Abstract
BackgroundPatient-delivered partner therapy (PDPT) is an evidence-based method of partner treatment, but further research was needed to understand theoretical underpinnings of potential PDPT use.PurposeWe sought to develop and test a theoretical framework to understand PDPT intentions.MethodsA Midwestern sample of sexually transmitted infection clinic patients were recruited to participate in a three-phase study incorporating semi-structured interviews (n = 20, total), cognitive interviews (n = 5), and surveys (n = 197; Mage = 31.3, 61% male, 91% Black or African-American). Thematic analysis was conducted to identify major themes, which guided development and testing of a theoretical framework on PDPT intentions using structural equation modeling.ResultsWe identified themes of information (knowledge); motivation (individual and partner protection beliefs, partner and provider motivation-to-comply); social support (sexual health and general); and behavioral skills (partner notification, medication delivery, and communication skills self-efficacy) in thematic analysis. The developed Interpersonal-Behavior model demonstrated good model fit in structural equation modeling [χ2(36) = 95.56, p<0.01; RMSEA = 0.09 (0.07–0.11, 90%C.I.); CFI = 0.94; SRMR = 0.05]. Information was associated with motivation (β = 0.37, p<0.001) and social support (β = 0.23, p = 0.002). Motivation was associated with social support (β = 0.64, p<0.001) and behavioral skills (β = 0.40, p<0.001), and social support was associated with behavioral skills (β = 0.23, p = 0.025). Behavioral skills were associated with higher PDPT intentions (β = 0.31, p<0.001), partially mediated the association of motivation with intentions (βdirect = 0.53, p<0.001; βindirect = 0.12, 95%CI: 0.03–0.30), and fully mediated the association of social support with intentions (βindirect = 0.07, 95%CI: 0.00–0.21).ConclusionsThe Interpersonal-Behavior model seems appropriate for PDPT intentions but should be tested longitudinally with PDPT outcomes and other interpersonal health behaviors.
Highlights
Transmitted infections (STIs) continue to be a common morbidity in the United States (US)
We identified themes of information; motivation; social support; and behavioral skills in thematic analysis
The Interpersonal-Behavior model seems appropriate for Patient-delivered partner therapy (PDPT) intentions but should be tested longitudinally with PDPT outcomes and other interpersonal health behaviors
Summary
Transmitted infections (STIs) continue to be a common morbidity in the United States (US). Patient-delivered partner therapy (PDPT)—wherein a patient diagnosed with a bacterial STI is given extra medication to deliver to their sexual partners—is one promising mechanism to increase rates of partner treatment, reduce the risk of repeat infections among index patients, and decrease community prevalence [4, 5]. The Information-Motivation-Behavioral skills model serves as an appropriate starting point, but further examination was needed to determine whether the model needed to be adapted to better understand barriers and facilitators of potential PDPT use among STI clinic patients In this mixed-method study, we sought to: 1) determine barriers and facilitators to PDPT use, 2) develop measurement tools with good construct validity and reliability, and 3) test a theoretical framework on intentions to use PDPT to support the development of a behavioral intervention. We sought to develop and test a theoretical framework to understand PDPT intentions
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