This study examined the effectiveness of two transtheoretical
model-tailored, computer-delivered interventions designed to impact multiple
substance use or energy balance behaviors in a middle school population
recruited in schools. Twenty middle schools in Rhode Island including sixth
grade students (N=4,158) were stratified and randomly assigned
by school to either a substance use prevention (decreasing smoking and alcohol)
or an energy balance (increasing physical activity, fruit and vegetable
consumption, and limiting TV time) intervention group in 2007. Each intervention
involved five in-class contacts over a 3-year period with assessments at 12, 24,
and 36 months. Main outcomes were analyzed using random effects modeling. In the
full energy balance group and in subsamples at risk and not at risk at baseline,
strong effects were found for physical activity, healthy diet, and reducing TV
time, for both categorical and continuous outcomes. Despite no direct treatment,
the energy balance group also showed significantly lower smoking and alcohol use
over time than the substance use prevention group. The energy balance
intervention demonstrated strong effects across all behaviors over 3 years among
middle school students. The substance use prevention intervention was less
effective than the energy balance intervention in preventing both smoking and
alcohol use over 3 years in middle school students. The lack of a true control
group and unrepresented secular trends suggest the need for further study.
This study examined whether the Multifaceted Model of HIV Risk (MMOHR) would predict unprotected sex based on predictors including gender, childhood sexual abuse (CSA), sexual victimization (SV), depression, and sexual assertiveness for condom use. A community-based sample of 473 heterosexually active men and women, aged 18–46 years completed survey measures of model variables. Gender predicted several variables significantly. A separate model for women demonstrated excellent fit, while the model for men demonstrated reasonable fit. Multiple sample model testing supported the use of MMOHR in both men and women, while simultaneously highlighting areas of gender difference. Prevention interventions should focus on sexual assertiveness, especially for CSA and SV survivors, as well as targeting depression, especially among men.
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