Predictive utility and measurement properties of the Strength of Implementation Intentions Scale (SIIS) for condom use

Abstract

Background Implementation intentions are situation-linked action plans that increase health behaviors such as condom use. Few studies have measured the strength of implementation intentions, especially regarding condom use. Non-injection drug users are at high risk for HIV due to risky sexual practices. Substance use before sex may increase risky sexual behaviors, and implementation intentions are a promising, practical route for HIV prevention. Purpose This prospective study assessed the measurement properties of the newly developed Strength of Implementation Intentions Scale (SIIS) for condom use and investigated whether the SIIS predicted condom use one-year later. The study evaluated whether behavioral intentions and alcohol or methamphetamine use before sex modified the relationship between the SIIS and condom use. Methods Participants were 590 non-injection drug users convicted of nonviolent drug offenses in court-mandated outpatient drug diversion programs. They completed self-directed computer assessments at baseline and at one-year follow-up. Measures included demographics, behavioral intentions to use condoms, the SIIS for condom use, alcohol and methamphetamine use before or during sex, and condom use. Psychometric properties, direct, and interaction effects of the SIIS were evaluated using structural equation modeling and general linear regressions. Results The SIIS, behavioral intentions, and condom use were positively correlated and discriminant validity between all three constructs; the SIIS predicted condom use one-year later in this high-risk population. No significant interactions were detected. Conclusions The SIIS is predictive of condom use behavior, is psychometrically sound and distinct from behavioral intentions, and can be incorporated into HIV prevention interventions and used as a mediator variable. In addition, it can be used as an outcome measure where a follow-up is not feasible. The SIIS can also be tailored for additional HIV-related behaviors such as HIV-testing, adhering to antiretroviral medication, prescribing and adhering to pre-exposure prophylaxis, and other health behaviors.

Implementation outcome instruments for use in physical healthcare settings: a systematic review

“…The majority of included studies reported measurement properties of instruments that assessed acceptability ( n = 33) [ 23 – 59 ], followed by appropriateness ( n = 7) [ 46 , 60 – 65 ], adoption ( n = 4) [ 66 – 69 ], feasibility ( n = 4) [ 46 , 70 , 71 , 80 ], penetration ( n = 4) [ 72 – 75 ] and sustainability of evidence-based practice (intervention or service) ( n = 3) [ 76 – 79 ]. No studies of intruments measuring implementation cost were identified (see Fig.…”

“…The number of studies assessing implementation outcome measures has increased over time, with one study published in 1998 [ 79 ], through to eight studies published in 2018/2019 [ 27 , 42 , 45 , 49 , 56 , 62 , 76 , 77 ]. Studies were predominantly conducted in high-income countries, with the majority conducted in the USA alone ( n = 22) [ 25 , 29 , 30 , 35 , 37 – 39 , 44 , 46 , 47 , 53 , 57 , 58 , 64 , 66 , 67 ]. A small number of studies were conducted in lower-middle-income countries (LMIC), namely Brazil [ 31 , 60 ] and Iran [ 52 ].…”

“…Commonly used terms: perceived fit, relevance, compatibility, suitability, usefulness, and practicability Diego et al [ 60 ] A questionnaire to measure the attitude of anesthesiologists and residents regarding the use of the checklist in the perioperative period Fair Good Not assessed Excellent (7) 2 Park et al [ 61 ] A questionnaire measuring motivational factors for using wearable healthcare devices Fair Fair Not assessed Good (28) 8 Razmak et al [ 62 ] A techno-humanist model for e-health adoption of innovative technology Fair Fair Not assessed Good (32) 1 Joice et al [ 63 ] Perceived usefulness of a stroke workbook-based intervention measure Poor Fair Not assessed Good (15) 6 Xiao et al [ 64 ] Baylor EHR UX survey Poor Fair Not assessed Good (29) 3 Weiner et al [ 46 ]** Intervention Appropriateness Measure (IAM) Poor Poor Not assessed Excellent (4) 8 King et al [ 65 ] The Portal Survey on Satisfaction and Impact on Care Poor Poor Not assessed Good (38) 5 Adoption (number of instruments = 4): the intention, initial decision or action to try or employ an innovation or evidence-based practice. Commonly used terms: uptake, utilisation, initial implementation and intention to try Nydegger et al [ 66 ] Strength of Implementation Intentions Scale (SIIS) for condom use Fair Fair Not assessed Good (22) 4 Everson et al [ 67 ]...…”

“…Acceptability: consumer = 10 [23,37,39,41,42,44,51,52,57,59], provider = 27 [24-36, 38, 40, 43, 45-50, 53-56, 58] Appropriateness: consumer = 3 [61][62][63], provider = 3 [46,60,64], both consumer and provider = 1 [65] Adoption: consumer = 1 [66], provider = 3 [67][68][69] Feasibility: provider = 4 [46,70,71,80] Penetration: organisation = 4 [72][73][74][75] Sustainability: provider = 2 [76,77], organisation = 2 [78,79] Methodological quality Table 1 presents the global COSMIN scores for reliability, validity and responsiveness, and rank orders the instruments by descending reliability scores. Detailed COSMIN scores for individual measurement properties are presented in Additional file 3.…”

Toward the prevention of alcohol use disorders: Overdrinking (unintentional binge drinking) in a community sample

“…Implementation intentions involve an “if-then strategy,” for example, “If it is 4 pm, I will go to the gym” ( Armitage, 2016 ; Gollwitzer, 1999 ; Hagger and Luszczynska, 2014 ). In a study of condom use among non-injecting drug users, implementation intentions (“I have detailed plans of what I will say if my partner refuses to use a condom.”) had a greater impact than simple behavioral intentions (“I intend to use a condom.”; Nydegger et al, 2017 ). As noted earlier, in one study of college-age participants, those who reported intending to limit their drinking over the weekend showed the most responsiveness to the text messaging program over a 12-week period as compared with those who did not intend to limit their drinking ( Suffoletto and Chung, 2016 ).…”