RESUMEN
BACKGROUND: Despite positive attitudes of Latinos using the Internet and the increased availability of health information resources, few studies have been conducted that examine actual use and barriers to web-based health information. OBJECTIVE: The aim of this study was to examine whether select sociodemographic factors and technology factors (e.g., computer and Internet access) predicted use of a web-based, parent-adolescent sexual communication program or a physical activity program, entitled Cuídalos, among Puerto Rican parents. METHODS: This study uses data from a randomized controlled trial designed to examine the long-term effectiveness of Cuídalos. Parents were recruited from community-based and school sites throughout Puerto Rico and randomly assigned to a web-based, parent-adolescent sexual communication (n = 245) or a physical activity (n = 247) program. Parents were instructed to complete the two-session program within 1 week and had access to the program for a period of 3 months. Outcomes in this secondary analysis were the number of log-ins and self-reported access during the 3-month period. Reasons for not accessing the program after the 3-month period were assessed. RESULTS: Self-reported access after completion of the Cuídalos program and the actual number of log-ins over the intervention period were low. There were no statistically significant differences in the number of log-ins between parents who accessed Cuídalos during the 3-month time frame and those who did not (p = .28). Logistic regression analyses demonstrated that the odds of accessing Cuídalos during the 3-month period was 72% higher (OR = 1.72, 95% CI [1.08, 2.75]) among parents with a high school education or less, as compared to parents with a college education (p = .02). Similarly, Poisson regression model results indicated that, with every year increase in age, the expected number of log-ins increased by 1% (RR = 1.01, 95% CI [1.00, 1.02]); compared to those who accessed the program at home, the expected number of log-ins ranged from 10% to 27% lower for parents accessing elsewhere. Reasons for not accessing the program during the 3-month period included not having easy access to a computer (n = 134, 48.6%), or they did not know how to access the program again (n = 56, 20.3%). DISCUSSION: Despite the availability of web-based and e-health resources, further research is needed to identify how to facilitate greater access and actual use of digital health resources by Latinos. This is an important effort in order to prevent a widening health equity gap caused by a lack of access and use of digital health resources.
Asunto(s)
Conducta del Adolescente/psicología , Promoción de la Salud/normas , Relaciones Padres-Hijo , Padres/psicología , Adolescente , Adulto , Femenino , Promoción de la Salud/métodos , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Internet/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Distribución de Poisson , Puerto Rico , Autoinforme , Encuestas y CuestionariosAsunto(s)
Hispánicos o Latinos/historia , Historia de la Enfermería , Liderazgo , Historia del Siglo XX , Humanos , Panamá , Estados UnidosRESUMEN
Mexican adolescents continue to be at increased risk for HIV infection due to inconsistent condom use. The purpose of this study was to identify predictors of condom use intentions and condom use among Mexican adolescents who participated in a randomized control trial designed to test a sexual-risk reduction intervention. Data from sexually active adolescents 17 to 21 years (n = 157) of age who were assigned to the control group were analyzed 48 months post intervention. Regression analysis showed that positive attitudes toward condoms, subjective norms, and control beliefs significantly explained intention to use condoms (R2 = .75, p < .001). Attitudes toward condoms (beta = .67, p <.001), technical skills (beta = .13, p = .01), and condom use self-efficacy (beta = .24, p < .001) were significant predictors of condom use intention. Compared to those who inconsistently used condoms, adolescents who used condoms consistently had greater intention to use condoms and greater impulse control. Findings suggest that attitudes and control beliefs should be further explored with Mexican adolescents in order to support consistent condom use.
Asunto(s)
Conducta del Adolescente/etnología , Actitud Frente a la Salud/etnología , Condones/estadística & datos numéricos , Sexo Seguro/etnología , Adolescente , Femenino , Estudios de Seguimiento , Infecciones por VIH/etnología , Infecciones por VIH/prevención & control , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Intención , Masculino , México/epidemiología , Psicología del Adolescente , Ensayos Clínicos Controlados Aleatorios como Asunto , Análisis de Regresión , Conducta de Reducción del Riesgo , Sexo Seguro/estadística & datos numéricos , Servicios de Salud Escolar , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To examine the effectiveness of a safer sex program (Cuídate) on sexual behavior, use of condoms, and use of other contraceptives among Mexican youth 48 months after the intervention. METHODS: A total of 708 or 85% of those who participated in the original randomized control study (n = 829) were assessed in the 48-month follow-up. Each participant completed a questionnaire on sexual behavior. RESULTS: Findings indicated that adolescents who participated in the Cuídate program were more likely to be older at first sex (odds ratio [OR], 1.27; 95% confidence interval [CI], 0.41-2.12; P < 0.05) and to use condoms at first sex (OR, 1.75; 95% CI, 1.14-2.69; P < 0.05) or some other type of contraception at first sex (OR, 1.53; 95% CI, 1.00-2.33; P < 0.05) than those in the control group. Effects of the intervention on consistent condom use, condom use at last sex, and number of sexual partners were not significant. Gender did not moderate any intervention effects. Social desirability moderated the effect of the intervention on age at first sex. CONCLUSIONS: Results demonstrate the efficacy of Cuídate among Mexican adolescents. Future research, policy, and practice efforts should be directed at sustaining safe sex practices across adolescents' developmental and relationship trajectory.
Asunto(s)
Anticoncepción/estadística & datos numéricos , Conducta de Reducción del Riesgo , Sexo Seguro/estadística & datos numéricos , Adolescente , Factores de Edad , Coito , Condones/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Masculino , México , Oportunidad Relativa , Evaluación de Programas y Proyectos de Salud , Sexo Seguro/psicología , Tamaño de la Muestra , Factores Sexuales , Parejas Sexuales , Deseabilidad Social , Adulto JovenRESUMEN
OBJECTIVE: To examine the effectiveness of a safer sex program (Cuídate) on sexual behavior, use of condoms, and use of other contraceptives among Mexican youth 48 months after the intervention. METHODS: A total of 708 or 85 percent of those who participated in the original randomized control study (n = 829) were assessed in the 48-month follow-up. Each participant completed a questionnaire on sexual behavior. RESULTS: Findings indicated that adolescents who participated in the Cuídate program were more likely to be older at first sex (odds ratio [OR], 1.27; 95 percent confidence interval [CI], 0.41-2.12; P < 0.05) and to use condoms at first sex (OR, 1.75; 95 percent CI, 1.14-2.69; P < 0.05) or some other type of contraception at first sex (OR, 1.53; 95 percent CI, 1.00-2.33; P < 0.05) than those in the control group. Effects of the intervention on consistent condom use, condom use at last sex, and number of sexual partners were not significant. Gender did not moderate any intervention effects. Social desirability moderated the effect of the intervention on age at first sex. CONCLUSIONS: Results demonstrate the efficacy of Cuídate among Mexican adolescents. Future research, policy, and practice efforts should be directed at sustaining safe sex practices across adolescents' developmental and relationship trajectory.
OBJETIVOS: Examinar la eficacia de un programa de promoción de actividad sexual de menor riesgo (Cuídate) en cuanto al comportamiento sexual, el uso de condones y el uso de otros anticonceptivos en jóvenes mexicanos, 48 meses después de la intervención. MÉTODOS: En el seguimiento después de 48 meses, se evaluó un total de 708 (85 por ciento) de los que participaron en el estudio de control aleatorizado original (n = 829). Cada participante respondió a un cuestionario sobre su comportamiento sexual. RESULTADOS: Los resultados indicaron que los adolescentes que participaron en el programa "Cuídate" tenían una probabilidad más alta de tener una edad mayor en la primera relación sexual (razón de posibilidades [OR]: 1,27; intervalo de confianza [IC]: de 95 por ciento, 0,41-2,12; p < 0,05) y de usar condones (OR: 1,75; IC 95 por ciento: 1,14-2,69; P < 0,05) o algún otro tipo de medida anticonceptiva en la primera relación sexual (OR: 1,53; IC 95 por ciento: 1,00-2,33; P < 0,05) en comparación con los del grupo de referencia. Los efectos de la intervención sobre el uso constante de condones, el uso de condones en la última relación sexual y el número de compañeros sexuales no fueron considerables. El género no moderó los efectos de la intervención. La conveniencia social moderó el efecto de la intervención sobre la edad en la primera relación sexual. CONCLUSIONES: Los resultados demuestran la eficacia del programa "Cuídate" en los adolescentes mexicanos. En el futuro, la investigación, las políticas y la práctica deberán diri-girse a promover actividades sexuales de menor riesgo en el desarrollo y las relaciones de los adolescentes.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Anticoncepción , Conducta de Reducción del Riesgo , Sexo Seguro/estadística & datos numéricos , Factores de Edad , Coito , Condones , Estudios de Seguimiento , México , Oportunidad Relativa , Evaluación de Programas y Proyectos de Salud , Sexo Seguro/psicología , Tamaño de la Muestra , Factores Sexuales , Parejas Sexuales , Deseabilidad Social , Adulto JovenAsunto(s)
Conducta del Adolescente , Conducta Sexual , Salud del Adolescente , Conducta de Reducción del Riesgo , Estudios de Seguimiento , Ensayo Clínico Controlado Aleatorio , México , Conducta del Adolescente , Conducta Sexual , Salud del Adolescente , Conducta de Reducción del Riesgo , Estudios de Seguimiento , Ensayo Clínico Controlado Aleatorio , Sexo Seguro , Factores de Edad , Coito , Condones , Estudios de Seguimiento , Oportunidad Relativa , Tamaño de la Muestra , Factores Sexuales , Parejas Sexuales , Adulto Joven , Anticoncepción , Conducta de Reducción del Riesgo , Evaluación de Programas y Proyectos de Salud , Deseabilidad SocialRESUMEN
Despite widespread adolescent alcohol use, research on individual and contextual factors among Mexican adolescents is limited. This study describes the relationship between adolescent risk/protective factors, parent-adolescent communication, and their effects on alcohol use of 14- to 17-year-old adolescents living in Mexico (N = 829; 458 girls, 371 boys). In this study, adolescents reported that 55% ever used alcohol, 24% used alcohol in the past 30 days, and 10% reported binge drinking. Adolescents with high family intimacy were less likely to report ever using alcohol and binge drinking. Regression analysis revealed that parent-adolescent communication mediated the effect of family intimacy on overall and binge drinking. Alcohol use prevention with Mexican adolescents should focus on family intimacy and parent-adolescent communication.
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Conducta del Adolescente , Consumo de Bebidas Alcohólicas/epidemiología , Comunicación , Relaciones Familiares , Adolescente , Consumo de Bebidas Alcohólicas/etnología , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , México/epidemiología , Factores de Riesgo , Población UrbanaRESUMEN
This article reports results of a randomized controlled trial designed to test an intervention to increase parent-adolescent sexual risk communication among Mexican parents. Data were analyzed from parents (n = 791) randomly assigned to an HIV risk reduction or health promotion intervention. Measures were administered at pretest, posttest, and 6- and 12-month follow-ups. Generalized estimation equation (GEE) analysis indicates parents in the HIV risk reduction intervention reported significantly more general communication (p < .005), more sexual risk communication (p < .001) and more comfort with communication (p < .001) than parents in the control intervention. Behavioral, normative, and control beliefs significantly mediated the effect of the intervention on all communication outcomes. This study demonstrates the efficacy of an intervention to increase the quality and quantity of parent-adolescent communication related to general and sex-specific communication.
Asunto(s)
Infecciones por VIH/prevención & control , Educación en Salud/métodos , Relaciones Padres-Hijo , Conducta de Reducción del Riesgo , Adolescente , Conducta del Adolescente , Adulto , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Conducta SexualRESUMEN
OBJECTIVE: To test the efficacy of a behavioral intervention designed to decrease risk sexual behaviors for HIV/AIDS and unplanned pregnancies in Mexican adolescents. MATERIAL AND METHODS: Randomized controlled trial with four follow ups; 832 adolescents recruited from high schools, age 14-17, were randomly assigned to the experimental or control group. The six hour intervention used active learning strategies, and was delivered in two sessions on two consecutive Saturdays. The study was carried out in Monterrey, Mexico, 2002-2005. RESULTS: GEE analysis indicated no differences in sexual relationships intentions between the two conditions, however, the experimental group had higher intentions to use condoms and contraceptives (mean differences 0.15 and 0.16, CI 95%) in the next three months, as compared with the control group. Theoretical variables, such as control beliefs, were significant mediators of the intervention. CONCLUSIONS: The behavioral intervention represents an important effort in promoting safe sexual behaviors among Mexican adolescents.
Asunto(s)
Conducta de Reducción del Riesgo , Asunción de Riesgos , Conducta Sexual , Adolescente , Femenino , Humanos , MasculinoRESUMEN
OBJETIVO: Determinar la eficacia de una intervención conductual-educativa diseñada para disminuir las conductas sexuales de riesgo de VIH/SIDA y embarazos no planeados de adolescentes mexicanos. MATERIAL Y MÉTODOS: Ensayo controlado aleatorizado con cuatro seguimientos en un año; 832 adolescentes reclutados de escuelas preparatorias, entre 14 y 17 años, se asignaron aleatoriamente al grupo experimental o al control. La intervención, de seis hrs. de duración, aplicó estrategias de aprendizaje activo. El estudio se realizó en Monterrey, México, de 2002 a 2005. RESULTADOS: De acuerdo al análisis GEE, no hubo diferencia en las intenciones de tener relaciones sexuales, pero sí mayor nivel de intenciones de usar condón y anticonceptivos (diferencia de medias 0.15 y 0.16, IC 95 por ciento) en el grupo experimental comparado con el control. Variables teoréticas como creencias sobre control fueron mediadoras de la intervención. CONCLUSIONES: La intervención conductual representa un importante esfuerzo en la promoción de conductas sexuales seguras en adolescentes mexicanos.
OBJECTIVE: To test the efficacy of a behavioral intervention designed to decrease risk sexual behaviors for HIV/AIDS and unplanned pregnancies in Mexican adolescents. MATERIAL AND METHODS: Randomized controlled trial with four follow ups; 832 adolescents recruited from high schools, age 14-17, were randomly assigned to the experimental or control group. The six hour intervention used active learning strategies, and was delivered in two sessions on two consecutive Saturdays. The study was carried out in Monterrey, Mexico, 2002-2005. RESULTS: GEE analysis indicated no differences in sexual relationships intentions between the two conditions, however, the experimental group had higher intentions to use condoms and contraceptives (mean differences 0.15 and 0.16, CI 95 percent) in the next three months, as compared with the control group. Theoretical variables, such as control beliefs, were significant mediators of the intervention. CONCLUSIONS: The behavioral intervention represents an important effort in promoting safe sexual behaviors among Mexican adolescents.
Asunto(s)
Adolescente , Femenino , Humanos , Masculino , Conducta de Reducción del Riesgo , Asunción de Riesgos , Conducta SexualRESUMEN
This study describes the sexual knowledge and communication of Mexican parents and adolescents. Preintervention data were analyzed from 829 high school students (ages 14-17) and one of the parents of each. Differences were found between parents and adolescents in sexual knowledge (M = 16.16 vs. M = 14.92; t = 7.20, p < .001); specifically, parents had higher knowledge related to sexually transmitted diseases, HIV/AIDS, and condom use. Parents perceived more general communication (t [787] = 6.33, p < .001), and less discomfort talking about sex (t [785] = 4.69, p < .001) than adolescents. Parents with higher education levels scored higher in HIV knowledge and general communication. Fathers had higher total sexual knowledge, whereas mothers perceived higher sexual communication than fathers. There were no differences in knowledge and communication by parental socioeconomic level. Results suggest health care providers need to assist parents in developing specific knowledge and skills to support their adolescents' sexual decision-making.
Asunto(s)
Comunicación , Americanos Mexicanos/etnología , Relaciones Padres-Hijo/etnología , Psicología del Adolescente , Educación Sexual/métodos , Adolescente , Conducta del Adolescente/etnología , Adulto , Análisis de Varianza , Actitud Frente a la Salud/etnología , Escolaridad , Femenino , Estudios de Seguimiento , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Michigan , Investigación Metodológica en Enfermería , Padres/educación , Padres/psicología , Ensayos Clínicos Controlados Aleatorios como Asunto , Asunción de Riesgos , Conducta Sexual/etnología , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To test the efficacy of a prevention intervention to reduce sexual risk behavior among Latino adolescents. DESIGN: Randomized controlled trial from April 2000 through March 2003, with data collection before and after intervention and at 3, 6, and 12 months. SETTING: Northeast Philadelphia schools. PARTICIPANTS: Latinos aged 13 through 18 years (249 males and 304 females); 81.6% retained at 12-month follow-up. INTERVENTIONS: The HIV and health-promotion control interventions consisted of six 50-minute modules delivered by adult facilitators to small, mixed-gender groups in English or Spanish. Main Outcome Measure Self-reported sexual behavior. RESULTS: Analyses using generalized estimation equations over the follow-up period revealed that adolescents in the HIV intervention were less likely to report sexual intercourse (odds ratio, 0.66; 95% confidence interval [CI], 0.46-0.96), multiple partners (odds ratio, 0.53; 95% CI, 0.31-0.90), and days of unprotected intercourse (relative risk, 0.47; 95% CI, 0.26-0.84) and more likely to report using condoms consistently (odds ratio, 1.91; 95% CI, 1.24-2.93). Baseline sexual experience and language use moderated intervention efficacy. Adolescents assigned to the HIV intervention who were sexually inexperienced at baseline reported fewer days of unprotected sex (relative risk, 0.22; 95% CI, 0.08-0.63); Spanish speakers were more likely to have used a condom at last intercourse (odds ratio, 4.73; 95% CI, 1.72-12.97) and had a greater proportion of protected sex (mean difference, 0.35; P<.01) compared with similar adolescents in the health-promotion intervention. CONCLUSION: Results provide evidence for the efficacy of HIV intervention in decreasing sexual activity and increasing condom use among Latino adolescents.
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Condones/estadística & datos numéricos , Infecciones por VIH/etnología , Promoción de la Salud/métodos , Hispánicos o Latinos , Conducta Sexual/etnología , Adolescente , Conducta del Adolescente , Adulto , Femenino , Estudios de Seguimiento , Infecciones por VIH/prevención & control , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Philadelphia , Puerto Rico/etnología , Conducta de Reducción del Riesgo , Conducta Sexual/estadística & datos numéricosRESUMEN
AIDS is a global epidemic. Regardless of the present incidence of AIDS, all countries must confront the threat of this devastating disease. The shared border and continued migration between Mexico and the United States as well as shared concerns about HIV/AIDS are compelling reasons to promote AIDS prevention as an important public health endeavor for both countries. This article describes collaborative efforts between nurse researchers in the United States and Mexico to decrease the risk of sexually transmitted HIV infection among adolescents. The significance of this effort to both countries and the processes and preliminary work that led to the development of a study funded by the National Institute of Nursing Research are discussed.