Psychoeducational group approach: HIV risk reduction in drug users.

In two trials of a small-group AIDS prevention approach, 50 methadone maintenance patients and 98 heroin abusers in outpatient detoxification were randomly assigned to experimental or comparison conditions. Experimental condition subjects received a 6-hour, small-group intervention that aimed to improve their knowledge and attitudes about AIDS, skills in syringe sterilization and condom use, and changing high-risk needle use and sexual behaviors. Comparison subjects received a set of written materials about AIDS. At posttest and 3-month follow-ups, experimental condition subjects in both maintenance and detoxification demonstrated greater knowledge of AIDS and risk reduction practices and improved skill in demonstrating condom use. Although outpatient detoxification subjects displayed considerably more risk behaviors at study outset, the intervention's effect appeared to be more robust in methadone maintenance patients. The relative lack of impact on subjects' behaviors points out that more potent, sustained interventions need to be developed to slow the spread of HIV among injecting drug users.

PIP: In two trials of a small-group AIDS prevention approach in the programs of Substance Abuse Services, Department of Psychiatry, at San Francisco General Hospital, 50 methadone maintenance patients and 98 heroin abusers in outpatient detoxification were randomly assigned to experimental, psychoeducational groups or information-only comparison groups employing a pre-post-follow-up design. The 50 methadone maintenance subjects included 33 men and 17 women with a mean age of 40.7 years, mean education of 11.8 years, a mean of 6 previous years in methadone maintenance, and 8.6 previous detoxification attempts. Both groups of subjects received a packet of education brochures about AIDS. Experimental subjects also received a 6-hour intervention to improve their knowledge and attitudes about AIDS, syringe sterilization and condom use skills, and changing high-risk sexual behaviors. Comparison subjects received only the packet of brochures about AIDS. The interaction of Condition (experimental versus comparison) with the contrast between pretest and posttest was significant for knowledge about AIDS (p .001), knowledge of AIDS sexual risk-reduction practices (p .01), drug-related self-efficacy (p .05), sex-related self-efficacy (p .05), and the condom use demonstration (p .001). The 98 heroin abusers in outpatient detoxification included 64 men and 34 women with a mean age of 37.2 years, mean education of 11.5 years, a mean of 1.8 previous years in methadone maintenance, and 9.5 previous detoxification attempts. 60 subjects who participated in all three interviews revealed that the interaction of Condition with the contrast between pretest and posttest was significant for knowledge about AIDS (p .05), knowledge of AIDS sexual risk-reduction practices (p .05), and the condom use demonstration (p .001). The interaction for drug-related self-efficacy was significant (p .05), the comparison condition showed a large increase. The interaction for the syringe demonstration was marginally significant in the expected direction (p .10). The interaction between Condition and the contrast between pretest and the follow-up was significant for knowledge of AIDS sexual risk reduction practices (p .05), perceived susceptibility to AIDS (p .01), and the condom use demonstration (p .05).

Assessment of methods for measuring social support.

A rapidly expanding literature documents the effects of social support on physical and psychological well-being. Although definitions vary, most include both tangible components (e.g., financial assistance and physical aid) and intangible components (e.g., encouragement and guidance). Social support has been implicated in the mediation of stressful life events, recovery from illness, and increased program adherence. There are many inconsistent findings in the literature, however, and it is difficult to resolve discrepancies because measures of social support vary widely from study to study. To guide in the selection of measurement methods for research and applied work, 23 techniques for assessing social support are reviewed and evaluated. Criteria for favorable evaluation included reliability coefficients greater than .8 and documentation of validity. Correlations between various social support and criterion measures are simulated in order to demonstrate the consequences of choosing a measure with low reliability. Scale developers reported reliability data for 19 of the reviewed measures. Internal consistency coefficients ranged from .31 to .98. Test-retest coefficients ranged from .22 to .96. At least some validity documentation was available for 13 of the scales. Discriminant validity evidence, however, is almost universally absent. Despite psychometric weaknesses and variability among the scales, researchers have several instruments available to them.

Sex differences in weight loss among adults with type II diabetes mellitus.

The treatment of choice for Type II or non-insulin-dependent diabetes mellitus is a behavioral program for the management of weight. However, compliance with this lifelong dietary regimen is often poor. In the current investigation male and female adults with diagnosed Type II diabetes were randomly assigned to either a behavior modification, a cognitive modification, a cognitive-behavior modification, or a control group. Patients were evaluated in terms of weight, percentage of body fat, and glycosylated hemoglobin measures. Men lost significantly more weight than women and subjects in the behavior modification group lost more weight and demonstrated greater decreases in diabetes control than subjects in the cognitive-behavior modification, cognitive, and control groups. A significant interaction indicated that diabetic men may benefit more from behavioral weight reduction programs than diabetic women. Several explanations for these findings are considered.