Predictors of condom use among Mexican adolescents.

Mexican adolescents continue to be at increased risk for HIV infection due to inconsistent condom use. The purpose of this study was to identify predictors of condom use intentions and condom use among Mexican adolescents who participated in a randomized control trial designed to test a sexual-risk reduction intervention. Data from sexually active adolescents 17 to 21 years (n = 157) of age who were assigned to the control group were analyzed 48 months post intervention. Regression analysis showed that positive attitudes toward condoms, subjective norms, and control beliefs significantly explained intention to use condoms (R2 = .75, p < .001). Attitudes toward condoms (beta = .67, p <.001), technical skills (beta = .13, p = .01), and condom use self-efficacy (beta = .24, p < .001) were significant predictors of condom use intention. Compared to those who inconsistently used condoms, adolescents who used condoms consistently had greater intention to use condoms and greater impulse control. Findings suggest that attitudes and control beliefs should be further explored with Mexican adolescents in order to support consistent condom use.

Examining long-term effects of Cuídate-a sexual risk reduction program in Mexican youth.

OBJECTIVE: To examine the effectiveness of a safer sex program (Cuídate) on sexual behavior, use of condoms, and use of other contraceptives among Mexican youth 48 months after the intervention. METHODS: A total of 708 or 85% of those who participated in the original randomized control study (n = 829) were assessed in the 48-month follow-up. Each participant completed a questionnaire on sexual behavior. RESULTS: Findings indicated that adolescents who participated in the Cuídate program were more likely to be older at first sex (odds ratio [OR], 1.27; 95% confidence interval [CI], 0.41-2.12; P < 0.05) and to use condoms at first sex (OR, 1.75; 95% CI, 1.14-2.69; P < 0.05) or some other type of contraception at first sex (OR, 1.53; 95% CI, 1.00-2.33; P < 0.05) than those in the control group. Effects of the intervention on consistent condom use, condom use at last sex, and number of sexual partners were not significant. Gender did not moderate any intervention effects. Social desirability moderated the effect of the intervention on age at first sex. CONCLUSIONS: Results demonstrate the efficacy of Cuídate among Mexican adolescents. Future research, policy, and practice efforts should be directed at sustaining safe sex practices across adolescents' developmental and relationship trajectory.

Examining long-term effects of Cuídate-a sexual risk reduction program in Mexican youth / Examen de los efectos a largo plazo de Cuídate, un programa de reducción del riesgo sexual en jóvenes mexicanos

OBJECTIVE: To examine the effectiveness of a safer sex program (Cuídate) on sexual behavior, use of condoms, and use of other contraceptives among Mexican youth 48 months after the intervention. METHODS: A total of 708 or 85 percent of those who participated in the original randomized control study (n = 829) were assessed in the 48-month follow-up. Each participant completed a questionnaire on sexual behavior. RESULTS: Findings indicated that adolescents who participated in the Cuídate program were more likely to be older at first sex (odds ratio [OR], 1.27; 95 percent confidence interval [CI], 0.41-2.12; P < 0.05) and to use condoms at first sex (OR, 1.75; 95 percent CI, 1.14-2.69; P < 0.05) or some other type of contraception at first sex (OR, 1.53; 95 percent CI, 1.00-2.33; P < 0.05) than those in the control group. Effects of the intervention on consistent condom use, condom use at last sex, and number of sexual partners were not significant. Gender did not moderate any intervention effects. Social desirability moderated the effect of the intervention on age at first sex. CONCLUSIONS: Results demonstrate the efficacy of Cuídate among Mexican adolescents. Future research, policy, and practice efforts should be directed at sustaining safe sex practices across adolescents' developmental and relationship trajectory.

OBJETIVOS: Examinar la eficacia de un programa de promoción de actividad sexual de menor riesgo (Cuídate) en cuanto al comportamiento sexual, el uso de condones y el uso de otros anticonceptivos en jóvenes mexicanos, 48 meses después de la intervención. MÉTODOS: En el seguimiento después de 48 meses, se evaluó un total de 708 (85 por ciento) de los que participaron en el estudio de control aleatorizado original (n = 829). Cada participante respondió a un cuestionario sobre su comportamiento sexual. RESULTADOS: Los resultados indicaron que los adolescentes que participaron en el programa "Cuídate" tenían una probabilidad más alta de tener una edad mayor en la primera relación sexual (razón de posibilidades [OR]: 1,27; intervalo de confianza [IC]: de 95 por ciento, 0,41-2,12; p < 0,05) y de usar condones (OR: 1,75; IC 95 por ciento: 1,14-2,69; P < 0,05) o algún otro tipo de medida anticonceptiva en la primera relación sexual (OR: 1,53; IC 95 por ciento: 1,00-2,33; P < 0,05) en comparación con los del grupo de referencia. Los efectos de la intervención sobre el uso constante de condones, el uso de condones en la última relación sexual y el número de compañeros sexuales no fueron considerables. El género no moderó los efectos de la intervención. La conveniencia social moderó el efecto de la intervención sobre la edad en la primera relación sexual. CONCLUSIONES: Los resultados demuestran la eficacia del programa "Cuídate" en los adolescentes mexicanos. En el futuro, la investigación, las políticas y la práctica deberán diri-girse a promover actividades sexuales de menor riesgo en el desarrollo y las relaciones de los adolescentes.

Cognitive performance associated with self-care activities in Mexican adults with type 2 diabetes.

PURPOSE: The purpose of this study was to determine the effect of memory-learning on self-care activities in adults with type 2 diabetes moderated by previous education/understanding in diabetes and to explore the explicative capacity of age, gender, schooling, diabetes duration, and glycemic control in memory-learning. METHODS: A descriptive correlational study was conducted in a randomized sample of 105 Mexican adult patients with type 2 diabetes at a community-based outpatient clinic. Evaluation measures included the Wechsler Memory Scale for memory-learning; 2 questionnaires for self-care activities and previous education/understanding in diabetes, respectively; and glycosylated hemoglobin for glycemic control. Multiple linear regression analysis was used to examine the effect of memory-learning on self-care activities and the moderator capacity of previous education/understanding on diabetes. Multivariate analysis was used to identify the capacity of age, schooling, diabetes duration, and glycemic control in memory-learning types. RESULTS: A significant positive effect of memory-learning on self-care activities was found. Education/understanding in diabetes moderated the relationship between immediate and delayed memory-learning and self-care in glucose monitoring and diet. Gender, schooling, and the gender-glycemic control interaction explained memory-learning performance. CONCLUSIONS: Immediate and delayed verbal and visual memory-learning were important for the patient to carry out self-care activities, and this relationship can be moderated by previous education/understanding in diabetes. These findings suggest potential benefits in emphasizing cognitive strategies to promote relearning of self-care behaviors in persons who live with diabetes.

[Intervention to reduce adolescents sexual risk behaviors: a randomized controlled trial]. / Intervención para reducir riesgo en conductas sexuales de adolescentes: un ensayo aleatorizado y controlado.

OBJECTIVE: To test the efficacy of a behavioral intervention designed to decrease risk sexual behaviors for HIV/AIDS and unplanned pregnancies in Mexican adolescents. MATERIAL AND METHODS: Randomized controlled trial with four follow ups; 832 adolescents recruited from high schools, age 14-17, were randomly assigned to the experimental or control group. The six hour intervention used active learning strategies, and was delivered in two sessions on two consecutive Saturdays. The study was carried out in Monterrey, Mexico, 2002-2005. RESULTS: GEE analysis indicated no differences in sexual relationships intentions between the two conditions, however, the experimental group had higher intentions to use condoms and contraceptives (mean differences 0.15 and 0.16, CI 95%) in the next three months, as compared with the control group. Theoretical variables, such as control beliefs, were significant mediators of the intervention. CONCLUSIONS: The behavioral intervention represents an important effort in promoting safe sexual behaviors among Mexican adolescents.

Intervención para reducir riesgo en conductas sexuales de adolescentes: un ensayo aleatorizado y controlado / Intervention to reduce adolescents’ sexual risk behaviors: a randomized controlled trial

OBJETIVO: Determinar la eficacia de una intervención conductual-educativa diseñada para disminuir las conductas sexuales de riesgo de VIH/SIDA y embarazos no planeados de adolescentes mexicanos. MATERIAL Y MÉTODOS: Ensayo controlado aleatorizado con cuatro seguimientos en un año; 832 adolescentes reclutados de escuelas preparatorias, entre 14 y 17 años, se asignaron aleatoriamente al grupo experimental o al control. La intervención, de seis hrs. de duración, aplicó estrategias de aprendizaje activo. El estudio se realizó en Monterrey, México, de 2002 a 2005. RESULTADOS: De acuerdo al análisis GEE, no hubo diferencia en las intenciones de tener relaciones sexuales, pero sí mayor nivel de intenciones de usar condón y anticonceptivos (diferencia de medias 0.15 y 0.16, IC 95 por ciento) en el grupo experimental comparado con el control. Variables teoréticas como creencias sobre control fueron mediadoras de la intervención. CONCLUSIONES: La intervención conductual representa un importante esfuerzo en la promoción de conductas sexuales seguras en adolescentes mexicanos.

OBJECTIVE: To test the efficacy of a behavioral intervention designed to decrease risk sexual behaviors for HIV/AIDS and unplanned pregnancies in Mexican adolescents. MATERIAL AND METHODS: Randomized controlled trial with four follow ups; 832 adolescents recruited from high schools, age 14-17, were randomly assigned to the experimental or control group. The six hour intervention used active learning strategies, and was delivered in two sessions on two consecutive Saturdays. The study was carried out in Monterrey, Mexico, 2002-2005. RESULTS: GEE analysis indicated no differences in sexual relationships’ intentions between the two conditions, however, the experimental group had higher intentions to use condoms and contraceptives (mean differences 0.15 and 0.16, CI 95 percent) in the next three months, as compared with the control group. Theoretical variables, such as control beliefs, were significant mediators of the intervention. CONCLUSIONS: The behavioral intervention represents an important effort in promoting safe sexual behaviors among Mexican adolescents.

Lifestyle changes in descendants of parents with diabetes type 2.

UNLABELLED: This study aimed to explore the disposition of diabetic parents' descendents in changing eating and physical activity patterns. It was based on the heritability concept and Prochaska's Transtheoretical Model. This is a descriptive-correlational study; participants included 30 parents, randomly selected, and 60 children. RESULTS AND CONCLUSION: 68% of the children was classified as obese, 42% with insulin resistance, and 15% with carbohydrate intolerance. None of the risk factors was associated with the stages of change. The heritability factor was 1.37%; more people younger than 40 and women report decreasing in the consumption of fat food (Xi(2)=6.04, p=.020; and 4.41, p=.040, respectively). These results suggest a high influence of environmental factors on the participants' unhealthy life styles.

Heritability and genetic correlations of metabolic disease-related phenotypes in Mexico: preliminary report from the GEMM Family Study.

Cardiovascular disease (CVD) is a major cause of mortality in the Republic of Mexico, and metabolic syndrome, a complex of CVD risk factors, is increasingly prevalent. To date, however, there have been few studies of the genetic epidemiology of metabolic syndrome in Mexico. As a first step in implementing the GEMM Family Study, a large, multicenter collaborative study, we recruited 375 individuals in 21 extended families, without ascertainment on disease, at 9 medical institutions across Mexico. Participants were measured for anthropometric (stature, weight, waist circumference) and hemodynamic (blood pressure, heart rate) phenotypes; glucose, cholesterol, and triglyceride levels were measured in fasting blood. Variance components-based quantitative genetic analyses were performed using SOLAR. All phenotypes except diastolic blood pressure were significantly heritable. Consistent with the definition of metabolic syndrome, many phenotypes exhibited significant environmental correlation, and significant genetic correlations were found between measures of adiposity and fasting glucose and fasting triglyceride levels. These preliminary data represent the first heritability estimates for many of these phenotypes in the Republic of Mexico and indicate that this study design offers excellent power for future gene discovery relative to metabolic disease.

Lifestyle changes in descendants of parents with diabetes type 2 / Cambio en los patrones de vida en descendientes de progenitores con diabetes mellitus tipo 2 del noreste de Mexico / Mudança em os padrões de vida em descendentes de progenitores com diabetes mellitus tipo 2 do nordeste do México

This study aimed to explore the disposition of diabetic parents' descendents in changing eating and physical activity patterns. It was based on the heritability concept and Prochaska's Transtheoretical Model. This is a descriptive-correlational study; participants included 30 parents, randomly selected, and 60 children. Results and conclusion: 68 percent of the children was classified as obese, 42 percent with insulin resistance, and 15 percent with carbohydrate intolerance. None of the risk factors was associated with the stages of change. The heritability factor was 1.37 percent; more people younger than 40 and women report decreasing in the consumption of fat food (Xi² = 6.04, p = .020; and 4.41, p = .040, respectively). These results suggest a high influence of environmental factors on the participants' unhealthy life styles.

El objetivo general del estudio fue explorar la disposición al cambio de patrones alimentarios y actividad física en descendientes de progenitores con diabetes mellitus tipo 2 (DMT2), aplicando un diseño descriptivo correlacional. La base teórica la constituyó el componente genético heredabilidad (h²) y el Modelo Transteorético de Prochaska; participaron 30 progenitores con DMT2 y 60 descendientes. Resultados y Conclusión: El 68 por ciento de los descendientes fueron obesos, 60 por ciento con riesgo de enfermedad cardiovascular, 42 por ciento con resistencia a la insulina (RI) y 15 por ciento intolerantes a la glucosa; ninguno de los factores de riesgo se asoció con las etapas de cambio. El componente genético para RI fue mínimo (h² = 1.37 por ciento). Una mayor proporción de menores de 40 años (p = .020) y de mujeres "contemplan" disminuir el consumo de grasas (p = .040). Estos resultados sugieren un mayor peso de factores del medio ambiente sobre el estilo de vida nocivo de los participantes.

O objetivo geral do estudo foi explorar à disposição à mudança dos padrões alimentares e atividade física nos descendentes de progenitores com diabetes mellitus tipo 2 (DMT2). Aplicou-se un desenho descritivo correlacionar. A base teórica constituiu-se pelo Componente Genético (h²) e o Modelo Transteorético de Prochaska. Participaram 30 progenitores com DMT2 e 60 descendentes. Resultados e Conclusões: O 68 por cento dos descendentes presentaram obesidade, 60 por cento com risco de doença cardiovascular, 42 por cento com resistência à insulina (RI) e 15 por cento intolerância à glucose; nenhum dos fatores de risco associaram-se com as etapas de mudança. O componente genético para RI foi mínimo (h² = 1.37 por cento). Uma maior proporcão dos menores de 40 anos (Xi² = 6.04, p = .020) e das mulheres (Xi² = 4.41, p=.040) contemplam diminuir o consumo de gorduras. Os resultados sugerem um maior peso dos fatores do meio ambiente sobre o estilo de vida nocivo dos participantes.

Research brief: sexual communication and knowledge among Mexican parents and their adolescent children.

This study describes the sexual knowledge and communication of Mexican parents and adolescents. Preintervention data were analyzed from 829 high school students (ages 14-17) and one of the parents of each. Differences were found between parents and adolescents in sexual knowledge (M = 16.16 vs. M = 14.92; t = 7.20, p < .001); specifically, parents had higher knowledge related to sexually transmitted diseases, HIV/AIDS, and condom use. Parents perceived more general communication (t [787] = 6.33, p < .001), and less discomfort talking about sex (t [785] = 4.69, p < .001) than adolescents. Parents with higher education levels scored higher in HIV knowledge and general communication. Fathers had higher total sexual knowledge, whereas mothers perceived higher sexual communication than fathers. There were no differences in knowledge and communication by parental socioeconomic level. Results suggest health care providers need to assist parents in developing specific knowledge and skills to support their adolescents' sexual decision-making.

Metabolic control of adults with type 2 diabetes mellitus through education and counseling.

PURPOSE: To test the efficacy of a controlled nursing intervention focused on education and counseling to improve metabolic control of adults diagnosed with diabetes mellitus type 2 in (DMT2) ambulatory care. DESIGN: A quasi-experimental design with repeated measures was selected. A sample of 45 subjects participated, of which 25 were in the experimental group, and 20 in the comparison group. Measures were taken at 0, 3, 6, 9, and 12 months, including glycosylated hemoglobin (HbAlc), psychosocial, and clinical variables. FINDINGS: Results showed a significant decrease in HbAlc in the experimental group, as well as positive effects of self-care agency, adaptation, and barriers to treatment (plus one interaction) on the HbA1c levels and on the scores of self-care actions. CONCLUSIONS: The counseling and educational model applied in the intervention was effective to improve the metabolic control of diabetic patients in the experimental group. Self-care agency, adaptation, and barriers were predictors of self-care measures and level of HbA1c.

Conductas protectoras de salud en adultos con diabetes mellitus tipo II / Health protective behaviors in adults with type II diabetes mellitus

El propósito de la investigación fue determinar el efecto de la dieta y el ejercicio como conductas protectoras en el control glucémico de adultos con diabetes tipo II (DMII), así como identificar la capacidad explicativa de variables afectivas y cognoscitivas en la dieta y el ejercicio. El estudio se realizó en dos hospitales, uno público y otro privado, en agosto de 1999. La base teórica la constituyen algunos de los conceptos planteados en el modelo de Promoción de la Salud. El estudio fue de tipo descriptivo y se llevo a cabo con 120 adultos de ambos sexos, seleccionados en forma intencional entre los asistentes a la consulta de control de DM. La información se recolectó por entrevista personal; las mediciones incluyeron: peso, talla, hemoglobina glucosilada y la aplicación de cuatro escalas. El análisis fue de tipo cuantitativo. Los resultados mostraron un porcentaje importante de personas obesas (62 por ciento) y con descontrol glucémico (42 por ciento). Las variables afectivas influyeron en las conductas protectoras (F= 5.2, p <.00,R2= 15 por ciento); pero no afectaron el control glucémico. La edad y los años con DMII explicaron 18.5 por ciento de variación en las cifras de hemoglobina glucosilada, e indican la presencia de otras variables no medidas en esta investigación. Conclusión: El apoyo familiar, las barreras ambientales y los beneficios percibidos por las personas con DMII que participaron en este estudio predicen las conductas protectoras de la dieta y el ejercicio en el adulto con DM.

La uniendo de fronteras: collaboration to develop HIV prevention strategies for Mexican and Latino youth.

AIDS is a global epidemic. Regardless of the present incidence of AIDS, all countries must confront the threat of this devastating disease. The shared border and continued migration between Mexico and the United States as well as shared concerns about HIV/AIDS are compelling reasons to promote AIDS prevention as an important public health endeavor for both countries. This article describes collaborative efforts between nurse researchers in the United States and Mexico to decrease the risk of sexually transmitted HIV infection among adolescents. The significance of this effort to both countries and the processes and preliminary work that led to the development of a study funded by the National Institute of Nursing Research are discussed.

Capacidades de autocuidado del adulto con diabetes tipo 2 / Self-care capabilities of adult patients with type 2 diabetes

El propósito de este estudio fue definir las capacidades especializadas de autocuidado del paciente diabético tipo 2 a partir de lo que ellos expresan sobre el cuidado de su enfermedad. Los sujetos de estudio fueron ocho diabéticos: seis hombres y dos mujeres, con edad promedio de 53,6 años; escolaridad de 13,5 años, y provenientes de tres estratos socioeconómicos diferentes. El método utilizado fue el de entrevista de preguntas abiertas a partir de cuestiones sobre el cuidado de la diabetes. La información se analizó con la técnica análisis de contenido. Los resultados mostraron acciones de autocuidado relacionadas con la condición de diabético, con el tratamiento y sus efectos, y con cambios de hábitos y actitudes. Las capacidades especializadas necesarias son de tipo físico, mental, emocional y de orientación. Estas categorías corresponden con el modelo presentado por Backscheider y pueden ser utilizados como marco de referencia al elaborar programas educativos en pacientes con diabetes tipo 2.