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Evaluating the stages of behavior change model for use in diverse cultures: Hong Kong versus the United StatesSilverman, Ellen S. 11 May 2006 (has links)
This study evaluated the efficacy of the Stages of Behavior Change (SBC) Model for use with Hong Kong Chinese. The SBC Model has demonstrated empirical support in a variety of health behaviors and across diverse populations. Further, the SBC has implications for the development of behavior change interventions. The SBC is composed of three components: stages of change, self-efficacy, and decisional balance. The stages of change are used to determine intention and time frames for behavior change. The SBC model applies Bandura's (1977) definition of self-efficacy and Janis and Manns’ (1968, 1977) conflict theory of decision making. The surveys used to measure these components have been validated and are predictive for condom acquisition. Survey data related to HIV/AIDS prevention (condom use) were collected from university students in Hong Kong and the United States. Comparisons were made across cultures (Hong Kong and the United States) and within the two cultural groups. Exploratory factor analyses using Principal Components Analysis revealed a single-factor model for self-efficacy and a 4-factor model for decisional balance (2 factors for advantages and 2 factors for disadvantages) concerning self (1) and others (we). Main effects for culture and staging were found for self-efficacy and the disadvantage component of decisional balance. Main effects for stage were found for advantages with a significant interaction. These data described an increase in self-efficacy across the stages of change for condom use and greater self-efficacy in HK then the US. The hypotheses for this study were supported with the exception of the advantages component of decisional balance within Hong Kong. Post hoc tests found no difference in self-efficacy in sexually active versus sexually non-active subjects in HK and the US and demonstrated differences in sexually active versus sexually non-active subjects in HK for advantages and disadvantages. Results offer support for using this model with Hong Kong Chinese as the data suggest more similarities than differences across two diverse cultures. These results have important implications for understanding behavior change mechanisms in diverse cultural groups and have significance for intervention planning in Hong Kong for AIDS risk reduction. / Ph. D.
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