This study explored one mechanism through which acute disaster stress (injury, life threat, property damage, loss) may produce lasting psychological distress (depression, anxiety, somatization, hostility). More specifically, the study examined the mediating roles of seven domains of chronic stress (marital, parental, filial, financial, occupational, ecological, physical) within a sample of 930 disaster victims and controls. The results provided strong support for the hypothesis that chronic stress mediates the long‐term effects of acute disaster stress on psychological distress. The main effects of loss, though limited in strength, were completely explained by victims’ higher financial, marital, filial, and physical stress. The effects of injury, though quite strong, were largely mediated by these same domains of chronic stress. Likewise, the effects of life threat were largely mediated by all these domains plus ecological stress. A mediational model was not appropriate for understanding the consequences of property damage because it did not exhibit a main effect on psychological distress.
Young men who have sex with men (MSM) of color are at increased risk for HIV infection. Mpowerment (MP) is an intervention designed to reduce risky sexual behavior and increase HIV testing among young MSM ages 18-29. From 2009 to 2012, three community-based organizations with support from the U.S. Centers for Disease Control and Prevention evaluated MP among N = 298 participants. Following a repeated measures design, data from 3- and 6-month follow-ups were compared to baseline. HIV testing and self-efficacy for safer sex increased at both follow-up time points; self-acceptance as an MSM was higher at follow-up 2. Condomless anal/vaginal sex was lower at follow-up 1 only. Frequency of exchange of safer sex messages among gay/bisexual/transgender friends was lower at follow-up 1, but similar to baseline at follow-up 2. Exposure to MP was associated with improved perceived positive social norms about safer sex and safer sex messages among gay/bisexual/transgender friends.
The concept of core elements was developed to denote characteristics of an intervention, such as activities or delivery methods, presumed to be responsible for the efficacy of evidence-based behavioral interventions (EBIs) for HIV/AIDS prevention. This paper describes the development of a taxonomy of core elements based on a literature review of theoretical approaches and characteristics of EBIs. Sixty-one categories of core elements were identified from the literature and grouped into three distinct domains: implementation, content and pedagogy. The taxonomy was tested by categorizing core elements from 20 HIV prevention EBIs disseminated by Centers for Disease Control and Prevention. Results indicated that core elements represented all three domains but several were difficult to operationalize due to vague language or the inclusion of numerous activities or constructs. A process is proposed to describe core elements in a method that overcomes some of these challenges. The taxonomy of core elements can be used to identify core elements of EBIs, strengthen the translation of EBIs from research to practice and guide future research seeking to identify essential core elements in prevention interventions.
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