Predictors of Reducing Sexual and Reproductive Risk Behaviors Based on the Information-Motivation-Behavioral Skills (IMB) Model among Unmarried Rural-To-Urban Female Migrants in Shanghai, China

Abstract

BackgroundDue to the increase of premarital sex and the lack of reproductive health services, unmarried rural-to-urban female migrants experience more risks of sex and reproductive health (SRH). This study was designed to describe SRH related knowledge, attitude and risk behaviors among unmarried rural-to-urban female migrants and examine the predictors of reducing sexual and reproductive risk behaviors based on information-motivation-behavioral skills (IMB) model and to describe the relationships between the constructs.MethodsWe conducted a cross-sectional study to assess SRH related information, motivation, behavioral skills and preventive behaviors among unmarried rural-to-urban female migrants in Shanghai, one of the largest importers of migrant laborers in China. Structural equation modeling (SEM) was used to assess the IMB model.ResultsA total of 944 subjects completed their questionnaires. The mean age was 21.2 years old (SD = 2.3; range 16 to 28). Over one-fourth of participants reported having had premarital sex (N = 261, 27.6%) and among whom 15.3% reported having had the experience of unintended pregnancy, 14.6% with the experience of abortion. The final IMB model provided acceptable fit to the data (CFI = 0.99, RMSEA = 0.034). Reducing sexual and reproductive risk behaviors was significantly predicted by SRH related information (β = 0.681, P<0.001) and behavioral skills(β = 0.239, P<0.001). Motivation (β = 0.479, P<0.001) was the significant indirect predictor of reducing sexual and reproductive risk behaviors mediated through behavioral skills.ConclusionsThe results highlight the importance and necessity of conducting reproductive health promotion among unmarried rural-to-urban female migrants in China. The IMB model could be used to predict reducing sexual and reproductive risk behaviors and it suggests future interventions should focus on improving SRH related information and behavioral skills.

The Information–Motivation–Behavioral Skills Model Revisited: A Network-Perspective Structural Equation Model Within a Public Sexually Transmitted Infection Clinic Sample of Hazardous Alcohol Users

“…Our results suggest motivation had a direct effect on behavioral skills, but also had a direct effect on sexual risk behavior. This partial mediation effect of motivation on sexual risk behavior through behavioral skills is consistent with other IMB model research [21,25,27–29,31,35,44,54], but conflicts with evidence of a fully-mediating effect [32,36,43,49]. Thus, motivation and behavioral skills remain important components of the IMB model, but some populations may rely more heavily upon behavioral skills to enact protective behavior compared to others.…”

“…Specifically, past studies found that information does not always have a direct effect on sexual risk behavior, but many studies suggest that information remains a necessary component of HIV prevention interventions because of the influence knowledge has on behavioral skills. Our results fit with other studies that found that information significantly predicted behavioral skills, but did not directly predict sexual risk behavior [21–22,24,32,44,48–49,54]; however, our results conflict with those that found no effect of information [25–28,31,35] and those with a direct relationship with condom use [22,43]. It has been argued that the importance of HIV prevention information may be attenuated within populations with higher levels of knowledge [37], and we found low levels of HIV prevention knowledge within this sample of alcohol-using STI clinic patients providing additional evidence in support of this hypothesis.…”

“…Gender-specific situational questions were used, and an example question is “how confident are you that you could bring up the issue of condoms or safe sex in a conversation in this situation?” [42]. Self-efficacy has been frequently used as a proxy for behavioral skills within the IMB model literature [22–25,27–28,30,32,35–36,43–49]. …”

Sexual and Reproductive Health among Unmarried Rural-Urban Female Migrants in Shanghai China: A Comparative Analysis

“…All the questions were constructed from answers on a 5-point Likert scale (1 completely agree to 5 completely disagree) [33]. Four items (e.g., What do you think of married women who have sexual intercourse with males besides their husbands?)…”

Determinants of Consistent Condom Use among College Students in China: Application of the Information-Motivation-Behavior Skills (IMB) Model

“…1) It combines the concepts of other theories, such as the self-efficacy concept from the social cognitive theory model and the theory of reasoned action by enhancing the understanding the motivation. The model also considers various types of factors, such as socio-psychological factors that may affect the human behavior [19] ; 2) as an integrated multivariable model, it has been proved effective in some people groups, such as high school students [20] , unmarried rural-to-urban female migrants [21] ; 3) the model can translate theory into practice more easily; and 4) the IMB model are regarded as highly generalizable for HIV risk behavior prevention among various at risk populations [22] , [23] , [24] .…”