Ralph DiClemente
Ralph DiClemente
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Professor of Social and Behavioral Sciences
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Professional overview
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Dr. Ralph DiClemente was trained as a Health Psychologist at the University of California, San Francisco where he received his PhD in 1984 after completing a ScM at the Harvard School of Public Health. He earned his undergraduate degree at the City University of New York.
Dr. DiClemente’s research has four key foci:
- Developing interventions to reduce the risk of HIV/STD among vulnerable populations
- Developing interventions to enhance vaccine uptake among high-risk adolescents and women, such as HPV and influenza vaccine
- Developing implementation science interventions to enhance the uptake, adoption and sustainability of HIV/STD prevention programs in the community
- Developing diabetes screening and behavior change interventions to identify people with diabetes who are unaware of their disease status as well as reduce the risk of diabetes among vulnerable populations.
He has focused on developing intervention packages that blend community and technology-based approaches that are designed to optimize program effectiveness and enhance programmatic sustainability.
Dr. DiClemente is the author of ten CDC-defined, evidence-based interventions for adolescents and young African-American women and men. He is the author of more than 540 peer-review publications, 150 book chapters, and 21 books. He serves as a member of the Office of AIDS Research Advisory Council.
Previously, Dr. DiClemente served as the Charles Howard Candler Professor of Public Health at the Rollins School of Public Health at Emory University. He was also Associate Director of the Center for AIDS Research, and was previously Chair of the Department of Behavioral Sciences and Health Education at the Rollins School of Public Health.
Dr. DiClemente is Past President of the Georgia chapter of the Society for Adolescent Health & Medicine. He previously served as a member of the CDC Board of Scientific Counselors, and the NIMH Advisory Council.
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Education
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BA, The City College of the City University of New York (CCNY), New York, NYScM, Behavioral Sciences, Harvard University, Cambridge, MAPhD, Health Psychology, University of California San Francisco Center for Behavioral Sciences, San Francisco, CAPostdoctoral Fellow, University of California, San Francisco, CA
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Areas of research and study
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Community InterventionsDiabetesHIV/AIDSImplementation scienceInfluenzaPsychology
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Publications
Publications
Juvenile justice staff endorsement of HIV/STI prevention, testing, and treatment linkage
AbstractGardner, S. K., Elkington, K. S., Knight, D. K., Huang, S., DiClemente, R., Spaulding, A. C., Oser, C. B., Robertson, A. A., & Baird-Thomas, C. (n.d.).Publication year
2019Journal title
Health and JusticeVolume
7Issue
1AbstractBackground: While involvement in the legal system offers an opportunity to educate, screen, and treat high-risk youth, research shows that staff attitudes toward these practices can serve as barriers to implementation. The current study investigates the degree to which JJ staff endorse HIV prevention, testing, and treatment linkage practices with youth under community supervision and examines differences between individuals who supervise youth (e.g., juvenile probation officer) and those working in non-supervisory roles (e.g., case manager, assessment specialist). Methods: Juvenile justice staff consenting to participation in JJ-TRIALS completed an initial staff survey (N = 501). Survey items measured perceived importance of HIV/STI prevention (4 items); perceived importance of HIV/STI testing (7 items); and perceived importance of HIV/STI treatment linkage (8 items). Results: Confirmatory Factor Analysis (CFA) was computed (SAS CALIS procedure) for each of the three domains. Findings suggest that while staff recognize that youth are at risk for HIV/STIs and require provision of HIV/STI prevention and treatment linkage, attitudes concerning the importance of procuring or providing testing services for youth is substantially lower. Furthermore, analytic models comparing staff with and without supervision responsibilities (computed using SAS PROC MIXED) indicated that attitudes differed by site and staff responsible for supervision rated HIV treatment linkage practices as less important compared to non-supervising staff. Conclusions: Establishing partnerships with health agencies equipped with resources and skillsets to provide HIV/STI testing and related services may be an effective model to promote greater awareness and use of best practices among JJ staff and more effectively address the unmet needs of this high-risk population of youth.Location of Pre-exposure Prophylaxis Services Across New York City Neighborhoods : Do Neighborhood Socio-demographic Characteristics and HIV Incidence Matter?
AbstractKim, B., Callander, D., DiClemente, R., Trinh-Shevrin, C., Thorpe, L. E., & Duncan, D. T. (n.d.).Publication year
2019Journal title
AIDS and BehaviorVolume
23Issue
10Page(s)
2795-2802AbstractDespite an increasing pre-exposure prophylaxis (PrEP) use among populations at highest risk of HIV acquisition, comprehensive and easy access to PrEP is limited among racial/ethnic minorities and low-income populations. The present study analyzed the geographic distribution of PrEP providers and the relationship between their location, neighborhood characteristics, and HIV incidence using spatial analytic methods. PrEP provider density, socio-demographics, healthcare availability, and HIV incidence data were collected by ZIP-code tabulation area in New York City (NYC). Neighborhood socio-demographic measures of race/ethnicity, income, insurance coverage, or same-sex couple household, were not associated with PrEP provider density, after adjusting for spatial autocorrelation, and PrEP providers were located in high HIV incidence neighborhoods (P < 0.01). These findings validate the need for ongoing policy interventions (e.g. public health detailing) vis-à-vis PrEP provider locations in NYC and inform the design of future PrEP implementation strategies, such as public health campaigns and navigation assistance for low-cost insurance.Mental representation of self in relationships indirectly affects young Black women’s engagement in risky sexual behaviors through psychosocial HIV/STI risk factors
AbstractGause, N. K., Brown, J. L., & DiClemente, R. (n.d.).Publication year
2019Journal title
Vulnerable Children and Youth StudiesVolume
14Issue
1Page(s)
1-16AbstractBlack females are disproportionately affected by human immunodeficiency virus (HIV)/sexually transmitted infections (STIs), though individual-level sexual risk factors do not appear to explain racial/ethnic HIV incidence rate disparities. The current study examined the roles of attachment representations, working models of self and others, with psychosocial risk factors related to population-level sexual network features in association with risky sexual behaviors. A total of 560 Black emerging adult females (M age = 20.58, SD = 1.89) enrolling in a behavioral HIV prevention intervention trial completed the baseline assessment used in the current analyses. A series of multiple mediator models examined indirect effects of working models of self and others on sexual risk engagement through the following psychosocial HIV/STI risk factors: (a) partner communication self-efficacy, (b) fear of condom negotiation, (c) peer norms for risky sexual behavior, (d) partner trust and (e) sex-related alcohol expectancies. Results indicated an indirect effect of working model of self on the following: condom use with boyfriend/main partner through peer norms for risky sex (ab = .08, 95% CI [.02,.17]), any alcohol use prior to sex through peer norms for risky sex (ab = −.06, 95% CI [−.12, −.02]) and alcohol use prior to sex through sex-related alcohol expectancies (ab = −.13, 95% CI [−.21, −.05]). Findings provided evidence of a direct association between working model of self and each psychosocial HIV/STI risk factor included in the mediation models. Working model of self may help identify Black females at elevated risk for HIV/STI through these psychosocial risk factors.Need for innovation in public health research
AbstractDiClemente, R., Nowara, A., Shelton, R., & Wingood, G. (n.d.).Publication year
2019Journal title
American journal of public healthVolume
109Page(s)
S117-S120AbstractThe recent conference Turning the Tide: A New Generation of Public Health Interventions highlighted the need to utilize innovative and emergent methodologies to confront increasingly complex public health challenges. In this commentary,we discuss three dominant themes from the conference: addressing multiple levels of causality in reducing health problems; technologybasedmethodologies to enhance health promotion; and improving translation and sustainment of effective health promotion programs. The subsequent articles, included in this supplement issue of AJPH, provide compelling examples and arguments supporting these progressive approaches to public health promotion. We recommend that public health researchers draw inspiration from these examples and embrace interdisciplinary, innovative methods within their future work.Operationalizing a Behavioral Health Services Cascade of Care Model : Lessons Learned from a 33-Site Implementation in Juvenile Justice Community Supervision1
AbstractDennis, M. L., Smith, C. N., Belenko, S., Knight, D., McReynolds, L., Rowan, G., Dembo, R., DiClemente, R., Robertson, A., & Wiley, T. (n.d.).Publication year
2019Journal title
Federal ProbationVolume
83Issue
2Page(s)
52-64Abstract~Parent-adolescent communication scale
AbstractSales, J. M., Mülhausen, R. R., & DiClemente, R. (n.d.).Publication year
2019Page(s)
225-227Abstract~Partner communication scale
AbstractMülhausen, R. R., Sales, J. M., & DiClemente, R. (n.d.).Publication year
2019Page(s)
230-232Abstract~Pregnancy Coercion as a Risk Factor for HIV and Other Sexually Transmitted Infections Among Young African American Women
AbstractCapasso, A., DiClemente, R., & Wingood, G. M. (n.d.).Publication year
2019Journal title
Journal of acquired immune deficiency syndromes (1999)Volume
82Page(s)
S155-S161AbstractBACKGROUND: Pregnancy coercion (PC), defined as a restriction of women's reproductive autonomy, may be associated with increased HIV and sexually transmitted infection (STI) risk. However, there are few empirical studies defining the association between PC and HIV risk, particularly among vulnerable African American women. SETTING AND METHODS: African American women (N = 560), ages 17-24, completed an audio computer-assisted self-interview assessing PC prevalence and its association with HIV/STI risk. Women were screened for prevalent STIs using polymerase chain reaction assays. Multivariate logistic and linear regressions evaluated the association of PC and multiple HIV/STI risk-associated outcomes. RESULTS: Women who had experienced PC in the last 3 months, relative to those not experiencing PC, were 78% more likely to test positive for an STI [adjusted odds ratio = 1.78, 95% confidence interval (CI) = 1.10 to 2.90]. Among women who experienced PC, odds of noncondom use in their last sexual encounter were 3.45-fold greater relative to women not experiencing PC (95% CI = 1.55 to 7.85). Women who experienced PC had lower condom use intentions (coefficient, -1.31, P = 0.002), greater fear of condom negotiation, and perceived more barriers to condom use (coefficients, 3.89 and 5.74, respectively, both P < 0.001). Women who experienced PC had 1.98 (95% CI = 1.22 to 3.21) and 1.82 (95% CI = 1.09 to 3.04) odds of depression and HIV worry relative to women not experiencing PC. CONCLUSION: Among African American women, PC was associated with a range of adverse sexual health outcomes and HIV/STI-related behaviors and attitudes. The findings underscore the need for promoting gender-equitable social norms in HIV prevention interventions.Problem Solving Reduces Sexual Risk Associated with Sensation Seeking, Substance Use, and Depressive Symptoms Among African-American Adolescents
AbstractDunne, E. M., Norris, A. L., Romer, D., DiClemente, R., Vanable, P. A., Valois, R. F., Brown, L. K., & Carey, M. P. (n.d.).Publication year
2019Journal title
Journal of Child and Adolescent Substance AbuseVolume
28Issue
2Page(s)
113-118AbstractAfrican-American adolescents experience higher rates of sexually transmitted infections (STIs) compared to same-age Caucasian peers. Substance use, sensation seeking, and depression have all been linked to risky sexual practices. Theory suggests that problem-solving skills may help to buffer against these risk factors. To test this hypothesis, we used data from African-American adolescents (N = 1,018; M age = 16.7, SD = 1.1; 58% female) who participated in a prevention trial. Nearly half of the sample (47%) reported lifetime marijuana use, while 13% reported drug use prior to most recent sexual encounter. Sexual sensation seeking was directly associated with drug use prior to sex (β = 1.13, b = 0.13, SE = 0.02, pSexual communication self-efficacy scale
AbstractQuinn-Nilas, C., Mülhausen, R. R., Breuer, R., Bailey, J. V., Pavlou, M., DiClemente, R., & Wingood, G. M. (n.d.).Publication year
2019Page(s)
233-235Abstract~The Social and Behavioral Sciences Research Network : Shaping a Contemporary Agenda for Research in HIV
AbstractBlank, M. B., Metzger, D. S., Wingood, G. M., & DiClemente, R. (n.d.).Publication year
2019Journal title
Journal of acquired immune deficiency syndromes (1999)Volume
82Page(s)
S81-S83Abstract~Worry about sexual outcomes scale
AbstractSales, J. M., Mülhausen, R. R., Spitalnick, J., & DiClemente, R. (n.d.).Publication year
2019Page(s)
106-108Abstract~КЛИНИЧЕСКИЕ И ЛИЧНОСТНЫЕ ХАРАКТЕРИСТИКИ ЖЕНЩИН С КОИНФЕКЦИЕЙ ВИЧ/ВГС, УПОТРЕБЛЕНИЕМ АЛКОГОЛЯ И НАРКОТИКОВ НА ЭТАПАХ ЗАБОЛЕВАНИЯ
AbstractKhalezova, N. B., Boeva, E. V., V.Rassokhin, V., Gutova, L. V., DiClemente, R., & Belyakov, N. A. (n.d.).Publication year
2019Journal title
HIV Infection and Immunosuppressive DisordersVolume
11Issue
4Page(s)
40-50AbstractThe objective of the survey: to analyze clinical, psychosocial and personal status in women co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), and their alcohol addiction. Materials and methods: the check-up of 191 surveyed women with HIV and HCV co-infection taking into account epidemiologic evidence, laboratory parameters: immunologic (CD4 lymphocyte count), virological (HIV and HCV RNA, HCV genotype) and complete and biochemical blood count was made. Detailed check-up of psychosocial and narcological status with the following assessment of alcohol use in 166 surveyed women was made; clinical, laboratory (ethyl glucuronide (EtG) determination in urine and carbohydrate-deficient transferrin (CDT) determination in serum), and instrumental methods. Results: Mean age of patients was 34,9±3,9 years. Most women (88%) had satisfactory social status. Most women had a long-standing co-infection. 3,7% of women were in the subclinical stage of HIV infection, 92.1% had stage 4A, 4B-11% and 4B-11%. The median number of CD4 lymphocytes was 470 cells/μl. 92,2% received ART, and 96,7% of women showed a high rate of treatment compliance. Among the prevalent HIV-associated diseases were candidiasis (53,2%) and viral infections (8,1%) and bacterial diseases (3%); a high percentage (15%) of past tuberculosis of various localization was noted. In 89,9% of women, a high replicative activity of HCV was detected in the blood. According to the results of indirect liver elastometry, 98,3% had minimal and moderate fibrosis (METAVIR ≤F2). 86,9% of patients showed total bilirubin level within the normal range, median alanine aminotransferase (ALT) was 62 cells/μl and median aspartate aminotransferase (AST) was 48 cells/μl. Comorbid infectious and non-infectious diseases were diagnosed in 65,4% of women. Antiviral therapy (ART) of chronic hepatitis C was performed in 4,7% of surveyed women who received the combination of pegylated interferon (pegIFN) and ribavirin. Mean history of psychoactive drug use was 7,2±4,1 years. By the time of survey, 96,4% of women denied use of any psychoactive drugs other than alcohol. In past medical history, 81,9% of patients used opioids, regular use of alcohol with the following addiction syndrome was diagnosed in 88,6% of patients. Increasing CDT concentration was revealed in 3 patients and in 3 cases, this parameter was within borderline unstable zone. Under assessment of psychopathologic status, prevalent psychopathologic syndromes were insomnia, psychoorganic syndromes and anxiety. According to aggression scale, high indices by «relational aggression», «irritation », «grievance», «suspicion», «guilt». Prevalent types of attitude to HIV-infecton were ergopathic, sensitive, anosognosic.ЭПИДЕМИОЛОГИЧЕСКАЯ, КЛИНИЧЕСКАЯ И ФИНАНСОВАЯ СОСТАВЛЯЮЩИЕ РЕЗУЛЬТАТОВ МНОГОЛЕТНЕЙ АНТИРЕТРОВИРУСНОЙ ТЕРАПИИ ПАЦИЕНТОВ С ВИЧИНФЕКЦИЕЙ
AbstractBelyakov, N. A., Rassokhin, V. V., Kolbin, A. S., DiClemente, R., Panteleev, A. M., Azovtseva, O. V., Ogurtsova, S. V., Simakina, O. E., Stepanova, E. V., Vyaltsin, S. V., Zholobov, V. E., Kovelenov, A. Y., Melnikova, T. N., Kurganova, T. Y., & Ulumbekova, G. E. (n.d.).Publication year
2019Journal title
HIV Infection and Immunosuppressive DisordersVolume
11Issue
4Page(s)
7-19AbstractThe aim of the study was to analyze the results of long-term antiretroviral therapy (ARV) in patients with HIV-infection basing on epidemiological, clinical and economical parameters in the Northwestern Federal District (NFD) of Russia. Materials and methods. Epidemiogical analysis was conducted using the data of reports from 10 NFD regions in the period from 2005 to 2018: morbidity rate, prevalence of HIV-infection, number of people living with HIV-infection (PLWH) and being under regular medical check-up. For clinical analysis were used some key indices of ARV effectiveness such as patients' therapy coverage, clinical stages of HIV-infection, mortality rate and lethality rate in patients. Health costs were calculated basing on ARV procurement in the District from federal and regional programs as well as from funds allocated on diagnostic products and prevention programs. Study results. On the top of administered ARV, rates of mortality and prevalence of HIV-infection in the RF and NFD had increasing tendency. The rate of mortality in PLWH increased in several times while the lethality rate changed insignificantly. Number of PLWH on the stage of clinical signs grew sixfold reaching 63,1%. Questionnaire survey was held in 74 infectious disease physicians with the following estimation of values of some reasons of low effectiveness of ARV and transformation of epidemic into severe and comorbid forms. By reason rating, low ARV coverage in patients was the most common, late detection of HIV-infection and treatment onset, poor adherence and therapy discontinuation, qualified staff shortage, low accessibility of medical organizations, insufficient choice and quality of ARV. In considering financial costs on ARV, insufficient appropriation of funds and insufficient support of other activities including organizational and preventive measures were revealed.A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework in the design and measurement of a large scale collaborative multi-site study
AbstractBecan, J. E., Bartkowski, J. P., Knight, D. K., Wiley, T. R., DiClemente, R., Ducharme, L., Welsh, W. N., Bowser, D., McCollister, K., Hiller, M., Spaulding, A. C., Flynn, P. M., Swartzendruber, A., Dickson, M. F., Fisher, J. H., & Aarons, G. A. (n.d.).Publication year
2018Journal title
Health and JusticeVolume
6Issue
1AbstractBackground: This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners. Methods: The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the mapping of implementation strategies to EPIS stages, articulation of research questions, and selection, content, and timing of measurement protocols. Among other key developments, the project led to a reconceptualization of its governing implementation science framework into cyclical form as the EPIS Wheel. The EPIS Wheel is more consistent with rapid-cycle testing principles and permits researchers to track both progressive and recursive movement through EPIS. Moreover, because this randomized controlled trial was predicated on a bundled strategy method, JJ-TRIALS was designed to rigorously test progress through the EPIS stages as promoted by facilitation of data-driven decision making principles. The project extended EPIS by (1) elucidating the role and nature of recursive activity in promoting change (yielding the circular EPIS Wheel), (2) by expanding the applicability of the EPIS framework beyond a single evidence-based practice (EBP) to address varying process improvement efforts (representing varying EBPs), and (3) by disentangling outcome measures of progression through EPIS stages from the a priori established study timeline. Discussion: The utilization of EPIS in JJ-TRIALS provides a model for practical and applied use of implementation frameworks in real-world settings that span outer service system and inner organizational contexts in improving care for vulnerable populations. Trial registration: NCT02672150. Retrospectively registered on 22 January 2016.African American Women’s Language Use in Response to Male Partners’ Condom Negotiation Tactics
AbstractLi, Y., Samp, J. A., Coles Cone, V. B., Mercer Kollar, L. M., DiClemente, R., & Monahan, J. L. (n.d.).Publication year
2018Journal title
Communication StudiesVolume
69Issue
1Page(s)
67-84AbstractAfrican American women are vulnerable for sexual health risk; thus, condom use is essential. Guided by research linking goals to communicative content, this study explored women’s use of I-, you-, we-, and hedging language during condom negotiation. Female participants (N = 193) engaged in a condom negotiation role play with male confederates, where language use measures were coded. I-language was used the most frequently. Language use differed as a function of men’s tactics, such that women primarily used I-language in response to verbal attacks, you-language in response to seduction, and I- and we-language in response to information seeking. Women who engaged in more recent condom use were more likely to use you-language and, when confederates attacked, they responded with more you-language and less hedging.Ecologies of risk among African American girls in juvenile detention
AbstractLogan-Greene, P., Kim, B. K., Quinn, C. R., DiClemente, R., & Voisin, D. (n.d.).Publication year
2018Journal title
Children and Youth Services ReviewVolume
85Page(s)
245-252AbstractAfrican American girls are disproportionately represented in juvenile detention, yet less is known about their distinctive and heterogeneous needs, especially regarding their psychosocial contexts. Latent class analysis determined four subgroups based on the adolescent ecology (neighborhood, family, peers) among detained African American girls ages 13–17 (N = 188). The Shielded class (32%) displayed the lowest levels of risk and highest levels of protective factors. The Typical class (24%) was close to the sample average on all indicators, with elevated histories of family incarceration. The Family Distress class (16%) reported the lowest neighborhood risk but was marked by high family risk levels and abuse history. The Highest Risk class (28%) had elevated risk on most indicators but particularly high neighborhood and peer risk. These classes significantly varied by youth social context and mental health. Findings bolster the need to consider the diverse, multidimensional contextual experiences of detained and at-risk African American girls.HIV and symptoms of depression are independently associated with impaired glucocorticoid signaling
AbstractBekhbat, M., Mehta, C. C., Kelly, S. D., Vester, A., Ofotokun, I., Felger, J., Wingood, G., Anastos, K., Gustafson, D. R., Kassaye, S., Milam, J., Aouizerat, B., Weber, K., Golub, E. T., Moore, M. F., DiClemente, R., Fischl, M., Kempf, M. C., Maki, P., & Neigh, G. N. (n.d.).Publication year
2018Journal title
PsychoneuroendocrinologyVolume
96Page(s)
118-125AbstractChronic inflammation caused by HIV infection may lead to deficient glucocorticoid (GC) signaling predisposing people living with HIV to depression and other psychiatric disorders linked to GC resistance. We hypothesized that comorbid HIV and depressive symptoms in women would synergistically associate with deficits in GC signaling. This cross-sectional study used samples obtained from the Women's Interagency HIV Study (WIHS). The Centers for Epidemiological Studies (CES-D) was used to define depression in four groups of women from the Women's Interagency HIV Study (WIHS): 1) HIV-negative, non-depressed (n = 37); 2) HIV-negative, depressed (n = 34); 3) HIV-positive, non-depressed (n = 38); and 4) HIV-positive, depressed (n = 38). To assess changes in GC signaling from peripheral blood mononuclear cells (PBMCs), we examined baseline and dexamethasone (Dex)-stimulated changes in the expression of the GC receptor (GR, gene: Nr3c1) and its negative regulator Fkbp5 via quantitative RT-PCR. GR sensitivity was evaluated in vitro by assessing the Dex inhibition of lipopolysaccharide (LPS)-stimulated IL-6 and TNF-α levels. Depressive symptoms and HIV serostatus were independently associated with elevated baseline expression of Fkbp5 and Nr3c1. Depressive symptoms, but not HIV status, was independently associated with reduced LPS-induced release of IL-6. Counter to predictions, there was no interactive association of depressive symptoms and HIV on any outcome. Comorbid depressive symptoms with HIV infection were associated with a gene expression and cytokine profile similar to that of healthy control women, a finding that may indicate further disruptions in disease adaptation.Psychometric Evaluation of a Brief Depression Measure for Justice-Involved Youths : A Multigroup Comparison
AbstractDembo, R., Faber, J., Cristiano, J., DiClemente, R., Krupa, J. M., Wareham, J., & Terminello, A. (n.d.).Publication year
2018Journal title
Journal of Child and Adolescent Substance AbuseVolume
27Issue
3Page(s)
146-155AbstractThe Center for Epidemiological Studies Depression Scale (CES-D) is a widely used screening tool for depression among adults and children. However, the validity of the CES-D has yet to be established among justice-involved youths, a population known to have higher levels of depressive symptoms in comparison to samples of community adolescents. The current study examines the psychometric characteristics of the eight-item version of the CES-D among newly arrested youths. Data were obtained through a local health coach service project, designed to provide linkage to treatment for justice-involved youths who are drug involved, test positive for HIV or other STDs, or have high levels of depressive symptoms. A multigroup, confirmatory factor analysis of the depression symptoms for subgroups defined by gender/race self-identification was conducted to assess the psychometric characteristics of the CES-D among these newly arrested youths. Results produced statistical evidence in support of one factor in the eight-item depression data and a similar factor structure across the various gender/racial groups. Criterion-related validity of the depression factor was also explored. Findings support the usefulness of the eight-item CES-D for use among gender-diverse and ethnically diverse youths.The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication
AbstractHadley, W., Lansing, A., Barker, D. H., Brown, L. K., Hunter, H., Donenberg, G., & DiClemente, R. (n.d.).Publication year
2018Journal title
Journal of Child and Family StudiesVolume
27Issue
4Page(s)
1098-1109AbstractParents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11 h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.The MEDIA model : An innovative method for digitizing and training community members to facilitate an HIV prevention intervention
AbstractRenfro, T., Johnson, E., Lambert, D. N., Wingood, G., & DiClemente, R. (n.d.).Publication year
2018Journal title
Translational Behavioral MedicineVolume
8Issue
6Page(s)
815-823AbstractAs human immunodeficiency virus (HIV) continues to disproportionately affect African American women, practitioners remain committed to developing innovative strategies to reduce HIV prevalence. These strategies include training community organizations, such as churches, and utilizing digital media to make intervention dissemination more sustainable. This article describes one such effort to train lay community members within predominantly Black churches in Atlanta, GA, to implement an HIV prevention intervention. Lay educators were trained by translating a face-to-face Training of Facilitators (TOF) to a digital platform using the MEDIA (Motivate-Engage-Digitize-Implement-Assess) model. Formative evaluations, consultation with experts in the digital platform of choice, and the experience of two P 4 for Women Master Trainers informed our translation. The model guided the translation process as our research team worked alongside topical experts and a production company to develop storyboards for core curriculum activities, which were later scripted and filmed with mock participants. A user guide, toolkit, and program website were also developed as supplemental materials to accompany the video training. Lessons learned from this study indicate future attempts at digitizing TOFs should keep in mind that digitization can be a time-consuming process, pilot testing in the new format is necessary even for a previously tested intervention, and the structure provided by facilitators in face-to-face training must be embedded into the format of digitized trainings.Theory-Based Analysis of Interest in an HIV Vaccine for Reasons Indicative of Risk Compensation Among African American Women
AbstractPainter, J. E., Temple, B. S., Woods, L. A., Cwiak, C., Haddad, L. B., Mulligan, M. J., & DiClemente, R. (n.d.).Publication year
2018Journal title
Health Education and BehaviorVolume
45Issue
3Page(s)
444-453AbstractLicensure of an HIV vaccine could reduce or eliminate HIV among vulnerable populations. However, vaccine effectiveness could be undermined by risk compensation (RC), defined by an increase in risky behavior due to a belief that the vaccine will confer protection. Interest in an HIV vaccine for reasons indicative of RC may serve as an indicator of actual RC in a postlicensure era. This study assessed factors associated with interest in an HIV vaccine for reasons indicative of RC among African American women aged 18 to 55 years, recruited from a hospital-based family planning clinic in Atlanta, Georgia (N = 321). Data were collected using audio-computer–assisted surveys. Survey items were guided by risk homeostasis theory and social cognitive theory. Multivariable logistic regression was used to assess determinants of interest in an HIV vaccine for reasons indicative of RC. Thirty-eight percent of the sample expressed interest in an HIV vaccine for at least one reason indicative of RC. In the final model, interest in an HIV vaccine for reasons indicative of RC was positively associated with higher impulsivity, perceived benefits of sexual risk behaviors, and perceived benefits of HIV vaccination; it was negatively associated with having at least some college education, positive future orientation, and self-efficacy for sex refusal. Results suggest that demographic, personality, and theory-based psychosocial factors are salient to wanting an HIV vaccine for reasons indicative of RC, and underscore the need for risk-reduction counseling alongside vaccination during the eventual rollout of an HIV vaccine.Willingness to pay for an Ebola vaccine during the 2014–2016 ebola outbreak in West Africa : Results from a U.S. National sample
AbstractPainter, J. E., von Fricken, M. E., Viana de O. Mesquita, S., & DiClemente, R. (n.d.).Publication year
2018Journal title
Human Vaccines and ImmunotherapeuticsVolume
14Issue
7Page(s)
1665-1671AbstractThe 2014–2016 Ebola virus outbreak in West Africa led to advances in the development of vaccines against Ebola. This study examined factors associated with willingness to pay for an Ebola vaccine among a U.S. national sample during the recent Ebola outbreak. From April 30–May 8, 2015, a national survey was conducted using the GfK Group's KnowlegePanel®. Main outcome measures included willingness to pay at least $1; more than $50; and more than $100 for an Ebola vaccine. Analyses were conducted using weighted multivariable logistic regression. Among participants (N = 1,447), 583 (40.3%) would not pay for an Ebola vaccine; 864 (59.7%) would pay at least $1. Among those willing to pay at least $1: 570 (66.0%) would pay $1–50; 174 (20.1%) would pay $51–100; and 120 (13.9%) would pay more than $100. Willingness to pay at least $1 for an Ebola vaccine was associated with international travel; interest in getting an Ebola vaccine; and beliefs that the U.S. government should spend money to control Ebola and assume worldwide leadership in confronting emerging epidemics. Willingness to pay more than $50 was associated with similar variables. Willingness to pay more than $100 was associated with international travel; interest in getting an Ebola vaccine; information seeking; and beliefs that the U.S. government should assume worldwide leadership in confronting emerging epidemics. International travel and interest in an Ebola vaccine were key predictors of willingness to pay across all price points. Understanding willingness to pay for vaccines against emerging infectious diseases remains critical.A Multigroup, Longitudinal Study of Truant Youths, Marijuana Use, Depression, and STD-Associated Sexual Risk Behavior
AbstractDembo, R., Krupa, J. M., Wareham, J., Schmeidler, J., & DiClemente, R. (n.d.).Publication year
2017Journal title
Journal of Child and Adolescent Substance AbuseVolume
26Issue
3Page(s)
192-204AbstractTruant youths are likely to engage in a number of problem behaviors, including sexual risky behaviors. Previous research involving non-truant youths has found sexual risk behaviors to be related to marijuana use and depression, with differential effects for male and female youths. Using data collected in a National Institute on Drug Abuse (NIDA)-funded, prospective intervention project, results are reported of a male-female, multi-group, longitudinal analysis of the relationships among truant youth baseline sexual risk behavior, marijuana use, and depression, and their sexual risk behavior over four follow-up time points. Results indicated support for the longitudinal model, with female truants having higher depression scores, and showing stronger relationships between baseline depression and future engagement in sexual risk behavior, than male truants. Findings suggest that incorporating strategies to reduce depression and marijuana use may decrease youth sexual risk behavior.Changing risk trajectories and health outcomes for vulnerable adolescents : Reclaiming the future
AbstractDiClemente, R., & Wingood, G. M. (n.d.).Publication year
2017Journal title
PediatricsVolume
139Issue
2Abstract~