Testing the Interpersonal-Behavior model to explain intentions to use patient-delivered partner therapy

Steven A John, Jennifer L Walsh, Katherine G Quinn, Young Ik Cho, Lance S Weinhardt, Steven A John, Jennifer L Walsh, Katherine G Quinn, Young Ik Cho, Lance S Weinhardt

Abstract

Background: Patient-delivered partner therapy (PDPT) is an evidence-based method of partner treatment, but further research was needed to understand theoretical underpinnings of potential PDPT use.

Purpose: We sought to develop and test a theoretical framework to understand PDPT intentions.

Methods: A Midwestern sample of sexually transmitted infection clinic patients were recruited to participate in a three-phase study incorporating semi-structured interviews (n = 20, total), cognitive interviews (n = 5), and surveys (n = 197; Mage = 31.3, 61% male, 91% Black or African-American). Thematic analysis was conducted to identify major themes, which guided development and testing of a theoretical framework on PDPT intentions using structural equation modeling.

Results: We identified themes of information (knowledge); motivation (individual and partner protection beliefs, partner and provider motivation-to-comply); social support (sexual health and general); and behavioral skills (partner notification, medication delivery, and communication skills self-efficacy) in thematic analysis. The developed Interpersonal-Behavior model demonstrated good model fit in structural equation modeling [χ2(36) = 95.56, p<0.01; RMSEA = 0.09 (0.07-0.11, 90%C.I.); CFI = 0.94; SRMR = 0.05]. Information was associated with motivation (β = 0.37, p<0.001) and social support (β = 0.23, p = 0.002). Motivation was associated with social support (β = 0.64, p<0.001) and behavioral skills (β = 0.40, p<0.001), and social support was associated with behavioral skills (β = 0.23, p = 0.025). Behavioral skills were associated with higher PDPT intentions (β = 0.31, p<0.001), partially mediated the association of motivation with intentions (βdirect = 0.53, p<0.001; βindirect = 0.12, 95%CI: 0.03-0.30), and fully mediated the association of social support with intentions (βindirect = 0.07, 95%CI: 0.00-0.21).

Conclusions: The Interpersonal-Behavior model seems appropriate for PDPT intentions but should be tested longitudinally with PDPT outcomes and other interpersonal health behaviors.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. The Interpersonal-Behavior (I-B) model.
Fig 1. The Interpersonal-Behavior (I-B) model.
Fig 2. The structural equation model results…
Fig 2. The structural equation model results testing the Interpersonal-Behavior model on intentions to use PDPT among STI clinic patients.
Notes: * p < 0.05. Non-significant pathways are not shown for interpretability but can be found in the Results section.

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