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Relationship between social cognitive theory constructs and

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Leigh Johnson

on 27 February 2015

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Transcript of Relationship between social cognitive theory constructs and

Social Cognitive Theory
Author's Expertise/Field of Study
All authors have expertise in sexual health research, including STD prevention and intervention
Expertise among authors also includes community health promotion, young adult risk behaviors, and infectious disease
Edward Leinaar
Leigh Johnson
Sirena Gandy
Mary Pedrick
Lindsey Crosnoe-Shipley
Background
Sexually Transmitted Disease (STD) Facts:
External factors
Vicarious learning
Reinforcements
Situation
Condoms work!
Condoms provide different levels of protection depending upon routes of STD transmission. (4)

Works Cited
1. Snead MC, O’Leary AM, Mandel MG, et al. Relationship between social cognitive theory constructs and self-reported condom use: assessment of behaviour in a subgroup of the Safe in the City trial. BMJ Open 2014;4:e006093. doi:10.1136/bmjopen-2014-006093.
2. CDC fact sheet: information for teens: staying healthy and preventing STDs. Centers for Disease Control and Prevention website. http://www.cdc.gov/std/life-stages-populations/stdfact-teens.htm. Accessed February 1, 2015.
3. HIV in the United States: At a glance. Centers for Disease Control and Prevention website. http://www.cdc.gov/hiv/statistics/basics/ataglance.html. Accessed February 1, 2015.
4. Condoms and STDs: fact sheet for public health personnel. Centers for Disease Control and Prevention website. http://www.cdc.gov/condomeffectiveness/docs/condoms_and_stds.pdf. Accessed February 1, 2015.
5. McKay A. The effectiveness of latex condoms for prevention of STI/HIV. The Canadian Journal of Human Sexuality. 2007;16(1-2):57-61.
6. Bandura A. Chapter 6: Social cognitive theory of mass communication. In: Media Effects, advances in theory and research. Jennings B, Zillmann D, eds. Mahwah, NJ: Taylor & Frances e-Library, 2008:121-.
7. Lopez LM, Tolley EE, Grimes DA, et al. Theory-based interventions for contraception. Cochrane Database Syst Rev 2011;(3):CD007249.
Relationship between social cognitive theory constructs and
self-reported condom use: assessment of behavior in a subgroup of the Safe in the City trial
Impermeable barrier to STD pathogen-sized particles (4)
Condom use, in heterosexual males, reduced HIV incidence by 80%. (5)
20 million new cases each year in the U.S. (2)
Half of occur in young people, aged 15-24 (2)
1.2 million in the U.S. are infected with HIV
(14% are unaware of their infection) (3)

Social Cognitive Theory (SCT)
Views psychosocial functioning as a:
Multi-directional

&
Reciprocal
relationship between self & society
In this relationship,
Individual attributes

&
Environmental factors
interact with bidirectional influence. (6)
Research has show SCT interventions to improve condom use and lower STD transmission in 10 out of 12 studies reviewed. (7)
Introduction
SCT intervention is thought to improve individuals' health behavior and self-efficacy. (1)
The intervention:
Safe in the City
Aim of
Safe in the City
is to utilize SCT to change condom use behavior
A previous controlled trial found the
Safe in the City
intervention effective. How the intervention modified participants' behavior is unclear. (1)
Objective
: to investigate the influence of SCT methods on participants' self-reported condom use during their most recent sexual encounter
Journal Quality

The BMJ has continuous publication
Average weekly print circulation of 121,762
Browsers of online print reached 1,365,786
External peer revision
Impact Factor
16.3 in 2014


Social cognitive theory can change individuals' reactions
Factors that contribute to the behavior of individuals includes:
self-efficacy
risk prevention
self-control
hedonisitic outcomes
Different interventions may be able to alter the behaviors
MAARIE Critique
Method
Assignment
Assessment
Results
Interpretation
Extrapolation
To answer the question of Social Cognitive Theory (SCT) constructs influence on sexual risk behaviors
Hypothesis
: SCT constructs influences sexual risks behaviors such as condom use
Selection Criteria:
Participants were a subset of the participants from the Safe in the City (SITC) trial
patients at one of 3 publicly funded STI clinics
sample size: n=1252 (of 40000)
Strengths
:
Self-assessment performed by computerized system
reduces interviewer bias
Limitations:
Power of study is not disclosed
External validity
Non-randomized
Patients self-select
Potential for bias:
Self-selection bias
Sociodemographic factors were potential confounders
Compensation for participation
SCT constructs significantly associated:
sexual self-efficacy (RR=1.50, CI=1.23-1.84)
self-control self-efficacy (RR=1.67, CI=1.37-2.04)
self-efficacy with most recent partner (RR=2.56, CI=2.01-3.27
more favorable hedonistic outcomes expectancies (RR=1.83, CI =1.54-2.17)
more favorable partner expected outcomes were significant with last condom use at last sexual act (RR=9.74, CI=3.21-29.57)
Regression analysis controlled for confounding
Given the results, SCT constructs are positively associated with condom use
Prevention programs seeking to increase condom use should consider incorporating SCT constructs to increase social cognitive skills
Other prevention programs
Overall Significance
Discussion Questions
1. Was this study successful? If yes, why do you think so? If not, what could have been done differently to improve their validity?

2. What other prevention programs might benefit from Social Cognitive Theory interventions?
Nested behavioral assessment
administered to participants following initial clinic visit and at a 3 months follow-up
Multi-variable Poisson regression models estimated relative risk (RR) with a 95% confidence interval (CI)

Snead, M.C, O'Leary, A.M., Mandel, M.G., Kourtis, A.P., Wiener, J., Jamieson, D.J., Warner, L., . . . Margolis, A.D. (2014)
Internal factors
Self efficacy
Expectations
Self control
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