Should We Worry About Setting? Association of Program Fidelity with Youths' Satisfaction and Intention to Practice Safer Sex.

PURPOSE: To examine whether deviation from fidelity in the implementation of an evidence-based program on safer sex education affected youth satisfaction and intention to avoid risky sexual behaviors. DESIGN: Implementation evaluation. SETTING: In-school and out-of-school settings in South Carolina. PARTICIPANTS: Three thousand seventy-three youths aged 10 to 14 years. INTERVENTION: Making Proud Choices. MEASURES: Fidelity variables were implementation setting, program length, class size, gender composition, and curriculum adaptations. Outcome variables were youth program satisfaction and intentions to remain abstinent or avoid risky sexual behaviors postintervention. ANALYSIS: Chi-square and t tests tested in-school and out-of-school comparisons. Multiple linear regression examined predictors of youth program satisfaction and intention to avoid risky behaviors. RESULTS: Program duration (B = .002), class size (B = .074), program completion rate (B = .004), gender (B = .223), and race (B = .263) predicted program satisfaction (P < .05; R2 = 0.094). Longer program duration was negatively associated with planned abstinence (B = -.002), contraception use (B = -.004), and condom use (B = -.002). Participants in single-gender classes (B = .387) and females (B = .256) were more likely to practice safer sex. Low R2 showed limited impact on intention to practice safer sex (R2 = .030 and.015) and remaining abstinent (R2 = .033). CONCLUSION: Although fidelity deviations do impact youth satisfaction and intentions, the impact is not large. Implementations adapted to fit local settings can still be beneficial.

Influence of socioeconomic status and BMI on the quality of life after mastectomy in Bangladeshi breast cancer patients in a public hospital.

OBJECTIVE: Quality of life after diagnosis and during treatment phases of breast cancer varies across individual to individual, country to country and from ethnicity to ethnicity. So factors affecting it are of growing research interest. The aim of the study was to investigate the influence of socioeconomic status and body mass index on the quality of life of breast cancer patients during the phases of treatment-before and after mastectomy. METHODS: Two hundred and fifty-one women with breast cancer undergoing surgery were interviewed prior to and after mastectomy in National Institute of Cancer Research and Hospital, Dhaka from January 2012 to March 2013 using European Organization for Research and Treatment of Cancer Core Questionnaire (and QLQ-Br23). Socioeconomic factors like educational status, family income, occupation and body mass index were taken as investigating factors against global health status and breast cancer-related factors. RESULTS: Significant reduction of the scores found that means deterioration of function in the following domains of the quality of life were found such as physical well-being (P = 0.019), emotional well-being (P = 0.035), cognitive status (P = 0.05) and the breast-specific subscales like BRBI (body image), BRBS (breast symptoms), BRAS (arm symptoms); (P = 0.013, 0.103, 0.015) was observed after surgery in lower income group. Worker group expressed also similar effect on the global health status/quality-of-life scales (P = 0.05, 0.043, 0.021) and breast subscales (P = 0.002, 0.027, 0.05), patients with lower body mass index also have a lower score also. Educational status does not affect the two groups. Younger age group patients expressed much distress. CONCLUSIONS: Improvement of family income, nutritional status and improvement of working environment might have an impact on the improvement of the quality of life of breast cancer patients during the phases of treatment.