Content and characteristics of goals created during a self-management intervention for people with epilepsy.

Goals are presented in the chronic illness literature as effective strategies to help people adopt self-management behaviors; however, not much is known about the types and characteristics of individuals' goals. The purpose of this study was to examine goal setting among people with epilepsy who participated in the WebEase program. WebEase is an Internet-based, theory-driven, self-management program with modules on medication adherence, stress management, and sleep habits. Participants had the opportunity to create and evaluate goals over the course of 6 weeks, with 2 weeks for each module. The goals were analyzed using three dimensions: content, specificity, and proximity. Most participants in the sample wrote goals for each week of the program. Several main content areas emerged within the modules. Goal quality, measured by specificity and proximity, did not differ according to readiness for behavior change. Readiness to change did not differ between those who wrote a goal and those who did not. The diversity of goal content and quality indicates that individuals should be supported in goal development and encouraged to set their own self-management goals, regardless of their readiness for behavior change.

A descriptive analysis of seizure events among adults who participated in a computer-based assessment.

The purpose of this study was to document seizure events associated with the use of a computer-based assessment and to describe the contextual factors surrounding these seizure episodes. Study participants were adults with epilepsy who were enrolled at research sites in Atlanta and Boston. Subjects were asked to complete a computer-based assessment at 3 time points. Fourteen seizure events were documented; they occurred during 1.6% of all completed assessments (896) and affected 4.4% of the participants (320). The mean age of participants who experienced seizure events was 41.4 years; about 70% were female, and 70% were white. A variety of possible precipitating factors for seizure events included hunger, fatigue, stress, and medication changes. Participants indicated computer use could have triggered their seizures in 2 instances. These findings suggest use of computer-based assessments may pose minimal risks for adults with epilepsy, particularly those without a history of photosensitivity epilepsy.

An exploration of social cognitive theory mediators of father-son communication about sex.

OBJECTIVES: R.E.A.L. MEN (responsible, empowered, aware, living) is an HIV prevention project developed for fathers and their sons. The primary aim of R.E.A.L. MEN was to test the efficacy of an intervention to promote delay of sexual intercourse among 11- to 14-year-old adolescents and to enhance the father's role as a sexuality educator. In this article, we report the outcomes related to father-son communication about sex and the results of an exploratory analysis to test the hypothesis that the intervention effect on father-son communication about sex-related topics is mediated by the social cognitive variables of self-efficacy and outcome expectations. METHODS: Two hundred seventy-seven fathers and their sons enrolled in the study. Fathers randomized to the intervention group attended seven group sessions, and their sons attended the final session with them. Fathers and sons completed baseline and 3-, 6-, and 12-month follow-up assessments. The fathers who completed the 3-month follow-up assessment were included in the mediation analyses described in this article. RESULTS: All the participants were male, most were African American (97%), and most fathers and sons reported residing in the same household. The mean age of father participants was 40.5 years; most had graduated from high school, and about 60% reported a yearly income over 30,000 dollars. Based on the results of mediation analyses, the data supported a mediation model that suggests that the effect of the intervention on father-son communication was mediated by differences in self-efficacy. A mediation effect for outcome expectations was weak and could not be validated using additional tests. CONCLUSIONS: The mediation analysis provides some understanding of the role of self-efficacy and outcome expectations in promoting behavioral change. Understanding the active components of interventions can help refine the interventions to eliminate nonfunctioning components and enhance the active components leading to more streamlined programs.

Predictors of father-son communication about sexuality.

Examining the factors that influence adolescents' sexual behaviors is crucial for understanding why they often engage in risky sexual behaviors. Using social cognitive theory, we examined predictors of father-son communication about sexuality. Fathers (N=155) of adolescent sons completed a survey measuring 12 variables, including self-efficacy and outcome expectations. We found that (a) son's pubertal development, father's sex-based values, father's education; father's communication with his father, outcome expectations, and general communication accounted for 36% of the variance in information sharing communication and (b) son's pubertal development, outcome expectations, general communication, and father-son contact accounted for 20% of the variance in values sharing communication. Study findings can aid professionals in designing guidelines for programs to promote father-son general communication and sex-based communication.

Sexual possibility situations and sexual behaviors among young adolescents: the moderating role of protective factors.

PURPOSE: To examine sexual possibility situations (SPS) and protective practices associated with involvement in intimate sexual behaviors and the initiation of sexual intercourse among young adolescents and to determine if protective factors moderate the relationship between SPS and sexual behaviors. METHODS: Data for these analyses were obtained from the baseline assessment for adolescents conducted as part of an HIV prevention study called "Keepin' it R.E.A.L.!" The study was conducted with a community-based organization (CBO) in an urban area serving a predominantly African-American population. In addition to items assessing SPS, intimate sexual behaviors, and initiation of sexual intercourse, adolescents provided information on the following protective factors: educational goals, self-concept, future time perspective, orientation to health, self-efficacy, outcome expectations, parenting, communication, values, and prosocial activities. Background personal information, including age and gender, was also collected. The analyses were conducted on data from 491 predominantly African-American adolescents, 61% of whom were boys. Variables were combined to form SPS and protective indices that were used in the first set of regression analyses. In a second set of analyses, the indices were unbundled and individual variables were entered into regression analyses. RESULTS: Both SPS and protective indices explained significant portions of variance in intimate sexual behaviors, and the SPS index explained a significant portion of variance in the initiation of sexual intercourse. The regression analysis using the unbundled SPS and protective factors revealed the following statistically significant predictors for intimate sexual behaviors: age, gender, time alone with groups of peers, time alone with a member of the opposite sex, behavior self-concept, popularity self-concept, self-efficacy for abstinence, outcome expectations for abstinence, parental control, personal values, and parental values. A similar regression analysis revealed that age, time alone with a member of the opposite sex, and personal values were significant predictors of initiation of sexual intercourse. CONCLUSIONS: These results provide evidence for the important role of protective factors in explaining early involvement in sexual behaviors and show that protective factors extend beyond personal characteristics to include both familial and peer factors.