Risk Behaviors In Young Adults Research Articles

Preliminary Efficacy of a Multi-Behavioral Zoom-Based Peer Health Coaching Intervention in Young Adults: A Stepped Wedge Randomized Controlled Trial.

The purpose of this study was to test the preliminary efficacy of a Zoom-based peer coaching intervention on health and risk behaviors in young adults. A convenience sample of young adults was recruited from one U.S. university (N = 89; 73.0 percent female). Participants were randomized to one of two coaching session sequences within the framework of a stepped wedge randomized controlled trial. One experimental sequence received a control condition and a single coaching session, and the second sequence received two sessions. The intervention was a 1-hour program delivered by peer health coaches in a one-on-one setting on Zoom. The program consisted of a behavior image screen, a consultation, and goal planning. Behavioral assessments were completed after each condition. Mixed-effects models were employed to test for behavior differences after coaching sessions compared with the control condition (no coaching session) adjusting for baseline scores. Participants reported significantly higher levels of vigorous physical activity (b = 750 metabolic equivalent of task minutes, p < 0.001), a lower frequency of e-cigarette use (b = -2.1 days; p < 0.001), and a lower risk of e-cigarette susceptibility after two sessions (relative risk = 0.04, p = 0.05), and higher odds of using stress reduction techniques after one session (odds ratio = 1.4, p = 0.04). A nonsignificant trend was observed for longer weekday sleep (b = 0.4 h/night, p = 0.11) after two coaching sessions. The Zoom-based peer health coaching intervention may be an efficient way to improve vigorous physical activity, lower e-cigarette use and susceptibility, and facilitate the use of stress reduction techniques in young adults. The results observed from this preliminary study warrants further investigation using powered effectiveness trials.

Parental Anti-Smoking Encouragement as a Longitudinal Predictor of Young Adult Cigarette and E-cigarette Use in a US National Study.

Young adulthood is a critical period for the adoption of risk behaviors like tobacco use. Protective factors in adolescence may promote a tobacco-free transition to young adulthood. We examine associations between the frequency of parental anti-smoking encouragement in adolescence and cigarette and e-cigarette use in young adulthood. We analyzed data from Waves 1 (2009-2010, 10th grade, mean age = 16.2 years) and 5 (2013-2014 mean age = 20.3 years) of the US nationally representative NEXT Generation Health Study (n = 1718). At Wave 1, participants reported how often their parents or guardians encourage them to not smoke cigarettes (1 = Rarely or Never, 7 = Frequently). We used separate weighted multiple logistic regression models to model Wave 5 past 30-day cigarette and e-cigarette use as functions of the frequency of parental anti-smoking encouragement at Wave 1, adjusting for sociodemographic and parenting factors, initial substance use, and peer tobacco use. The average frequency of parental encouragement to not smoke cigarettes was fairly high (mean = 5.35). At Wave 5, 24.7% and 14.2% of respondents reported cigarette and e-cigarette use in the past 30 days, respectively. Greater frequency of parental anti-smoking encouragement was associated with lower odds of subsequent cigarette smoking (adjusted odds ratio 0.91, 95% confidence interval 0.83, 0.99) but its association with e-cigarette use was not significant (adjusted odds ratio 0.93, 95% confidence interval 0.84, 1.04). The longitudinal negative association between anti-smoking encouragement and cigarette use suggests that parental anti-tobacco communication could be a long-term protective factor against young adult tobacco use. Our findings may also suggest the importance of product-specific messages in the evolving tobacco use landscape. This study builds upon prior investigations of parenting in adolescence as a protective factor against young adult risk behavior. We isolate the frequency of anti-smoking encouragement during adolescence as an actionable factor distinct from other parenting variables. Our findings also suggest that message specificity may be an important factor in parental anti-tobacco communication as youth and young adult tobacco use becomes increasingly dominated by e-cigarettes.

Reducing Risk Behavior with Family-Centered Prevention During the Young Adult Years.

Family-centered prevention is effective at reducing risk behavior throughout the life span and promoting healthy development. Despite research that suggests parents continue to play a significant role in the lives of their children during emerging adulthood, very few studies have examined effective family-centered strategies for preventing risk behavior in young adults. Typical prevention efforts for this age group have focused on college students and substance use prevention, with no integration of families or systems of support that may sustain the effects of the intervention. In this study, we evaluated a version of the Family Check-Up (FCU) that was adapted for young adults and their families, the Young Adult Family Check-Up (YA-FCU). Families were randomly assigned to receive the FCU or school as usual during the middle school years. Ten years later, they were offered the YA-FCU, which was adapted for families of emerging adult children. Intent-to-treat and complier average causal effect analyses were used to examine change in young adult risk behavior approximately 1year after receiving the YA-FCU. Analyses indicated that random assignment alone or simple engagement was not associated with reductions in young adult risk behavior. However, dose-response analyses indicated that the more hours that youth and families were engaged in the YA-FCU, the greater the reductions in young adult risk behavior relative to those who did not engage or engaged very little in the intervention, resulting in a medium effect size of the YA-FCU on risk behavior.

Information for CME Credit — Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults

Information for CME Credit — Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults

Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults

Skin cancer is the most common cancer, and its incidence is increasing. Young adults expose themselves to large amounts of ultraviolet radiation (UV) and engage in minimal skin protection, which increases their risk. Internet interventions are effective in modifying health behaviors and are highly disseminable. The current study's purpose was to test an Internet intervention to decrease UV exposure and increase skin protection behavior among young adults. RCT conducted in 2014, with data analyzed in 2015. A national sample of adults aged 18-25 years at moderate to high risk of developing skin cancer by a self-report measure was recruited online. Participants were randomized to one of three intervention conditions: assessment only, the website of a skin cancer organization, or a tailored interactive multimedia Internet intervention program (UV4.me) based on the Integrative Model of Behavioral Prediction. Self-reported overall UV exposure and skin protection assessed at 3 and 12 weeks after baseline. Secondary outcomes were self-reported intentional and incidental UV exposure, sunburns, sunscreen use, and skin cancer screening. For the intervention arm, there were significant decreases in UV exposure and increases in skin protection at both follow-up time points compared with the assessment-only condition (p<0.001). The effect sizes (Cohen's d) comparing the experimental and assessment-only arm for exposure behaviors were 0.41 at 3-week follow-up and 0.43 at 12-week follow-up. The effect sizes for protection behaviors were 0.41 at 3-week follow-up and 0.53 at 12-week follow-up. The control condition was not significantly different from the assessment only condition. All three conditions exhibited decreased exposure and increased protection at both follow-ups (p<0.01), but the effect was much stronger in the intervention group. Secondary outcomes were generally also significantly improved in the intervention condition compared with the other conditions. This is the first published report describing the results of an RCT of an Internet intervention to modify skin cancer risk behaviors among young adults. The UV4.me intervention significantly improved self-reported skin cancer prevention behaviors. Future research will investigate mechanisms of change and approaches for dissemination. This study is registered at www.clinicaltrials.gov NCT02147080.

Differential patterns of amygdala and ventral striatum activation predict gender-specific changes in sexual risk behavior.

Although the initiation of sexual behavior is common among adolescents and young adults, some individuals express this behavior in a manner that significantly increases their risk for negative outcomes including sexually transmitted infections. Based on accumulating evidence, we have hypothesized that increased sexual risk behavior reflects, in part, an imbalance between neural circuits mediating approach and avoidance in particular as manifest by relatively increased ventral striatum (VS) activity and relatively decreased amygdala activity. Here, we test our hypothesis using data from seventy 18- to 22-year-old university students participating in the Duke Neurogenetics Study. We found a significant three-way interaction between amygdala activation, VS activation, and gender predicting changes in the number of sexual partners over time. Although relatively increased VS activation predicted greater increases in sexual partners for both men and women, the effect in men was contingent on the presence of relatively decreased amygdala activation and the effect in women was contingent on the presence of relatively increased amygdala activation. These findings suggest unique gender differences in how complex interactions between neural circuit function contributing to approach and avoidance may be expressed as sexual risk behavior in young adults. As such, our findings have the potential to inform the development of novel, gender-specific strategies that may be more effective at curtailing sexual risk behavior.

Evaluating HIV Prevention Programs: Herpes Simplex Virus Type 2 Antibodies as Biomarker for Sexual Risk Behavior in Young Adults in Resource-Poor Countries

BackgroundMeasuring effectiveness of HIV prevention interventions is challenged by bias when using self-reported knowledge, attitude or behavior change. HIV incidence is an objective marker to measure effectiveness of HIV prevention interventions, however, because new infection rates are relatively low, prevention studies require large sample sizes. Herpes simplex virus type 2 (HSV-2) is similarly transmitted and more prevalent and could thus serve as a proxy marker for sexual risk behavior and therefore HIV infection.MethodsHSV-2 antibodies were assessed in a sub-study of 70,000 students participating in an education intervention in Western Province, Kenya. Feasibility of testing for HSV-2 antibodies was assessed comparing two methods using Fisher’s exact test. Three hundred and ninety four students (aged 18 to 22 years) were randomly chosen from the cohort and tested for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Out of these, 139 students were tested for HSV-2 with ELISA and surveyed for sexual risk behavior and 89 students were additionally tested for HSV-2 with a point-of-contact (POC) test.ResultsPrevalence rates were 0.5%, 1.8%, 0.3% and 2.3% for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, respectively. Prevalence of HSV-2 antibodies was 3.4 % as measured by POC test (n=89) and 14.4 % by ELISA (n=139). Specificity of the POC test compared with ELISA was 100%, and the sensitivity only 23.1%. Associations between self-reported sexual behavior and HSV-2 serostatus could not be shown.ConclusionsAssociations between self-reported sexual risk behavior and HSV-2 serostatus could not be shown, probably due to social bias in interviews since its transmission is clearly linked. HSV-2 antibody testing is feasible in resource-poor settings and shows higher prevalence rates than other sexually transmitted diseases thus representing a potential biomarker for evaluation of HIV prevention interventions.

Child maltreatment types and risk behaviors: Associations with attachment style and emotion regulation dimensions

Child maltreatment is a robust psychosocial risk factor linked to the development of a wide range of risk behaviors among young adults. Adult attachment style and emotion dysregulation are two potential mechanisms through which maltreatment leads to risk behaviors. Yet, less is known about the specificity of the relations among different maltreatment types, attachment styles, emotion regulation strategies, and risk behaviors. The present study examined the relations among various forms of maltreatment and risk behaviors (e.g., substance use; risky sex) among 361 undergraduate students and tested whether attachment styles and emotion dysregulation might underlie these relations. Emotional, and sexual but not verbal abuse (although verbal abuse was directly related to alcohol use), were related to anxious and avoidant attachment styles, emotion dysregulation, and a variety of risk behaviors. Among the emotion regulation dimensions, impulsivity showed the strongest indirect effect from child maltreatment to risk behaviors. Results support a cross-sectional link between child maltreatment and risk behavior outcomes via attachment styles and emotion regulation. Implications for treatment and prevention of these risk behaviors in young adults are discussed.

Sexting, Substance Use, and Sexual Risk Behavior in Young Adults

Cell phone use has become more widespread over the past decade. Young adults are frequently early adopters of new technologies, including cell phones. Most previous research examining sexting, the act of sending sexually explicit or suggestive images via text message, has focused on the legal or social consequences of this behavior. The current study focused on the public health implications of sexting by examining associations between sexting, substance use, and sexual risk behavior in youth. Young adults (N = 763) completed online questionnaires assessing demographics, cell phone use (e.g., texting, sexting), substance use, and sexual risk behaviors. Sexting was reported by a substantial minority of participants (44%). Compared with their nonsexting counterparts, participants who engaged in sexting were more likely to report recent substance use and high-risk sexual behaviors, including unprotected sex and sex with multiple partners. Of those who engaged in sexting, a considerable percentage (31.8%) reported having sex with a new partner for the first time after sexting with that person. In multivariate analyses, sexting was associated with high-risk sexual behavior, after accounting for demographic factors, total texting behaviors, and substance use. Results suggest that sexting is robustly associated with high-risk sexual behavior. Many individuals exchange explicit or provocative photos with long-term sexual partners, but at least some participants in this study were incurring new sexual risks after sexting. Additional research is needed to understand the contexts in which sexting occurs, motivations for sexting, and relationship of sexting to risk behavior.

Non-medical use of prescription drugs and sexual risk behavior in young adults

In recent years, the non-medical use of prescription drugs (without a doctor's prescription) has increased dramatically, particularly in young adults. Previous work has noted associations between the non-medical use of prescription drugs and the use of illicit drugs, and associations between the use of illicit drugs and sexual risk behavior. Investigations examining associations between the non-medical use of prescription drugs (NMUPD) and sexual risk behavior are sparse. In the present study, undergraduate students ( n = 435) ages 18–25 completed an instrument assessing these behaviors. Overall, 35.6% of participants reported NMUPD. Individuals who reported NMUPD were more likely to also report the use of alcohol, marijuana, ecstasy, cocaine, methamphetamine, and poppers. Participants who indicated they had used prescription medications without a doctor's consent had significantly higher rates of sexual risk behavior, including more sexual partners and more instances of unprotected sex in the previous 3 months. Results suggest that a significant minority of young adults are using prescription medication recreationally and are risking negative consequences, including the potential for addiction, dangerous interactions between prescription and recreational drugs, and greater risk for contracting sexually transmitted infections.

Executive function, approach sensitivity, and emotional decision making as influences on risk behaviors in young adults

Relations among executive function, behavioral approach sensitivity, emotional decision making, and risk behaviors (alcohol use, drug use, and delinquent behavior) were examined in single female college students (N = 72). Hierarchical multiple regressions indicated a significant Approach Sensitivity × Working Memory interaction in which higher levels of alcohol use were associated with the combination of greater approach tendency and better working memory. This Approach Sensitivity × Working Memory interaction was also marginally significant for drug use and delinquency. Poor emotional decision making, as measured by a gambling task, was also associated with higher levels of alcohol use, but only for individuals low in inhibitory control. Findings point to the complexity of relations among aspects of self-regulation and personality and provide much needed data on neuropsychological correlates of risk behaviors in a nonclinical population.

Sensation Seeking and Risk Behaviors in Young Adults With and Without a History of Head Injury

Research has demonstrated a relation between sensation seeking and risky behavior as well as an association between risky behavior and the occurrence of head injury. This study assessed sensation seeking in young adults with and without a history of head injury by administration of the Sensation Seeking Scale (SSS), the Driver Risk Index (DRI), and the MacAndrews Scale of the Minnesota Multiphasic Personality Inventory (MMPI). There was a significant difference between the groups for the Thrill and Adventure Seeking Subscale of the SSS and the MacAndrews Scale of the MMPI, with head-injured participants scoring higher. Gender differences were seen in both groups for subscales of the SSS, with men scoring higher. Significant correlations were found for head-injured participants between the DRI and the Boredom Susceptiblity Subscale of the SSS, suggesting that as knowledge of risk increased for these participants, so did their preferences for risky behaviors. However, non-head-injured participants indicated a lower interest in risky behaviors as their knowledge of risk increased.

A psychoeducational program increased knowledge and decreased sexual risk behaviors in young adults with genital herpes.

PARTICIPANTS A total of 252 adults (mean age: 27 years; 77% women; 80% white; 70% single; 84% employed; 10% lesbian or gay; mean education: 15 years; and mean annual income: $22,000) with confirmed symptomatic genital herpes diagnosed within the previous 5 years were included in the study. Adults with histories of inpatient treatment for psychiatric conditions or alcohol or drug misuse were excluded. Follow-up was 87%.

A psychoeducational program increased knowledge and decreased sexual risk behaviors in young adults with genital herpes

A total of 252 adults (mean age: 27 years; 77% women;80% white; 70% single; 84% employed; 10% lesbian orgay; mean education: 15 years; and mean annual income:$22,000) with confirmed symptomatic genital herpes di-agnosed within the previous 5 years were included in thestudy. Adults with histories of inpatient treatment for psy-chiatric conditions or alcohol or drug misuse were ex-cluded. Follow-up was 87%.

A Description of the Gender Differences in Risk Behaviors in Young Adults with Genital Herpes

The purpose of this paper is to describe gender differences in risk behaviors--substance use and sexual behavior--in young adults with genital herpes. Two-hundred fifty-two young adults with genital herpes were recruited into the study via newspaper advertisements in a West Coast metropolitan area. As a part of a large randomized clinical trial, participants completed questionnaires measuring demographic characteristics and the risk behaviors of substance use and sexual behavior. Participants had a mean age of 27.1 years and were largely Caucasian, employed, college-educated, and heterosexual. Women were two years younger than men and had less income. Gender differences were found in both substance use and sexual behavior. Men were more likely to report current use of illicit drugs than were women. Men were also more likely to report a history of gonorrhea, and urethral discharge. Women reported initiating sex at an older age and having fewer sexual partners over their lifetimes than men. There were no gender differences in use of condoms or spermicides specifically to prevent transmission of genital herpes. Further study is needed of these young adults as they are at high risk for transmission of the disease and also for contracting other sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection. Sensitive interventions are needed with this high-risk population.

The influence of mental health problems on AIDS-related risk behaviors in young adults.

This paper explores how symptoms of mental health problems influence acquired immune deficiency syndrome-related risk behaviors, and how changes in those symptoms relate to risk behaviors engaged in by young adults. Repeated interviews with 602 youths since 1984 provide a history of change in behaviors. Mental health symptoms during adolescence (alcohol/drug [r = .28]; conduct disorder [r = .27]; depression [r = .16]; suicide [r = .14]; anxiety [r = .16]; and posttraumatic stress [r = .09]) are associated with higher numbers of risk behaviors (specifically, prostitution, use of intravenous drugs, and choice of a high-risk sex partner) during young adulthood. Changes in mental health symptoms between adolescence and young adulthood are related to the number of risk behaviors engaged in by young adulthood (total number of symptoms [B = .10], alcohol/drug abuse or dependence [B = .34], depression [B = .20], suicidality [B = .35], anxiety [B = .13], and posttraumatic stress [B = .14]). Changes in symptoms of mental health problems are associated specifically with those risk behaviors that are initiated primarily in young adulthood: intravenous drug use, prostitution, and choice of risky partners. The findings show that prevention and treatment of mental health problems are important components of preventive interventions for human immunodeficiency virus infection in high-risk teens and young adults.