Bin Yu1, Xinguang Chen2, Bonita Stanton3, Ding-Geng Din Chen4, Yunan Xu1, Yan Wang1. 1. Department of Epidemiology, University of Florida, Gainesville, FL 32610, USA. 2. Department of Epidemiology, University of Florida, Gainesville, FL 32610, USA. Electronic address: jimax.chen@ufl.edu. 3. School of Medicine, Seton Hall University, South Orange, NJ 07079, USA. 4. School of Social Work, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC 27599, USA; Department of Statistics, University of Pretoria, South Africa.
Abstract
INTRODUCTION: The complex relationships among HIV knowledge, condom-use skills, self-efficacy, peer influence and intention to use condoms have been rigorously investigated. However, studies guided by a linear behavior change model often explain only a limited amount of variances. This study aims to advance our understanding of the relationships through a nonlinear quantum change paradigm. METHODS: Data (n = 1970, 40.61% male, mean age 16.94 ± 0.74) from a behavioral intervention program among high school students in the Bahamas were analyzed with a chained cusp catastrophe model in two steps. In the first step, self-efficacy was analyzed as the outcome with HIV knowledge/condom-use skills as asymmetry variables and peer influence as bifurcation variable. In the second step, condom-use intention was analyzed as the outcome while self-efficacy (outcome in the first step) was used as bifurcation variable allowing peer influence as bifurcation, and HIV knowledge/condom-use skills were included as asymmetry. Cusp modeling analysis was conducted along with equivalent linear models. RESULTS: The cusp model performed better than the linear and logistic models. Cusp modeling analyses revealed that peer influence significantly bifurcated the relationships between HIV knowledge/condom-use skills and self-efficacy; while both self-efficacy and peer influence significantly bifurcated the relationship between HIV knowledge/condom-use skills and condom-use intention. CONCLUSION: Our findings support the central role of self-efficacy and peer influence as two chains in bridging the complex quantum relationships between HIV knowledge/condom-use skills and condom-use intention among adolescents. The nonlinear cusp catastrophe modeling provided a new method to advance HIV behavioral research.
INTRODUCTION: The complex relationships among HIV knowledge, condom-use skills, self-efficacy, peer influence and intention to use condoms have been rigorously investigated. However, studies guided by a linear behavior change model often explain only a limited amount of variances. This study aims to advance our understanding of the relationships through a nonlinear quantum change paradigm. METHODS: Data (n = 1970, 40.61% male, mean age 16.94 ± 0.74) from a behavioral intervention program among high school students in the Bahamas were analyzed with a chained cusp catastrophe model in two steps. In the first step, self-efficacy was analyzed as the outcome with HIV knowledge/condom-use skills as asymmetry variables and peer influence as bifurcation variable. In the second step, condom-use intention was analyzed as the outcome while self-efficacy (outcome in the first step) was used as bifurcation variable allowing peer influence as bifurcation, and HIV knowledge/condom-use skills were included as asymmetry. Cusp modeling analysis was conducted along with equivalent linear models. RESULTS: The cusp model performed better than the linear and logistic models. Cusp modeling analyses revealed that peer influence significantly bifurcated the relationships between HIV knowledge/condom-use skills and self-efficacy; while both self-efficacy and peer influence significantly bifurcated the relationship between HIV knowledge/condom-use skills and condom-use intention. CONCLUSION: Our findings support the central role of self-efficacy and peer influence as two chains in bridging the complex quantum relationships between HIV knowledge/condom-use skills and condom-use intention among adolescents. The nonlinear cusp catastrophe modeling provided a new method to advance HIV behavioral research.
Authors: Kyung-Hee Choi; Colleen Hoff; Steven E Gregorich; Olga Grinstead; Cynthia Gomez; Wendy Hussey Journal: Am J Public Health Date: 2008-08-13 Impact factor: 9.308
Authors: Yunan Xu; Xinguang Chen; Akemi Wijayabahu; Zhi Zhou; Bin Yu; Emma C Spencer; Robert L Cook Journal: Curr HIV Res Date: 2020 Impact factor: 1.581