cultural differences were attributed to the reduced emphasis on agentic goals in more collectivist societies. It is noteworthy that external LOC does not carry the same negative connotations across cultures, and members of collectivist societies may be more ready to endorse such items. Culture has been examined at the country level, and the findings may not be applicable to any particular person in a cultural region. Implications for integrating cultural meaning of perceived control into formulation of theories, research design, and intervention programs are discussed.
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Trastornos de Ansiedad/psicología , Comparación Transcultural , Trastorno Depresivo/psicología , Control Interno-Externo , Percepción/fisiología , Adolescente , Adulto , África , Anciano , Anciano de 80 o más Años , Asia , Australia , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda , América del Norte , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVES: This study examined the link between coping and quality of life among patients with gastrointestinal (GI) cancer. Two hypotheses were tested. The active-personality hypothesis states that quality of life is associated with the predominant use of primary control coping (PCC) in general. The situational-flexibility hypothesis states that quality of life is related to flexible deployment of PCC and secondary control coping (SCC) according to situational controllability. METHODS: Participants were 180 Chinese adult patients diagnosed with colon or liver cancer. Their perceived controllability of stressors, coping, and quality of life were compared with those of a sex-and age-matched community sample. RESULTS: Three groups with distinct coping patterns were identified: (a) a flexible group characterized by the use of PCC in controllable situations but SCC in uncontrollable situations, (b) an active group characterized by predominant use of PCC in most situations, and (c) a passive group characterized by predominant use of SCC or avoidant coping in most situations. Patients in the active and the flexible groups had higher perceived controllability and psychological well-being scores than those in the passive group. CONCLUSIONS: Our results provide support for both the active-personality and the situational-flexibility hypotheses among GI cancer patients. Clinical and research implications of the findings are discussed.