title: Modeling early sexual initiation among young adolescents using quantum and continuous behavior change methods: implications for HIV prevention.
abstract: Behavioral research and prevention intervention science efforts have largely been based on hypotheses of linear or rational behavior change. Additional advances in the field may result from the integration of quantum behavior change and catastrophe models. Longitudinal data from a randomized trial for 1241 pre-adolescents 9-12 years old who self-described as virgin were analyzed. Data for 469 virgins in the control group were included for linear and cusp catastrophe models to describe sexual initiation; data for the rest in the intervention group were added for program effect assessment. Self-reported likelihood to have sex was positively associated with actual initiation of sex (OR = 1.72, 95% CI: 1.43-2.06, R² = 0.13). Receipt of a behavioral prevention intervention based on a cognitive model prevented 15.6% (33.0% vs. 48.6%, OR = 0.52, 95% CI: 0.24-1.11) of the participants from initiating sex among only those who reported 'very likely to have sex.' The beta coefficients for the cubic term of the usp assessing three bifurcating variables (planning to have sex, intrinsic rewards from sex and self-efficacy for abstinence) were 0.0726, 0.1116 and 0.1069 respectively; R² varied from 0.49 to 0.54 (p < 0.001 for all). Although an intervention based on a model of continuous behavior change did produce a modest impact on sexual initiation, quantum change has contributed more than continuous change in describing sexual initiation among young adolescents, suggesting the need for quantum change and chaotic models to advance behavioral prevention of HIV/AIDS.
authors.affiliation: Wayne State University School of Medicine, Detroit, MI, USA. jimchen@med.wayne.edu
authors.forename: Xinguang
authors.initials: X
authors.lastname: Chen
authors.forename: Sonja
authors.initials: S
authors.lastname: Lunn
authors.forename: Carole
authors.initials: C
authors.lastname: Harris
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.forename: Lynette
authors.initials: L
authors.lastname: Deveaux
authors.forename: Sharon
authors.initials: S
authors.lastname: Marshall
authors.forename: Leslie
authors.initials: L
authors.lastname: Cottrell
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
mesh_terms: D000293:Adolescent; D001444:Bahamas; D002648:Child; D003075:Coitus; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology*; D006801:Humans; D033182:Intention; D016013:Likelihood Functions; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D011789:Quantum Theory; D020377:Self Efficacy; D012736:Sex Education; D012746:Sexual Abstinence; D012725:Sexual Behavior