Date of Award
Master of Arts in Psychology
Patricia J. Morokoff
Between 1992 and 1999, the number of persons living with AIDS increased in all groups of women in the United States. In terms of ethnicity, the number of African American and Hispanic American infected with HIV has increased tremendously. In order to address the HIV pandemic among ethnic women in the United States, systematic methods for studying condom use and HIV prevention are being developed and validated.
The Transtheoretical Model (TTM) has been postulated as an integrative and comprehensive model of intentional behavior change that incorporates process oriented variables in an effort to predict how and when people adopt healthy behaviors. The purpose of this study is to assess the effectiveness of the decisional balance and self-efficacy constructs of the TTM in predicting condom stage of change for white and minority women. Much research has been done applying the TTM to white populations, but little has been done to apply this model to minority women. Because HIV/ AIDS is such a prevalent disease among these groups and because there are cultural and ethnic differences among these groups, assessing the effectiveness of this model between white and minority women is essential.
In this study, it was hypothesized that most women would be in earlier condom stages of change or not ready to use condoms. Decisional balance and self-efficacy variables were also hypothesized to differ based on stage and ethnicity when predicting condom stage. Furthermore, Transtheoretical variables (decisional balance and self-efficacy) were hypothesized to predict over and above demographic characteristics.
A subsample of 340 women at risk for HIV were selected from a pool of 816 sexually at-risk New England Community who had participated as part of a longitudinal study. The ethnic distribution consisted of whites (n=l 70), African Americans (n=77), Native Americans (n= 10), Asian Americans (n=25), Hispanic Americans (n=29), and other non-whites (29). The results of a Chi square test indicated a greater proportion of women in the earlier stages (44% in precontemplation and 20% in contemplation) than in later stages (6% in action and 16% in maintenance). Furthermore, an ethnicity by stage chi-square revealed a greater percentage of white women (53%) than minority women (37%) in the precontemplation stage. Moreover, a greater percentage of minority women (18%) than white women (10%) were in the preparation stage.
One-way ANOVAS indicated that pros, cons, and self-efficacy differ based on stage. Tukey HSD tests revealed that the lower the pros and self-efficacy the less readiness to use condoms. Two-way ANOVAS revealed that white and minority women's pros and self-efficacy did not differ based on stage. Standard multiple regression revealed that pros, cons, and self-efficacy predicted 21 % of the variance in condom stage accounting. Hierarchical multiple regressions on the Transtheoretical variables indicated that they accounted for 17% of the variance for the total sample, 20% of the variance for the white subsample, and 15% of the variance for the minority subsample over and above demographics.
These results indicate that Transtheoretical variables, including decisional balance and self-efficacy are predictive of stage of change for white as well as for minority women. Discussion of how these variables might be incorporated into interventions aimed at increasing condom use in minority women, as well as limitations of the study are discussed.
Gazabon, Shirley Amanda, "An Assessment of Decisional Balance, Self Efficacy, and Condom Stages of Change Among White and Minority Women" (2000). Open Access Master's Theses. Paper 1653.