Feel good now or regret it later? The respective roles of affective attitudes and anticipated affective reactions for explaining health-promoting and health risk behavioral intentions.

Evidence supporting the incorporation of affective constructs, such as affective attitudes and anticipated regret, into theoretical models of health behavior has been mounting in recent years; however, the role of positive anticipated affective reactions (e.g., pride) has been largely unexplored. The purpose of the present investigation was to assess how affective attitudes and anticipated affective reactions (both pride and regret for performing a behavior or not) may provide distinct utility for understanding intentions to perform health-promoting and health risk behaviors over and above cognitive attitudes and other established theoretical constructs from the theory of planned behavior (TPB). Participants (N = 210) were recruited via Amazon's Mechanical Turk to complete a one-time online battery assessing TPB and affective constructs. Self-reported intentions served as the main outcome measure, and hierarchical linear modeling was used to examine the effects of TPB and affective constructs across behaviors. Controlling for TPB constructs, more positive affective attitudes and greater anticipated regret, but not anticipated pride, predicted intentions to engage in future health behaviors. Anticipated affective reactions contributed explanatory variance for intentions to perform health risk behaviors, but anticipated pride and regret were not associated with intentions to perform health risk behaviors. Contributions made via the inclusion of both positively and negatively valence anticipated affective reactions for both action and inaction (performing a behavior or not) across a range of health promoting and health risk behaviors are discussed, as well as implications for future intervention work.

Dismantling the theory of planned behavior: evaluating the relative effectiveness of attempts to uniquely change attitudes, norms, and perceived behavioral control.

The current study compares the effectiveness of interventions that attempted to uniquely influence hypothesized determinants of behavior in the Theory of Planned Behavior versus some optimal combination of constructs (three constructs vs. four) to increase condom use among intentions and behavior college students. 317 participants (Mage = 19.31; SDage = 1.31; 53.3% female; 74.1% Caucasian) were randomly assigned to one of seven computer-based interventions. Interventions were designed using the Theory of Planned Behavior as the guiding theoretical framework. 196 (61.8%) completed behavioral follow-up assessments 3-month later. We found that the four construct intervention was marginally better at changing intentions (estimate = - .06, SE = .03, p = .06), but the single construct interventions were more strongly related to risky sexual behavior at follow-up (estimate = .04, SE = .02, p = .05). This study suggests that these constructs may work together synergistically to produce change (ClinicalTrials.gov Number NCT# 02855489).

Predictors of sexual coercion and alcohol use among female juvenile offenders.

Female juvenile offenders report high rates of sexual coercion and substance use, yet the temporal relationship between the two remains unclear. The focus of this study was to conduct a prospective examination of predictors of sexual coercion and substance use for a group of high-risk young women. Two hundred and forty five adolescent females (34 % of a sample including males and females), between the ages of 14-17, and from a larger study of juvenile offenders, were recruited from juvenile probation offices to participate in a longitudinal study on substance use and sexual risk. At baseline, participants completed measures associated with increased risk for sexual coercion, including substance use, perceived relationship control, and externalizing behavior. At 6- and 24-month follow-up, participants also completed a measure assessing sexually coercive experiences. Path analysis revealed that less relationship control at baseline predicted sexual coercion at 6-months. Additionally, 6-month sexual coercion predicted alcohol use and sexual coercion at 24-month follow-up. Logistic regression analysis revealed also that alcohol use at 6-months predicted sexual revictimization at 24-months. Sexual coercion appears to be associated with subsequent increases in alcohol use, suggesting that female juvenile offenders may be using alcohol to cope with the psychological and emotional consequences of victimization. Alcohol use is linked to increased risk for repeat sexual coercion, suggesting that exposure to risky environments also may be important in understanding these girls' risk. Difficulties responding assertively in sexual relationships (i.e., low relationship control) also seem to increase female juvenile offenders' risk for sexual coercion. Finally, previous sexual coercion appears to increase risk for future victimization, highlighting the importance of early intervention for this at-risk group.

A latent profile analysis using the theory of planned behavior to predict alcohol use.

OBJECTIVE: The current study sought to identify subgroups of adult drinkers who differ in their level of association between alcohol-related Theory of Planned Behavior (TPB) constructs (attitudes, perceived norms, self-efficacy, and intentions), and explore if distinct subgroup profiles relate to alcohol use two weeks later. DESIGN: Participants (N = 121) were recruited to participate in a two-week study about daily experiences with exercise and alcohol (Mage = 30.93; SDage = 9.88; 59.2% female; 71.1% Caucasian). MAIN OUTCOME MEASURES: Alcohol attitudes, subjective norms, alcohol refusal self-efficacy, and intentions were used to create class membership. Behavioral outcomes included (1) drinking frequency, (2) drinking quantity, and (3) drinking to get drunk. RESULTS: Two classes of drinkers were determined - Class 1 was categorized by moderate scores on all constructs, whereas Class 2 was categorized by moderate scores on attitudes and high scores on norms, alcohol refusal self-efficacy, and intentions. Class designation was associated with frequency, but not quantity of use. CONCLUSION: The current study suggests that a minority of individuals who score moderately across all constructs should receive intervention efforts that focus on just those included in the TPB, while the vast majority may require additional constructs to be addressed.

"Making Peace" with Bodies and Sexual Selves: Changes during COVID-19 among Adults in the United States.

The COVID-19 pandemic has negatively impacted the physical and mental health of many and has necessitated widespread societal shifts, including changes to work and family activities. These changes have impacted individuals' identity, including their sexual self-image and body image, yet research on perceptions of these changes is missing. This study reports on quantitative and qualitative data from an electronic survey with adults in the United States (N = 326) to examine these perceptions. Body appreciation did not significantly differ between demographic groups. Themes emerging from the qualitative results included changes in general self-image (becoming more restricted or disempowered), changes in sexual self-image (deepening, becoming more sexy/sexual, or less sexy/sexual), and changes in body image (positive, negative, and neutral). Our findings point to positive, negative, and neutral effects on sexual self-image and body image, implying that nuanced approaches are needed to understand how identity has transformed as a result of the COVID-19 pandemic.

An event-level examination of successful condom negotiation strategies among young women.

This study examines the effect of condom negotiation strategies on condom use and partner type and substance use before sex as moderators of strategy effectiveness. Women reported their daily sexual behavior during the last month. Withholding sex was more strongly associated with condom use when utilized with a non-casual sex partner. Directly requesting condom use was more strongly and using deceptive reasons to influence condom use was less strongly related to condom use during substance use. Results underscore the importance of understanding the contexts in which condom negotiation strategies are successful in order to improve HIV/sexually transmitted infection prevention efforts among women.

Measurement invariance of alcohol instruments with Hispanic youth.

INTRODUCTION: Despite their widespread use across clinical and research settings, no study has yet investigated the fit of several standard alcohol measures for Hispanic youth, including those used to assess motivation to change, self-efficacy, peer norms, and problem drinking. This study thus served to address this gap by evaluating measurement invariance with substance-using youth. METHODS: We enrolled a large sample of regular substance-using youth who were involved with the justice system (N=368; 72.9% male; 76.9% Hispanic; M age=16.17years). Similar to the broader Hispanic population of the southwest United States (U.S.), Hispanic youth in the sample were on average 3.5th generation (with at least 1 foreign-born grand-parent). Following standard administration and scoring procedures, all youth completed measures of motivation to change (e.g., readiness rulers, intentions to change), self-efficacy (e.g., drink refusal in social situations), peer norms (e.g., peer norms for substance use), and problem drinking (e.g., substance use quantity/frequency; Alcohol Use Disorders Identification Test; Rutgers Alcohol Problems Index; Timeline FollowBack). Measurement equivalence was evaluated via multiple group confirmatory factor analysis. RESULTS: Our results indicated that each measure evaluated herein worked equally well for Hispanic and Caucasian youth. We found measurement invariance at every level tested. CONCLUSIONS: This study supports the validity and future use of these important and widely-used alcohol use measures for high-risk substance-using Hispanic youth. Further, given the representativeness of this sample within the southwestern U.S., these results show promise for generalizability to U.S.-born Hispanic youth within this geographic region.

Comparing theory-based condom interventions: health belief model versus theory of planned behavior.

OBJECTIVE: This study sought to experimentally manipulate the core constructs of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) in order to compare the success of interventions to increase preparatory condom use behavior (i.e., purchasing condoms, talking to a boyfriend or girlfriend about using condoms, and carrying condoms) based on these theories. METHOD: A total of 258 participants were randomly assigned to one of three computer-based interventions (HBM, TPB, or information-only control). A total of 204 (79.1%) completed follow-up assessments 1 month later. RESULTS: Regression analyses were conducted to determine which set of theoretical constructs accounted for the most variance in behavior at baseline. A series of structural equation models were estimated to determine which constructs were the "active ingredients" of change. The TPB accounted for 32.8% of the variance in risky sexual behavior at baseline, while the HBM only explained 1.6% of the variance. Mediational analyses revealed differential intervention effects on perceived susceptibility, perceived benefits, and attitudes toward condom use. However, it was attitudes toward condom use and condom use self-efficacy that were associated with intentions, which then predicted preparatory condom use behavior at follow-up. CONCLUSION: Except for attitudes, the mediators that were successfully manipulated by the interventions (i.e., perceived susceptibility, perceived severity, and attitudes) were not the same constructs that predicted intentions (i.e., attitudes and condom use self-efficacy), and subsequently predicted behavior. This suggests that the constructs that explain behavior are not the same as those that produce behavior change.