Social Psychological Models of Intervention

Encouring Safer Sex Using Social Psychological Models of Intervention

Safer sex practices have increasingly grown as a significant health promotion intervention in many areas. The need to promote health in schools and communities has seen increased use of different models to encourage safer sex practices. The impending challenges associated with risky sexual behaviors include unwanted teenage pregnancies and contraction of sexually transmitted infections. In recent years, focus has shifted to managing health issues such as illnesses to ensuring health promotion through interventions. The use of social psychological models has grown in terms of health interventions aimed at promoting safer sex practices. Nonetheless, there is a wide range of models in application that may have differences in terms of their effectiveness in promoting safer sex practices. The following paper aims at critically discussing the effectiveness of using the self-regulatory model and the health belief model or the protection motivation theory.

The model of self-regulation has been used consistently in numerous psychological domains. This is especially in promoting healthy lifestyles where the model is developed to empower or encourage individual to manage, regulate, and monitor their health habits. The self-regulatory model is derived from the social cognition theory that is founded in the idea of health promotion interventions in numerous areas of psychology. When it comes to most psychological and health issues, their development cannot be altered through the act of will. It is rather a set of conditions and situations that allow people to face numerous health challenges and risks. Nonetheless, psychologists and health practitioners have established that through the use of self-management models, such health issues can be avoided, reduced, and prevented (Terry & Leary, 2011). It is through self-management models, rooted in the theory of social cognition that people are able to develop self-regulatory and motivational skills that allow individual to avoid, prevent, and reduce health issues (Terry & Leary, 2011). The self-regulatory model has become a critical variable in educational, clinical, health, developmental, and personality psychology. Self-regulation skills aim at changing behaviors, which is enabled by an individual sense of control. In general, when an individual believe they work or act to address a certain challenge, ne/she tends to become motivated to do so while feeling greater commitment to the decision. Therefore, the idea of self-determination and self-efficacy come into context to change one’s behavior. The use of self-regulation models has illustrated the idea of using personal action to alter risky health behaviors such as using individual skills to repel temptation or coercion. A growing body of research has supported the use of self-regulatory models specifically in promoting safer sex practices. Through this body of research, one can critically assess and understand the effectiveness of the self-regulatory model.

The self-regulatory has been studied and used in respect to the deterrence of unprotected or unsafe sexual behaviors. Numerous studies have attempted to use self-regulation to develop personal skills such as resistance sexual temptation and coercions as well as the use of condoms and contraceptives to avoid sexually transmitted diseases and unwanted pregnancies. For instance, according to Bandura, (2005) teenage girls with a high rate of unsafe sexual behaviors were found to use contraceptives and family planning approaches more effectively when they believed they could have control over their sexual behaviors and lifestyles. Terry & Leary, (2011) applied self-regulatory models on teenagers through role-playing and modeling on how to address peer pressures as well as use of contraceptives. Participants in the study believed that being able to play different roles in different situations developed increased motivation to take control of their sexual lifestyles. Again, researchers have also studied risky sexual behaviors such as not using condoms in both heterosexual and homosexual relationships involving single and multiple partners. Morin, et al. (2008) established the Healthy Living Project based on three modules divided into five sessions each to help gay men with HIV adopt safer sex practices. The sessions were designed to persons within a framework based on applied goal-setting and problem-solving methods. Its overreaching goal was based on individual striving that offered continuity for the whole session. The report outcomes were a substantial reduction in risky sexual behaviors facilitated by the ability to control sexual activities through self-regulation. A number of studies have illustrated that belief in an individual’s ability to convey safer sex behaviors was the significant predictor of effectiveness in terms of intervention.

The use of condoms as a means of preventing the spread or contraction of sexually transmitted infections has also received increased research. Importantly, the use of self-regulation and self-efficacy has been illustrated to play a substantial role in such practices. Bandura, (2005) studied the use of condoms among drug addicts where behaviors and intentions were projected by social norms, attitudes, and self-beliefs. The anticipated use of condoms was shown to have a high influence in the actual use of condoms. Moreover, the higher the rate of self-awareness and beliefs that condom use can protect against sexually transmitted infections illustrated increased reduction in risky sexual practices (Bandura, 2005). Increased research on use of condoms and contraceptives has illustrated the underlying effectiveness of the self-regulatory model in terms of promoting safer sex practices. Practicing safer sex through the use of condoms and contraceptives not only demands technical skills, but personal negotiation and awareness. The act of convincing a spouse to comply with safer sex behaviors demands a high sense of value in terms of controlling sexual activities. Most research on preventing HIV spread among gay people has concentrated on the level of efficacy in relation to adopting safer sex lifestyles. Zea, et al. (2009) study on gay Latino men with HIV illustrated a cross-level collaboration of self-regulation and self-efficacy and the individual-level as well as sexual desires. The study also illustrated that increased sexual desire among gay men was linked higher chances of unprotected anal intercourse for men with reduced self-efficacy while those with increased self-efficacy illustrated low sexual desire. The degree to which an individual is able to take control from their self-regulation has increasingly illustrated high chances of effectively promoting safer sexual behaviors.

The underlying challenge to self-regulatory model is illustrated in the numerous stages of interventions focused on promoting safer sex practices. Nonetheless, as illustrated earlier the ability to help individual gain personal control and beliefs of their sexual activities is effective. The challenge or weaknesses of self-efficacy are based on the individual level of commitment and motivation. Most studies investigate the effectiveness of the self-regulatory model based on the short-term. Nonetheless, long-term studies have illustrated the challenges on maintaining beliefs especially in more complex situations such as the shared-concerns of relationships (Bandura, 2005). Moreover, a range of issues are also tied to the self-regulatory model in terms of social norms and individual experiences. Issues such as resistance self-regulation focus on individual confidence to avoid risky sexual behaviors. Individual involved in risky sexual behaviors have to contend on their risk perceptions as well as outcome expectancy. This brings in a range of issues that are needed to promote self-regulation effectively such as self-esteem, confidence, and social skills (Zea, et al. 2009). In this case, having negative outcome expectancies can be detrimental to one’s ability to change behavior while positive outcome anticipations may result in the opposite. Moreover, such anticipations may be displaced when it comes to the actual change of behaviors as well as their maintenance. Again, confidence can also hinder behavioral change based on an individual’s ability to cope with stress and resources needed to achieve the situational requirements. Such beliefs on confidence and self-esteem may compromise the intention for adopting safer sex practices based on the amount of effort and commitment required to achieve this goals (Zea, et al. 2009). Persistence is also important based on the ability to pursue self-regulation regardless of setbacks and barriers that may weaken motivation. Despite these weaknesses, the idea of self-regulation and having a personal sense of control over sexual activities has had significant effectiveness in promoting safer sex behaviors.

The second effective social psychological model that offers the framework for successful interventions to promote safe sex practices is the Health Belief Model/Protection Motivation Theory (HBM) (Ahia, 1991). HBM was developed over fifty years ago after social psychologists were requested to explain the reasons why people do not contribute in health behaviors. This model is based on the theories of cognitive-behavioral theory and the operant theory. The basic premise of HBM is that persons will take action to control, prevent, or avoid a health condition. Such individuals believe to be vulnerable to health conditions that may have serious outcomes (Floyd, et al. 2000). Moreover, such individuals believe that a certain course of action can reduce their vulnerability and severity of outcomes. Lastly, individuals also believe that the expenses taking action outweigh its advantages or benefits.  The health belief model focuses on perceptive susceptibility and perceived seriousness in terms of vulnerability to health conditions as well as the seriousness of outcomes of health conditions (Downing-Matibag & Geisinger, 2009). People basically believe that a health condition is a threat responding with fear, thus the need to act. The protection motivation theory is an improved version of the health belief model. It incorporates perceived venerability, perceived seriousness, confidence, and response efficacy. In terms of promoting safe sex practices, the health belief model and protection motivation theory can be used to help individual evaluate their vulnerability as well as outcomes. In terms of vulnerability, individual who practice unprotected intercourse may be vulnerable sexually transmitted infections or unwanted pregnancies. In addition, the perceived severity of outcomes may be dealing with medication or death in case of AIDS as well as being parents. These elements create an effective approach for the successful promotion of safe sex practices and lifestyles.

Current research and interventions have evidenced increased effectiveness of using the health belief model and the protection motivation theory. Ahia, (1991) conducted a research to investigate compliance with safe-sex guidelines in heterosexual male drug users using the HBM and PMT models. Men who were found to adhere to the safe-sex guidelines illustrated perceived self-efficacy and perceived susceptibility as the main reasons for their behaviors. Self-efficacy in this case refers to the confidence an individual has to believe they have the ability to continue change in behaviors despite setbacks and hurdles as well as overcoming temptation. According to Ahai additional issues such as level of educational attainment, age, and knowledge on AIDS did not illustrate significant influence in complying with safe-sex guidelines. Floyd, et al. (2000) conducted a meta-analysis of PMT as a model for health promotion and disease prevention. This included articles and research concerning safer sex practices. The underlying outcomes of the analysis illustrated that rise in threat vulnerability, threat seriousness, and response efficacy enabled adaptive behaviors and intentions (Floyd, et al. 2000). Moreover, reductions in maladaptive response rewards and adaptive response expenses heightened adaptive behaviors and intentions (Floyd, et al. 2000). These facts illustrate that individual involved in unsafe sexual practices can easily assess their vulnerability, seriousness of the outcomes, and their confidence and ability to change their behaviors despite challenges to promote safe sex practices. The study concluded that PMT elements may be significant for community and individual interventions. In Huebner, et al. (2011) study, teenagers aged between 16 and 19 were surveyed on their views of whether alcohol, drugs, HIV, peer pressures, and exposure to media contributed to the increased use of condoms. Among the respondents who engaged in frequent sexual activity, about half of the them reported using condoms always based on their fear of getting AIDS as well as a way to prevent acquiring the disease (Huebner, et al., 2011). In Nader, et al. (1989) study, gay men were found to change perceived attitudes and norms based on previous risky sexual behaviors such as unprotected sex. The study also concluded the increased reliance on the HBM and PMT in terms of interventions for promoting safer sex practices among gay and bisexual individuals.

Nonetheless, the main challenge of the HBM and PMT interventions is based on individual beliefs and norms. A study among college students illustrated that “hook-up” behaviors was associated with increased sexual activity that was based on sexual beliefs and norms (Downing-Matibag & Geisinger, 2009). Nevertheless, the study found that most of the beliefs held by students were misinformed. This means that even with the reliance and effectiveness of using this model to promote safer sex behaviors, the issues of misinformation or having the wrong beliefs influence the overall effectiveness (Downing-Matibag & Geisinger, 2009). Nonetheless, the HBM focuses on educating individuals on the threat in terms of vulnerability, which results in fear appraisals. This means that individuals are able to review their behaviors based on their fear of the threat. Additionally, HBM also focuses on educating individuals concerning coping through self-efficacy and response efficacy, thus promoting health education on safer sex practices.

The need to promote health in schools and communities has seen increased use of different models to encourage safer sex practices. The impending challenges associated with risky sexual behaviors include unwanted teenage pregnancies and contraction of sexually transmitted infections. In recent years, focus has shifted to managing health issues such as illnesses to ensuring health promotion through interventions. The use of social psychological models has grown in terms of health interventions aimed at promoting safer sex practices. Nonetheless, there is a wide range of models in application that may have differences in terms of their effectiveness in promoting safer sex practices. The use of self-regulatory and health belief/protection motivation theory has illustrated increased success in promoting safer sex practices. The self-regulatory model is derived from the social cognition theory that is founded in the idea of health promotion interventions in numerous areas of psychology. When it comes to most psychological and health issues, their development cannot be altered through the act of will. It is rather a set of conditions and situations that allow people to face numerous health challenges and risks.

Nonetheless, psychologists and health practitioners have established that through the use of self-management models, such health issues can be avoided, reduced, and prevented. It is through self-management models, rooted in the theory of social cognition that people are able to develop self-regulatory and motivational skills that allow individual to avoid, prevent, and reduce health issues. The health belief model is based on the theories of cognitive-behavioral theory and the operant theory. The basic premise of HBM is that persons will take action to control, prevent, or avoid a health condition. Such individuals believe to be vulnerable to health conditions that may have serious outcomes. Moreover, such individuals believe that a certain course of action can reduce their vulnerability and severity of outcomes. Lastly, individuals also believe that the expenses taking action outweigh its advantages or benefits.  The health belief model focuses on perceptive susceptibility and perceived seriousness in terms of vulnerability to health conditions as well as the seriousness of outcomes of health conditions.

 

References

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Bandura, A. (2005). The growing centrality of self-regulation in health promotion and disease prevention. The european health psychologist, 1, 11-12.

Downing-Matibag, T. M., & Geisinger, B. (2009). Hooking up and sexual risk taking among college students: A health belief model perspective. Qualitative Health Research, 19(9), 1196-1209.

Floyd, D. L., Prentice‐Dunn, S., & Rogers, R. W. (2000). A meta‐analysis of research on protection motivation theory. Journal of applied social psychology, 30(2), 407-429.

Huebner, D. M., Neilands, T. B., Rebchook, G. M., & Kegeles, S. M. (2011). Sorting through chickens and eggs: a longitudinal examination of the associations between attitudes, norms, and sexual risk behavior. Health Psychology, 30(1), 110.

Morin, S. F., Shade, S. B., Steward, W. T., Carrico, A. W., Remien, R. H., Rotheram-Borus, M. J., … & Healthy Living Project Team. (2008). A behavioral intervention reduces HIV transmission risk by promoting sustained serosorting practices among HIV-infected men who have sex with men. Journal of acquired immune deficiency syndromes (1999), 49(5), 544.

Nader, P. R., Wexler, D. B., Patterson, T. L., McKusick, L., & Coates, T. (1989). Comparison of beliefs about AIDS among urban, suburban, incarcerated, and gay adolescents. Journal of Adolescent Health Care, 10(5), 413-418.

Riley, G. A., & Baah-Odoom, D. (2010). Do stigma, blame and stereotyping contribute to unsafe sexual behavior? A test of claims about the spread of HIV/AIDS arising from social representation theory and the AIDS risk reduction model. Social Science & Medicine, 71(3), 600-607.

Terry, M. L., & Leary, M. R. (2011). Self-compassion, self-regulation, and health. Self and Identity, 10(3), 352-362.

Zea, M. C., Reisen, C. A., Poppen, P. J., & Bianchi, F. T. (2009). Unprotected anal intercourse among immigrant Latino MSM: The role of characteristics of the person and the sexual encounter. AIDS and Behavior, 13(4), 700-715.