Skip to main content
SpringerLink
Log in

Predicting Condom Use Using the Information-Motivation-Behavioral Skills (IMB) Model: A Multivariate Latent Growth Curve Analysis

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

The Information-Motivation-Behavioral Skills (IMB) model often guides sexual risk reduction programs even though no studies have examined covariation in the theory’s constructs in a dynamic fashion with longitudinal data.

Purpose

Using new developments in latent growth modeling, we explore how changes in information, motivation, and behavioral skills over 9 months relate to changes in condom use among STD clinic patients.

Methods

Participants (N = 1281, 50% female, 66% African American) completed measures of IMB constructs at three time points. We used parallel process latent growth modeling to examine associations among intercepts and slopes of IMB constructs.

Results

Initial levels of motivation, behavioral skills, and condom use were all positively associated, with behavioral skills partially mediating associations between motivation and condom use. Changes over time in behavioral skills positively related to changes in condom use.

Conclusions

Results support the key role of behavioral skills in sexual risk reduction, suggesting these skills should be targeted in HIV prevention interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Because Mplus does not allow for the calculation of standardized, bootstrapped confidence intervals for covariances, this confidence interval was calculated by hand using the MLR standardized standard errors.

References

  1. Centers for Disease Control and Prevention: 2007 Disease Profile. Atlanta: Centers for Disease Control and Prevention, 2009.

    Google Scholar 

  2. Weinstock H, Berman S, Cates W: Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health. 2004, 36:6–10.

    Article  PubMed  Google Scholar 

  3. Hall HI, Song R, Rhodes P, et al.: Estimation of HIV incidence in the United States. JAMA. 2008, 300:520–529.

    Article  PubMed  CAS  Google Scholar 

  4. Centers for Disease Control and Prevention: HIV in the United States. Atlanta, GA, 2010.

  5. Leichliter J, Ellen J, Gunn R: STD repeaters: Implications for the individual and STD transmission in a population. In S. Aral, J. Douglas and J. Lipshutz (eds), Behavioral interventions for prevention and control of sexually transmitted diseases. New York: Springer, 2007, 354–373.

    Chapter  Google Scholar 

  6. Weinstock H, Sweeney S, Satten GA, Gwinn M, Grp SCHSS: HIV seroincidence and risk factors among patients repeatedly tested for HIV attending sexually transmitted disease clinics in the United States, 1991 to 1996. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology. 1998, 19:506–512.

    Article  PubMed  CAS  Google Scholar 

  7. Centers for Disease Control and Prevention: Condoms and STDs: Fact sheet for public health personnel. Atlanta, GA: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, 2010.

  8. Holmes KK, Levine R, Weaver M: Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization. 2004, 82:454–461.

    PubMed  Google Scholar 

  9. Pinkerton SD, Abramson PR: The Bernoulli-process model of HIV transmission: Applications and implications. In D. R. Holtgrave (ed), Handbook of economic evaluation of HIV prevention programs. New York, NY US: Plenum Press, 1998, 13–32.

    Google Scholar 

  10. Fisher JD, Fisher WA: Changing AIDS-risk behavior. Psychological Bulletin. 1992, 111:455–474.

    Article  PubMed  CAS  Google Scholar 

  11. Fisher JD, Fisher WA, Amico KR, Harman JJ: An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology. 2006, 25:462–473.

    Article  PubMed  Google Scholar 

  12. Fisher J, Fisher W, Shuper P: The Information–Motivation–Behavioral Skills model of HIV preventive behavior. Emerging theories in health promotion practice and research. 2009:21–63.

  13. Anderson ES, Wagstaff DA, Heckman TG, et al.: Information-Motivation-Behavioral Skills (IMB) model: Testing direct and mediated treatment effects on condom use among women in low-income housing. Annals of Behavioral Medicine. 2006, 31:70–79.

    Article  PubMed  Google Scholar 

  14. Fisher JD, Fisher WA, Williams SS, Malloy TE: Empirical tests of an information-motivation-behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychology. 1994, 13:238–250.

    Article  PubMed  CAS  Google Scholar 

  15. Kalichman SC, Picciano JF, Roffman RA: Motivation to reduce HIV risk behaviors in the context of the Information, Motivation and Behavioral Skills (IMB) model of HIV prevention. Journal of Health Psychology. 2008, 13:680–689.

    Article  PubMed  Google Scholar 

  16. Mustanski B, Donenberg G, Emerson E: I can use a condom, I just don't: The importance of motivation to prevent HIV in adolescent seeking psychiatric care. AIDS and Behavior. 2006, 10:753–762.

    Article  PubMed  Google Scholar 

  17. Fisher JD, Fisher WA, Misovich SJ, Kimble DL, Malloy TE: Changing AIDS risk behavior: effects of an intervention emphasizing AIDS risk reduction information, motivation, and behavioral skills in a college student population. Health Psychology. 1996, 15:114–123.

    Article  PubMed  CAS  Google Scholar 

  18. Jaworski BC, Carey MP: Effects of a brief, theory-based STD-prevention program for female college students. Journal of Adolescent Health. 2001, 29:417–425.

    Article  PubMed  CAS  Google Scholar 

  19. Kalichman S, Malow R, Devieux J, Stein JA, Piedman F: HIV risk reduction for substance using seriously mentally ill adults: Test of the information-motivation-behavior skills (IMB) model. Community Mental Health Journal. 2005, 41:277–290.

    Article  PubMed  Google Scholar 

  20. Kalichman SC, Cain D, Weinhardt L, et al.: Experimental components analysis of brief theory-based HIV/AIDS risk-reduction counseling for sexually transmitted infection patients. Health Psychology. 2005, 24:198–208.

    Article  PubMed  Google Scholar 

  21. Kalichman SC, Simbayi LC, Cain D, et al.: Generalizing a model of health behaviour change and AIDS stigma for use with sexually transmitted infection clinic patients in Cape Town, South Africa. AIDS Care. 2006, 18:178–182.

    Article  PubMed  Google Scholar 

  22. Malow RM, Stein JA, McMahon RC, et al.: Effects of a culturally adapted HIV prevention intervention in Haitian youth. Journal of the Association of Nurses in AIDS Care. 2009, 20:110–121.

    Article  PubMed  Google Scholar 

  23. Duncan TE, Duncan SC, Strycker LA: An introduction to latent variable growth curve modeling: concepts, issues, and applications (2nd Ed.). Mahwah, N.J.: Lawrence Erlbaum Associates, 2006.

  24. Carey MP, Senn TE, Vanable PA, Coury-Doniger P, Urban MA: Brief and intensive behavioral interventions to promote sexual risk reduction among STD clinic patients: results from a randomized controlled trial. AIDS and Behavior. 2010, 14:504–517.

    Article  PubMed  Google Scholar 

  25. Carey MP, Vanable PA, Senn TE, Coury-Doniger P, Urban MA: Evaluating a two-step approach to sexual risk reduction in a publicly-funded STI clinic: Rationale, design, and baseline data from the Health Improvement Project-Rochester (HIP-R). Contemporary Clinical Trials. 2008, 29:569–586.

    Article  PubMed  Google Scholar 

  26. Carey MP, Maisto SA, Kalichman SC, et al.: Enhancing motivation to reduce the risk of HIV infection for economically disadvantaged urban women. Journal of Consulting and Clinical Psychology. 1997, 65:531–541.

    Article  PubMed  CAS  Google Scholar 

  27. Carey MP, Braaten LS, Maisto SA, et al.: Using information, motivational enhancement, and skills training to reduce the risk of HIV infection for low-income urban women: A second randomized clinical trial. Health Psychology. 2000, 19:3–11.

    Article  PubMed  CAS  Google Scholar 

  28. Carey MP, Carey KB, Maisto SA, et al.: Reducing HIV-risk behavior among adults receiving outpatient psychiatric treatment: Results from a randomized controlled trial. Journal of Consulting and Clinical Psychology. 2004, 72:252–268.

    Article  PubMed  Google Scholar 

  29. Carey MP, Schroder KEE: Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Education and Prevention. 2002, 14:172–182.

    Article  PubMed  Google Scholar 

  30. Brown IS: Development of a Scale to Measure Attitude toward the Condom as a Method of Birth-Control. Journal of Sex Research. 1984, 20:255–263.

    Article  Google Scholar 

  31. Sacco W, Levine B, Reed D, Thompson K: Attitudes about condom use as an AIDS-relevant behavior: Their factor structure and relation to condom use. Psychological Assessment. 1991, 3:265–272.

    Article  Google Scholar 

  32. Noar SM, Morokoff PJ, Harlow LL: Condom negotiation in heterosexually active men and women: Development and validation of a condom influence strategy questionnaire. Psychology & Health. 2002, 17:711–735.

    Article  Google Scholar 

  33. Noar SM, Morokoff PJ, Harlow LL: Condom influence strategies in a community sample of ethnically diverse men and women. Journal of Applied Social Psychology. 2004, 34:1730–1751.

    Article  Google Scholar 

  34. Kline R: Principles and practice of structural equation modeling: The Guilford Press, 2010.

  35. Muthén L, Muthén B: Growth modeling with latent variables using Mplus. 2007.

  36. Muthén LK, Muthén BO: Mplus user’s guide (6 Ed.). Los Angeles, CA: Muthén & Muthén, 1998–2010.

  37. Asparouhov T, Muthen B: Multivariate statistical modeling with survey data. 2005.

  38. Kaplan D: Structural equation modeling: Foundations and extensions: Sage Publications, Inc, 2008.

  39. Muthén B, Asparouhov T: Latent variable analysis with categorical outcomes: Multiple-group and growth modeling in Mplus. Mplus Web Notes. 2002, 4:1–22.

    Google Scholar 

  40. Bentler PM: Comparative Fit Indexes in Structural Models. Psychological Bulletin. 1990, 107:238–246.

    Article  PubMed  CAS  Google Scholar 

  41. Tucker LR, Lewis C: Reliability Coefficient for Maximum Likelihood Factor-Analysis. Psychometrika. 1973, 38:1–10.

    Article  Google Scholar 

  42. Jöreskog KG, Sörbom D: LISREL V: Analysis of linear structural relationships by the method of maximum likelihood. Chicago: National Educational Resources, 1981.

    Google Scholar 

  43. Hu L, Bentler P: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal. 1999, 6:1–55.

    Article  Google Scholar 

  44. McArdle JJ: Dynamic but structural equation modeling of repeated measures data. In J. R. Nesselroade and R. B. Cattell (eds), Handbook of multivariate experimental psychology (2nd ed.). New York, NY US: Plenum Press, 1988, 561–614.

    Google Scholar 

  45. Nesselroade J: Temporal selection and factor invariance in the study of development and change. In P. Baltes and J. Brim, OG (eds), Life-span development and behavior (Vol. 5), 1983, 59–87.

  46. Singer JD, Willett JB: Applied longitudinal data analysis: Modeling change and event occurrence. New York, NY US: Oxford University Press, 2003.

    Google Scholar 

  47. Donenberg GR, Schwartz RM, Emerson E, et al.: Applying a Cognitive-Behavioral Model of HIV Risk to Youths in Psychiatric Care. AIDS Education and Prevention. 2005, 17:200–216.

    Article  PubMed  Google Scholar 

  48. Bryan AD, Fisher JD, Fisher WA, Murray DM: Understanding condom use among heroin addicts in methadone maintenance using the information-motivation-behavioral skills model. Substance Use and Misuse. 2000, 35:451–471.

    Article  PubMed  CAS  Google Scholar 

  49. Fisher W, Williams S, Fisher J, Malloy T: Understanding AIDS risk behavior among sexually active urban adolescents: An empirical test of the information–motivation–behavioral skills model. AIDS and Behavior. 1999, 3:13–23.

    Article  Google Scholar 

  50. Robertson AA, Stein JA, Baird-Thomas C: Gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the information-motivation-behavior skills (IMB) model. Journal of Adolescent Health. 2006, 38:18–25.

    Article  PubMed  Google Scholar 

  51. Carey MP, Morrison-Beedy D, Johnson BT: The HIV-Knowledge Questionnaire: Development and evaluation of a reliable, valid, and practical self-administered questionnaire. AIDS and Behavior. 1997, 1:61–74.

    Article  Google Scholar 

  52. Ehrhardt AA, Exner TM, Hoffman S, et al.: A gender-specific HIV/STD risk reduction intervention for women in a health care setting: short- and long-term results of a randomized clinical trial. AIDS Care. 2002, 14:147–161.

    Article  PubMed  CAS  Google Scholar 

  53. Fisher JD, Fisher WA, Bryan AD, Misovich SJ: Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychology. 2002, 21:177–186.

    Article  PubMed  Google Scholar 

  54. Jemmott JB, 3 rd, Jemmott LS, Fong GT: Abstinence and safer sex HIV risk-reduction interventions for African American adolescents: a randomized controlled trial. JAMA. 1998, 279:1529–1536.

    Article  PubMed  Google Scholar 

  55. Kalichman SC, Carey MP, Johnson BT: Prevention of sexually transmitted HIV infection: A meta-analytic review of the behavioral outcome literature. Annals of Behavioral Medicine. 1996, 18:6–15.

    Article  Google Scholar 

  56. Hennessy M, Bolan G, Hoxworth T, et al.: Using growth curves to determine the timing of booster sessions. Structural Equation Modeling: A Multidisciplinary Journal. 1999, 6:322–342.

    Article  Google Scholar 

  57. Pedlow CT, Carey MP: Developmentally appropriate sexual risk reduction interventions for adolescents: Rationale, review of interventions, and recommendations for research and practice. Annals of Behavioral Medicine. 2004, 27:172–184.

    Article  PubMed  Google Scholar 

  58. Des Jarlais DC, Paone D, Milliken J, et al.: Audio-computer interviewing to measure risk behaviour for HIV among injecting drug users: a quasi-randomised trial. Lancet. 1999, 353:1657–1661.

    Article  PubMed  CAS  Google Scholar 

  59. Newman JC, Jarlais D, Turner CF, et al.: The differential effects of face-to-face and computer interview modes. American Journal of Public Health. 2002, 92:294–297.

    Article  PubMed  Google Scholar 

  60. Schroder KEE, Carey MP, Vanable PA: Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Annals of Behavioral Medicine. 2003, 26:104–123.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest Statement

The authors have no conflict of interest to disclose.

Funding

This study was supported by grant R01-MH068171 from the Center for Mental Health Research on AIDS, National Institute of Mental Health to Michael P. Carey.

Author information

Authors and Affiliations

  1. Center for Health and Behavior, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244-2340, USA

    Jennifer L. Walsh Ph.D, Theresa E. Senn PhD, Lori A. J. Scott-Sheldon PhD, Peter A. Vanable PhD & Michael P. Carey PhD

Authors
  1. Jennifer L. Walsh Ph.D
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Theresa E. Senn PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lori A. J. Scott-Sheldon PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter A. Vanable PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael P. Carey PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer L. Walsh Ph.D.

About this article

Cite this article

Walsh, J.L., Senn, T.E., Scott-Sheldon, L.A.J. et al. Predicting Condom Use Using the Information-Motivation-Behavioral Skills (IMB) Model: A Multivariate Latent Growth Curve Analysis. ann. behav. med. 42, 235–244 (2011). https://doi.org/10.1007/s12160-011-9284-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-011-9284-y

Keywords

Search

Navigation