The Multidimensional Scale of Perceived Social Support (MSPSS): Reliability and Validity of Russian Version.

Objective: To assess factorial and construct validity along with reliability of the Russian version of the Multidimensional Scale of Perceived Social Support (MSPSS) in cardiac patients.Methods: The study included 1018 patients with coronary artery disease. All patients were offered the opportunity to complete a questionnaire to detect psychosocial risk and protective factors, including the MSPSS.Results: Internal consistency of the Russian version of the MSPSS was high: Cronbach's alpha coefficient in the group of patients with stable angina was .91 vs. .90 in the group with acute coronary syndrome. The three-factor structure of the MSPSS was proved with exploratory and confirmatory factor analyses. As expected, the Russian version of the MSPSS was negatively correlated with measures of anxiety and depression, and positively correlated with curiosity.Conclusions: The Russian version of MSPSS corresponds closely with the English version in reliability, consistency, and internal structure. Test-retest reliability was satisfactorally high and construct validity was supported with the results of the correlation analysis.Clinical Implications: Our study confirms that MSPSS questionnaire is a high valid tool to estimate social support and it can be successfully applied to define social support in patients with cardiac pathology.

Are Boys Ready for Human Papillomavirus Vaccine? A National Study of Boys in Malaysia.

BACKGROUND: The aim of this study was to investigate factors associated with the willingness of boys to accept the human papillomavirus (HPV) vaccine. METHODS: A nationwide cross-sectional survey among Secondary One male students in Malaysia. RESULTS: Among 2823 respondents, knowledge about HPV infection and the HPV vaccine was extremely poor. The mean total knowledge score was only 3.17 (SD ± 2.14), out of a possible score of 10. The majority of respondents were unaware that vaccinating boys can help protect girls against HPV infection (81.6%), and HPV is a sexually transmitted infection (70.1%). Many had the misconception that only females get HPV (78.9%). In multivariable analysis, the factors associated with the intention to receive the HPV vaccination were: agreeing boys need to be vaccinated against HPV infection (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.57-2.68), perceiving their parents might allow them to get the HPV vaccine (OR, 1.66; 95% CI, 1.18-2.34), perceived susceptibility to HPV infection (OR, 1.63; 95% CI, 1.06-2.52), and attending a rural school (OR, 1.49; 95% CI, 1.14-1.95). CONCLUSIONS: Public health educational programs that are focused and tailored on parents consenting to HPV vaccination for boys at a young age can be useful in improving HPV vaccination rates among boys. There is also a pressing need to educate boys about the benefits of HPV vaccination in males and about HPV disease susceptibility to facilitate adoption of the HPV vaccine by young adults in the future.

HPV vaccination intention among male clients of a large STI outpatient clinic in Amsterdam, the Netherlands.

We explored HPV vaccination intention and its determinants among male clients of the sexually transmitted infections (STI) clinic in Amsterdam. In 2015, male clients aged ≥18 years were invited to complete a web-based questionnaire regarding HPV vaccination intention and socio-psychological determinants. Determinants (scale -3 to +3) were assessed with linear regression, stratified for men who have sex with men (MSM) (including men who have sex with men and women) and men who only have sex with women (MSW). Additionally, we explored the effect of out-of-pocket payment on intention. Of 1490 participants (median age 33 years [IQR:25-44]), 1,053(71%) were MSM. HPV vaccination intention was high (mean 1.68, 95%CI:1.55-1.81 among MSW; mean 2.35, 95%CI:2.29-2.42 among MSM). In multivariable analyses, socio-psychological determinants had similar effects on intention in both groups (R2=0.70 among MSW; R2=0.68 among MSM), except for subjective norms, self-efficacy, and HPV knowledge (significantly stronger associations among MSW). HPV vaccination intention decreased significantly when vaccination would require out-of-pocket payment; intention was negative at the current list price (€350). HPV vaccination intention among male clients of the Amsterdam STI-clinic is high and variance in intention was mostly be explained by socio-psychological factors. Out-of-pocket payment had a strong negative effect on HPV vaccination intention.

The influence of resuscitation preferences on obstetrical management of periviable deliveries.

OBJECTIVE: To determine the relative influence of patients' resuscitation preferences on periviable delivery management. STUDY DESIGN: Surveyed 295 obstetrician-gynecologists about managing periviable preterm premature rupture of membranes. Across 10 vignettes, we systematically varied gestational age, occupation, method of conception and resuscitation preference. Physicians rated their likelihood (0 to 10) of proceeding with induction, steroids and cesarean. Data were analyzed via conjoint analysis. RESULT: Two hundred and five physician responses were included. Median ratings for management decisions were: induction 1.89; steroids 5.00; cesarean for labor 3.89; and cesarean for distress 4.11. Gestational age had the greatest influence on physician ratings across all decisions (importance values ranging from 72.6 to 86.6), followed by patient's resuscitation preference (range=9.3 to 21.4). CONCLUSION: Gestational age is weighted more heavily than patients' resuscitation preferences in obstetricians' decision making for periviable delivery management. Misalignment of antenatal management with parental resuscitation preferences may adversely affect periviable outcomes. Interventions are needed to facilitate more patient-centered decision making in periviable care.

Herpes simplex virus type 2 serological testing at a community court: predictors of test acceptance and seropositivity among female defendants.

Despite the high prevalence of herpes simplex virus type 2 (HSV-2), testing for asymptomatic infections is uncommon. One population for whom targeted interventions may be prioritized include individuals involved with the correctional system. Here we describe the acceptability of a novel HSV-2 screening program, implemented in a court setting, as a possible intervention for corrections-involved women. Female defendants completed an interviewer administered survey assessing factors associated with uptake/refusal of free point-of-care HSV-2 serologic testing and HSV-2 seropositivity. Participants included 143 women, 18-62 years old (mean 32.85) with diverse ethnicities. The majority (65.7%) accepted testing and 62.4% tested HSV-2 seropositive. Factors independently associated with test acceptance included higher perceived susceptibility to genital herpes infection and not receiving a preventative health screen. Women who were seropositive tended to be older, Black, report having previous STI, and be arrested on a prostitution charge. Findings suggest point-of-care testing in a court setting is acceptable to women and can be implemented to improve case finding of STI.

Low acceptance of HSV-2 testing among high-risk women.

We evaluated the acceptability of a community-based herpes simplex virus type 2 (HSV-2) screening programme for at-risk women and assessed factors related to uptake of point of care HSV-2 testing. One hundred recently arrested women (median age 34 years) were recruited from a community court handling lower-level misdemeanour cases in Indianapolis, Indiana. Individuals completed a survey assessing factors related to HSV-2 screening intentions and were offered point of care HSV-2 testing. Rates of HSV-2 infection in this population are high; 61.1% of women tested were positive. The majority (81%) accepted a prescription for suppressive therapy. Women in this sample indicated that HSV-2 screening is an important component of health care but were unwilling to pay the US$10 it cost to be tested. To encourage this and other high-risk populations to be screened for HSV-2, public health resources will be needed to help individuals overcome cost-related barriers to care.

Predictors of HPV vaccine uptake among women aged 19-26: importance of a physician's recommendation.

Among insured women, aged 19-26 years, those who discussed the HPV vaccine with their physician and received a recommendation were overwhelmingly more likely to be vaccinated. Student status and perception of the personal importance of vaccination were also predictive of vaccination. The strength of the physician's recommendation played a significant role in the decision to be vaccinated, resulting in a 4-fold greater likelihood of vaccination when women received a strong recommendation versus one that was not strong. Health care providers should be well-informed about HPV vaccination and recognize that the strength of their recommendation to patients will foster appropriate uptake.

Intent to accept and acceptance of herpes testing in adolescents and young adults.

OBJECTIVES: Understanding the intention-behaviour association with HSV-2 testing is important because it can inform interventions that might be needed to support an effective HSV-2 control programme. This study aims to understand attitudinal, symptomatic and historical precursors to intent to accept, and acceptance of, HSV-2 testing. METHODS: The sample included 900 individuals recruited from four sites located in two US cities. Participants completed self-report questionnaires. Expressed intent to accept HSV-2 testing was assessed with an item that asked about acceptance of a test with the same characteristics as the test offered later. The health behaviour outcome was acceptance of the HSV-2 test when it was offered. Predictors examined were STI history, genital symptoms, anxiety and STI-related stigma. RESULTS: Expressed intent significantly predicted test acceptance. However, a number of participants made testing decisions which were at odds with their stated intent. Genital symptoms and STI history significantly predicted both greater intent and test acceptance. STI stigma only predicted lower intent, whereas anxiety only predicted greater acceptance. Intent fully mediated the relationship between genital symptoms and test acceptance, but did not mediate the relationship between STI history and test acceptance. CONCLUSIONS: This study suggests that intent does not always predict behaviour, even when the two are measured within close temporal proximity. There are factors that may predict intent only or behaviour only, or may predict behaviour, but solely through influencing intent. Understanding how these various relationships work may be important to efforts designed to maximise acceptance of HSV-2 testing.

The psychosocial impact of serological diagnosis of asymptomatic herpes simplex virus type 2 infection.

OBJECTIVES: To evaluate the impact of a positive herpes simplex virus type 2 (HSV-2) serological test on psychosocial functioning among people with no known history of genital herpes. METHODS: Individuals (age 14-30 years) without a history of genital herpes were recruited from an urban university setting and sexually transmitted diseases (STD), primary care, and adolescent clinics. Participants completed a questionnaire addressing psychological functioning, psychosocial adjustment, and perceived quality of sex and were offered free HSV-2 antibody testing. 33 HSV-2 positive people and 60 HSV-2 negative people demographically matched from the same source of recruitment were re-evaluated at a 3 month follow up visit. HSV-2 positive participants also completed a genital herpes quality of life (GHQOL) measure. RESULTS: Of the 33 who were HSV-2 seropositive, four did not recall their diagnosis. In comparing those who were HSV-2 positive with those who were negative, repeated measures analysis of variance indicated there were no significant differences over time on any of the measures. None the less, many HSV-2 positive individuals indicated that the diagnosis had a notable impact on their quality of life. Also, among the HSV-2 positive people, lower GHQOL at the 3 month follow up was predicted by higher interpersonal sensitivity (r = -0.44, p<0.05), lower social support (r = 0.40, p<0.05), and quality of sex (r = 0.62, p<0.01) at baseline. CONCLUSIONS: A diagnosis of asymptomatic HSV-2 infection does not appear to cause significant lasting psychological difficulties. Those for whom the diagnosis had the greatest impact were interpersonally vulnerable before the diagnosis. These results suggest that assessment of interpersonal distress may be important to include as part of pretest and post-test counselling.

Attitudes about human papillomavirus vaccine among family physicians.

STUDY OBJECTIVE: Human papillomavirus (HPV) vaccines will soon be available for clinical use, and the effectiveness of vaccine delivery programs will depend largely upon whether providers recommend the vaccine. The objectives of this study were to examine family physicians' attitudes about HPV immunization and to identify predictors of intention to recommend immunization. DESIGN: Cross-sectional survey instrument assessing provider and practice characteristics, knowledge about HPV, attitudes about HPV vaccination, and intention to administer two hypothetical HPV vaccines. PARTICIPANTS: Surveys were mailed to a national random sample of 1,000 American Academy of Family Physicians (AAFP) members. MAIN OUTCOME MEASURE: Intention to administer two hypothetical HPV vaccines (a cervical cancer/genital wart vaccine and a cervical cancer vaccine) to boys and girls of different ages. RESULTS: One hundred fifty-five surveys (15.5%) were returned and 145 were used in the final sample. Participants reported higher intention to recommend both hypothetical HPV vaccines to girls vs. boys (P < 0.0001) and to older vs. younger adolescents (P < 0.0001). They were more likely to recommend a cervical cancer/genital wart vaccine than a cervical cancer vaccine to boys and girls (P < 0.001). Variables independently associated with intention (P < 0.05) included: female gender of provider, knowledge about HPV, belief that organizations such as the AAFP would endorse vaccination, and fewer perceived barriers to vaccination. CONCLUSIONS: Female gender, knowledge about HPV, and attitudes about vaccination were independently associated with family physicians' intention to recommend HPV vaccines. Vaccination initiatives directed toward family physicians should focus on modifiable predictors of intention to vaccinate, such as HPV knowledge and attitudes about vaccination.

More normal than not: a qualitative assessment of the developmental experiences of gay male youth.

PURPOSE: To examine gay youth experiences within the context of normal adolescent development. METHODS: Thematic analyses of interviews with 13 self-identified gay male youth, aged 16-22 years, each reporting minimal sexual identity distress, were completed. Interviews focused on: (a) descriptions of developmental changes perceived to occur for all adolescents, (b) descriptions of the participants' developmental experience, and (c) participants' direct comparisons of their perceptions of gay and nongay developmental experience. Data were analyzed by two investigators who, after initial review of the interview transcripts, developed a unified coding template to permit systematic analysis of the transcripts for recurrent themes. RESULTS: (a) Few (2 of 13) participants reported overall developmental experience markedly different from nongay peers. (b) Peer interaction was seen as the domain most different from that of nongay peers. (c) Open gay self-identification altered, generally positively, all peer interaction. (d) Increased peer interaction enhanced maturity in other domains. (e) Family dynamics were not substantively altered by open gay self-identification. (f) Middle and high school were identified as relatively hostile environments in which to openly identify as gay, affecting the timing and the extent of self-disclosure. (g) Developmental progress showed asynchrony across developmental domains. CONCLUSION: General developmental dysfunction is not inevitable for gay adolescents, nor is identifiable personal or family pathology directly related to sexual identity.

Acceptance of hepatitis B vaccination among adult patients with sexually transmitted diseases.

BACKGROUND: Sexually transmitted disease (STD) clinic patients are at risk for hepatitis B virus infection, but have been relatively neglected in terms of hepatitis B virus (HBV) immunization. Acceptance of HBV vaccine among patients attending an STD clinic was examined. GOAL: To evaluate potential predictors of HBV vaccine acceptance. STUDY DESIGN: In this study, 99 patients attending an STD clinic completed a brief questionnaire that addressed knowledge of STD and vaccines as well as sexual behavior. After the questionnaire, each patient was offered HBV vaccine, then interviewed to assess reasons for acceptance or refusal. RESULTS: Among the patients in this study, 23% accepted the vaccine and 11% reported prior vaccination. Acceptors were younger, had less education, and used condoms less frequently than those who refused vaccination. The reasons given for acceptance or rejection typically involved health beliefs related to infection or vaccination. CONCLUSION: The findings indicate an unacceptably low rate of HBV vaccine acceptance in a group at high risk for infection. However, some of the reasons for refusal may be modifiable through brief, targeted interventions.

The acceptability of HIV immunization: examining vaccine characteristics as determining factors.

The acceptance of a future HIV vaccine may be influenced, in part, by the characteristics of the vaccine itself. This study evaluated the relationship of vaccine characteristics to acceptability of hypothetical HIV immunization. Subjects were 549 undergraduates (18-56 years of age); 70.3% were female, and 80.4% were non-Hispanic white. Subjects completed a self-administered questionnaire assessing a series of 12 hypothetical vaccines that varied along the dimensions of efficacy (80 or 50%), cost (free or $300) and social saturation or percentage of the population already vaccinated (10, 50 or 90%). The vaccines were each rated on an 11-point scale ranging from zero ('I will never get this vaccine') to 100 ('I will definitely get this vaccine'), in increments of ten. All three dimensions were significantly associated with probability of vaccine acceptance, particularly vaccine efficacy and cost. The highest rated vaccine (free, 80% efficacious, 90% saturation level) received a mean acceptability score of 83.4, whereas the lowest rated vaccine ($300, 50% efficacious, 10% saturation level) received a mean score of 32.8. The mean acceptability rating across all 12 vaccines was 55.14. These findings indicate the potential importance of considering the influence of vaccine characteristics in future HIV immunization programmes.

Undergraduates' perception of HIV immunization: attitudes and behaviours as determining factors.

The development of a vaccine to prevent human immunodeficiency virus (HIV) infection is a highly desirable goal. However, there may be a number of psychosocial barriers to HIV vaccine acceptance. The purpose of this study was to evaluate the relationship of health beliefs and health lifestyles to acceptability of hypothetical HIV immunization. The subjects were 549 college students who completed self-administered questionnaires that addressed health beliefs, health behaviours, and acceptability of hypothetical HIV vaccines. Results showed that all 6 variables of health beliefs, based in part on the Health Belief Model, independently predicted HIV vaccine acceptability. For the overall sample, 5 health behaviours were significantly correlated with HIV vaccination: diet, smoking, drug use, alcohol use, and prior sexual experience. The results suggest that universal HIV acceptance cannot be assumed, and that certain health beliefs and behaviours are likely to influence decisions regarding HIV immunization.

Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents.

The psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS) were investigated in 222 urban, largely African-American adolescents (68%). High internal consistency was demonstrated, and factor analysis confirmed the three subscale structures of the MSPSS: family, friends, and significant other. Correlations with a family caring scale supported the discriminant validity of the Family subscale. These results confirm the reliability, validity, and utility of the MSPSS with an urban, largely African-American adolescent sample. Implications of the findings are discussed.

Acceptability of human papillomavirus immunization.

The purpose of this study was to examine the attitudes about hypothetical human papillomavirus (HPV) vaccines in two groups of women in clinical settings. Twenty adolescent women attending an urban community adolescent health clinic and 20 adult women attending a city health department sexually transmitted disease (STD) clinic were recruited to participate in individual interviews. Adolescents were 14-18 years of age (mean 15.6), 75% nonHispanic white, and 75% sexually experienced. Adults were 20-50 years of age (mean 33.6), 95% African American, and all were sexually experienced. As part of the interview, participants ranked nine hypothetical HPV vaccines in order of acceptability. Each vaccine was uniquely defined as a function of cost ($150, $50, or free), efficacy (50% or 90%), disease targeted (genital warts, cervical cancer, or both), and physician recommendation (not mentioned by a physician or specifically recommended). Rankings by adolescents and adults were highly concordant (Spearman rho = 0.9). Efficacy, physician's recommendation, and cost influenced rankings most strongly. Ranking decisions were often based on complex decision making, in which all characteristics were considered simultaneously. These findings suggest that certain features of an HPV vaccine might significantly affect vaccine acceptability. Vaccine efficacy, physician endorsement, and cost were particularly salient issues.

Vaccine characteristics and acceptability of HIV immunization among adolescents.

HIV immunization programmes will only be effective if sufficient numbers of persons accept the vaccine. Our aims were to evaluate HIV vaccine acceptability among adolescents and to examine how vaccine characteristics influence acceptability. We recruited 661 adolescents from community health clinics in Indianapolis, Indiana, USA to complete either written or computerized questionnaires, both of which assessed HIV vaccine acceptability as a function of efficacy, cost, type of vaccine, mode of delivery, and parental permission for immunization (required or not required). For both the written and computer methods, efficacy had the strongest effect on acceptability, followed by type of vaccine and cost. Low efficacy, high cost, and live-attenuated vaccines were associated with lower acceptability. These findings suggest that as efforts to develop HIV vaccines continue, it will be important, in parallel, to anticipate potential obstacles to vaccine acceptance, including the belief that a less efficacious HIV vaccine is unacceptable.

Human papillomavirus, genital warts, Pap smears, and cervical cancer: knowledge and beliefs of adolescent and adult women.

The high prevalence of genital warts, human papillomavirus (HPV), and the virus's cancer-causing potential warrant that women be well informed about these conditions and measures to prevent them. The purpose of this descriptive study was to examine women's knowledge and beliefs about genital warts, HPV, cervical cancer, and Pap tests. We interviewed 40 women recruited from health clinics in Chicago (20 adults) and Indianapolis (20 adolescents) about these issues. Audiotapes of the interviews were transcribed and analyzed. Among both the adults and adolescents there was a good deal of misunderstanding about symptoms associated with genital warts, about the purpose of Pap smears, and about the association of genital HPV with abnormal Pap smears and cervical cancer. The gaps in women's understanding about this potentially deadly infection suggest the need for more comprehensive education about preventing genital HPV, the infection's possible sequelae, and the significance of Pap screening for cancer detection and prevention.