M. Margaret Dolcini

Oregon State University | OSU · School of Social and Behavioural Sciences

BACKGROUND School-based sex education (SE) can reduce adolescent sexual health problems. However, only 49-55% of adolescents receive SE that meets national standards. African American youth (AAY), particularly males, are less likely to receive SE. AAY evidence a high prevalence of STIs/teen pregnancy. Internet-based SE offers a supplemental option....

Effective delivery of evidence-based practices (EBPs) depends on strong supervision and leadership. This case study analysis examined how supervisors contended with barriers and facilitators of implementation of R ³ , a supervisor-focused strategy to improve caseworker interactions with families in the child welfare system. A stratified random samp...

HIV represents a significant health burden in the United States. In 2012, the Centers for Disease Control and Prevention (CDC) stopped recommending many once-promoted interventions as part of a shift from one HIV intervention policy, Diffusion of Effective Behavioral Interventions (DEBI), to another, High Impact Prevention (HIP). Twenty-nine staff...

HIV prevention and care peer education interventions have demonstrated effectiveness at changing HIV risk and care behaviors among a variety of at-risk populations in different settings. However, little is known about the implementation of this type of intervention in community-based settings. Further, there is limited information available regardi...

PrEP adoption among African-American men-who-have-sex-with-men (AAMSM) remains low. We applied Diffusion-of-Innovations (DOI) theory to understand PrEP adoption processes among young HIV-negative/status unknown AAMSM (AAYMSM; N = 181; 17–24 years). Quantitative and qualitative analyses were used to examine predictors of PrEP diffusion stages. Most...

BACKGROUND Internet access is increasingly critical for adolescents with regard to obtaining health information and resources, participating in online health promotion and communicating with health practitioners. Yet, past work demonstrates that access is not uniform across U.S. youth, with lower access found among groups with higher health related...

Background: Internet access is increasingly critical for adolescents with regard to obtaining health information and resources, participating in online health promotion and communicating with health practitioners. Yet, past work demonstrates that access is not uniform across U.S. youth, with lower access found among groups with higher health relat...

Background: As more effective or efficient interventions emerge out of scientific advancement to address a particular public health issue, it may be appropriate to de-implement low-value interventions, or interventions that are less effective or efficient. Furthermore, factors that contribute to appropriate de-implementation are not well identifie...

Objectives: Evaluate the relationships between social characteristics of Floridian persons living with HIV (PLWH) and both use of digital technologies and willingness to use eHealth for HIV-related information. Methods: Ryan White case managers (N = 155) from 55 agencies in 47 Florida counties administered a survey to PLWH (N = 1268) from June 2...

Oral-Self Implemented HIV Testing (Oral-SIT) offers a low-cost way to extend the reach of HIV testing systems. It is unclear, however, if high risk populations are able to perform the test with high fidelity. Using a simulation-based research design, we administered desensitized Oral-SIT kits to African American MSM (AAMSM; 17–24 years, N = 178). P...

Tanzanian youth have high levels of HIV risk and poor access to HIV-testing. Oral self-implemented testing (Oral-SIT) provides an alternative that reduces barriers to HIV-testing. We examined adaptations to Oral-SIT training components in a randomized experiment to evaluate a “train-the-trainer” strategy for improving comprehension of graphic train...

High-quality implementation of evidence-based interventions is important for program effectiveness and is influenced by training and quality assurance (QA). However, gaps in the literature contribute to a lack of guidance on training and supervision in practice settings, particularly when significant adaptations in programs occur. We examine traini...

Objectives. Survey items used in surveillance systems to assess the use of emerging products like hookah and electronic inhalant devices (EIDs) may not match definitions used by high-risk populations. This qualitative study explored how African American youth and young adults (YYAs) (1) use hookah and EIDs and (2) identify patterns in the ways they...

Background: Research on the sexual behaviors of African American youth has primarily focused on associated risks, with a dearth of studies examining a fuller representation of African American adolescents' sexual lives. This study explored the range of messages African American adolescents receive from family members regarding sexual behavior and...

There is a need for sexual health promotion among African American youth. The internet is an efficient means of delivering sexual health information (SHI). However, there may be disparities that reduce internet reach to low-income African American youth. The present mixed-methods study analyzed data from the U.S. Current Population Survey (national...

Background: Sustaining evidence-based interventions (EBIs) is an ongoing challenge for dissemination and implementation science in public health and social services. Characterizing the relationship among human resource capacity within an agency and subsequent population outcomes is an important step to improving our understanding of how EBIs are s...

Evidence-based interventions (EBIs) often require competent staff, or human resources (HR), for implementation. The empirical evidence characterizing the influence of HR fluctuations on EBI delivery is limited and conflicting. Using the Interactive Systems Framework, we explored staff fluctuation and the subsequent influence on RESPECT, an HIV prev...

Evidence-based intervention (EBI) de–adoption and its influence on public health organizations are largely unexplored within public health implementation research. However, a recent shift in support for HIV prevention EBIs by the Centers for Disease Control and Prevention provides an opportunity to explore EBI de–adoption. The current mixed-method...

The purpose of this study was to identify cultural models of breast cancer held by Saudi women and to explore how these may influence early detection and treatment-seeking behaviors. Data were collected via semi-structured interviews with breast cancer survivors (n=20) from two Western cities in Saudi Arabia. Respondents were recruited through soci...

Numerous barriers to clinic-based HIV testing exist (e.g., stigmatization) for African American youth. These barriers may be addressed by new technology, specifically HIV self-implemented testing (SIT). We conducted a series of formative phase 3 translation studies (49 face-to-face interviews, 9 focus groups, 1 advisory panel review) among low-inco...

The purpose of the present study was to understand the extent to which urban African-American youth access information via the Internet for a variety of sexual health topics and to identify the conditions under which they find sexual health information. African-American heterosexual youth (N = 81; 15–17 years) residing in low-income neighborhoods c...

With few exceptions, much of sexual science builds upon data from opportunistic nonprobability samples of limited generalizability. Although probability-based studies are considered the gold standard in terms of generalizability, they are costly to apply to many of the hard-to-reach populations of interest to sexologists. The present article discus...

We examined the potential for increasing the reach of HIV testing to African American youths through the dissemination of oral-HIV testing. From 2012 through 2013 we examined the perceptions of alternatives to pharmacy dissemination of SITs in African American youths (5 focus groups) and service providers (4 focus groups), and conducted an ethnogra...

Dissemination of HIV behavioral prevention programs has increased the reach of evidence-based interventions, but there is a paucity of data on implementation and diffusion. The present mixed methods study focused on RESPECT, a brief counseling and testing intervention, examining compliance fidelity and the extent to which Centers for Disease Contro...

Background. Supervision has been identified as a central component of successful implementation of evidence-based interventions (EBIs). Staff inevitably fluctuate over time, potentially influencing program implementation. The current study qualitatively explored the impact of supervisor changes on implementation of RESPECT, an HIV prevention EBI....

Understanding the balance between fidelity and adaptation for evidence-based interventions has the potential to improve their translation from research to practice. The Translation into Practice study explores variation in program implementation within organizations utilizing the RESPECT program, an HIV counseling and testing intervention. Counselo...

The economic downturn of 2007 created significant fiscal losses for public and private agencies conducting behavioral prevention. Such macro-economic changes may influence program implementation and sustainability. We examined how public and private agencies conducting RESPECT, a brief HIV/STI (sexually transmitted infection) counseling and testing...

Background: The At-home HIV test (AHT) has the potential to increase knowledge of HIV status and linkage to care globally among populations that avoid testing due to fear of stigmatization. In the U.S., many young African Americans remain untested, resulting in negative medical outcomes. Our prior work showed that untested high-risk youth favored A...

This article describes psychosocial outcomes of a group randomized controlled trial of a friendship-based HIV/STI prevention intervention grounded in the AIDS Risk Reduction Model (ARRM). A total of 264 African American adolescent females were randomized to a single-session Project ÒRÉ HIV/STI prevention intervention or a nutrition/exercise health...

The emphasis on evidence-based practice requires attention to fidelity in translation of programs. Few studies have assessed fidelity of HIV/STI behavioral counseling and testing programs, including RESPECT. We examined client fidelity for 26 public health departments (HD) and community-based organizations (CBO) delivering RESPECT across the U.S.....

The recent economic downturn has affected HIV behavioral prevention funding in the U.S., but data on how reductions have impacted ongoing translation of evidence-based interventions are sparse. We examined how funding reductions impact the ability of health departments (HD) and community-based organizations (CBO) to deliver behavioral evidence-base...

Respect is considered an important quality in successful romantic relationships. To date, however, there has been limited attention to the meaning of respect in romantic relationships. The purpose of this article is to report on the meaning of respect in romantic relationships as conceptualized by low-income African-American adolescents during focu...

Introduction: Evidence-based health programs require sufficient timeframes for implementation to maintain fidelity to the program's core elements. Pre-implementation assessments of program fit should include consideration of time factors, but little is known about whether this takes place and the impact of time constraints on fidelity. The present...

Using a probability-based neighborhood sample of urban African American youth and a sample of their close friends (N = 202), we conducted a one-year longitudinal study to examine key questions regarding sexual and drug using norms. The results provide validation of social norms governing sexual behavior, condom use, and substance use among friendsh...

This article presents findings from a qualitative evaluation of an HIV/STI (sexually transmitted infection) prevention intervention for urban African American youth (Project ORE), which was delivered to groups of 3 to 8 adolescents who were members of the same friendship network. Sixteen focus groups (N = 63) were conducted with youth following the...

Over the last decade, the Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) program funded several hundred community-based organizations (CBOs) and health departments in a wide-scale HIV prevention national diffusion effort. We interviewed six California agencies funded to implement one of three gro...

Relationship dynamics develop early in life and are influenced by social environments. STI/HIV prevention programs need to consider romantic relationship dynamics that contribute to sexual health. The aim of this study was to examine monogamous patterns, commitment, and trust in African American adolescent romantic relationships. The authors also f...

There is a dearth of research regarding the influence of family members on adolescent dating. This study explored messages that African American adolescents received from family members regarding dating attitudes, norms and behaviors. Qualitative interviews were conducted with sexually experienced urban African American heterosexual adolescents (N...

This qualitative study examined sexual health information networks among urban African American youth living in low-income communities. The authors identified sources, message content, and utility of messages about sex and sexual health in a sample of 15-17-year olds (N = 81). Youth received sexual health information from a variety of sources. Mess...

Adolescents often engage in concurrent sexual partnerships as part of a developmental process of gaining experience with sexuality. The authors qualitatively examined patterns of concurrency and variation in normative and motivational influences on this pattern of sexual partnering among African American adolescents (31 males; 20 females), ages 15...

The authors employ a social-ecological framework to aid our understanding of the complex array of factors in the immediate and broader environment that influence adolescent sexual development. Further, sexual development is viewed as normative and critical to positive growth. The authors provide an overview of the Two-Cities Study, a multi-stage qu...

Sexual debut represents a developmental transition that holds possibility for growth and for risk. Family and neighborhood may impact timing of debut. This qualitative study examined family strategies (e.g., moving, parental monitoring), perceptions of neighborhood, and attitudes about sex and sexual debut among sexually experienced and inexperienc...

Background: Sexual health information is available from a variety of sources, including the Internet. Little is known about the extent to which poor urban African American youth use the Internet for sexual health information and integrate this into information from other sources. Methods: We obtained a purposive sample of sexually active African...

Since adolescents often live with and are influenced by family members, it is critical to understand the role that family members play in shaping sexual and reproductive risk and health behaviors. This study examined the range of messages that sexually active adolescents receive from multiple family members regarding sexual/reproductive behaviors a...

Background: The recent economic downturn has affected funding sources for HIV behavioral prevention in the US. We examine how funding reductions impact the ability of public health departments (HD) and community-based organizations (CBO) to translate evidence-based interventions, particularly HIV behavioral prevention programs. Methods: Two appro...

The burden of HIV among sexually active African American adolescents is significant, and when compared to other races/ethnicities, disproportionately high. Adolescent HIV prevention should consider beliefs and expectations about sex, which develop early in life and are influenced by social environment. This study examined beliefs and expectations a...

Efficacious behavioral interventions developed to address the spread of HIV/STIs are currently being disseminated in the USA through a national diffusion program (DEBI) spearheaded by the Centers for Disease Control and Prevention (CDC). Understanding how interventions are translated to real world settings is necessary to further scientific knowled...

There is an urgent need for continued innovation in the design of HIV/STI prevention interventions for African American females, a group at high risk for STIs and HIV. In particular, attention to social development and to culture is needed. The present study reports on a group randomized controlled trial of a friendship-based HIV/STI prevention int...

A need exists for the promotion of diversity in the scientific workforce to better address health disparities. In response to this need, funding agencies and institutions have developed programs to encourage ethnic-minority and early-career scientists to pursue research careers. We describe one such program, the University of California, San Franci...

This study examined whether uncontrollable stressful life events were associated with sexual risk taking among adolescents across a 1-year period, and whether supportive friendships modified associations. Participants were 159 sexually active African American adolescents (57% male; mean age [SD] = 17.0 [1.5] years at baseline). Participants were re...

IN A NATIONAL SURVEY OF INSTITUTIONS with federally assured human research protection programs, we obtained workload and other relevant data on their Institutional Review Boards (IRBs) and management organizations. The number of IRBs increased substantially from 1995 to 2005/06 (491 to 2,728 IRBs) with a further increase in 2008 to 3,853 IRBs. Nati...

WE OBTAINED DATA ON INSTITUTIONAL Review Boards (IRBs) that review mental health-related applications (MHRAs) in a national survey of institutions with federally assured human research protection programs. Approximately 57% of IRBs review MHRAs, and among these a small percentage may not have mental health experts on their committees (5%). Moreover...

WE EVALUATED 55 IRB CHAIRS' perspectives on ethical issues in a hypothetical study involving mental health-related genomics research using stored specimens to identify potential barriers and solutions to such research. Most Chairs identified the ethical issues of consent and confidentially as important. The majority of Chairs expressed concern abou...

This study presents preliminary findings of a brief friendship-based HIV/STI prevention intervention for urban African American youth. Using a no-control design, we found that the program is feasible, acceptable, and demonstrates promise with regard to changes in HIV/STI-related knowledge, beliefs, social norms, and behavior.

Background: Tailored interventions are needed to address the high rates of HIV/ STIs among young African American males living in urban communities. The development of tailored programs should be based on an understanding of the issues that surround sexuality for these youth. Previous research has linked conceptualization of masculinity to sexual b...

Behavioral science theory is recommended as a basis for prevention programs, yet many STD/HIV prevention providers have little academic background in this area and see no relevance of theory to their work. This study assessed STD/HIV prevention providers' intuitive insight about behaviors. Comparisons of behavioral determinants from providers "comm...

To examine the characteristics of inner city African-American adolescents nonschool-based and school-based friendship networks and to explore the influence of these networks on health risk behavior. We assessed close friendships networks in a probability sample of inner city African-American youth living in a single neighborhood and describe the ne...

This study examined the role of close friends in the sexual lives of African American adolescents. Fifteen African American adolescents residing in an urban neighborhood participated in individual in-depth qualitative interviews. The findings suggest that close friends play a critical role in the dating and sexual behaviors of inner-city African Am...

The HIV/STD epidemics have broadened the need for better behavioral intervention programs and highlighted the importance of providing training in behavioral theory to frontline program practitioners. However, there is a lack of effective methods for teaching theoretical concepts to people who may not have a background in behavioral science. This ar...

This research examined the validity of self-reports of adolescent smoking and explored factors that may influence agreement between self-reported smoking and biological indicators. Data were obtained from 1,881 adolescents as part of a household probability study in the southeastern United States. Adolescents aged 12-14 years reported their tobacco...

The authors present HIV prevalence and risk behavior data for urban men who have sex with men (MSM) aged 50 years or older. Data are based on a probability sample of MSM conducted in 1997 (n = 2881 total; 507 older MSM) in New York, Los Angeles, Chicago, and San Francisco. The authors determined HIV status through self-report and biologic measures....

y experienced. Adolescents' location in their social world is associated with sexual behavior among the close friends of a household sample of urban African American youth. INTRODUCTION Thebiological,emotional,andpsychologicalvulnerabilityofadolescenceaccentuatepotentialnegative outcomes of sexual activity, such as sexually transmitted diseases and...

Based on national level surveys, we examined data relevant to the United States' overall effort to prevent the spread of HIV among heterosexual adults. We examined changes in condom use among at-risk heterosexuals over the past decade. The observed increases over time in condom use across all heterosexual at-risk population segments are consistent...

Little is known about whether adolescents' sexual behavior is influenced by their place in their social networks. Adolescents who are central to a network may be affected differently by peer norms than a more peripheral network member. The objective of this study was to test the hypothesis that urban African American youth who are well-integrated i...

Women represent one of the fastest growing groups of U.S. AIDS cases. This study examined women with risky male sexual partners drawn from a national/urban probability telephone sample. Our analyses use a matched control design to profile women with risky sexual partners and their male partners. We used the multifaceted model of HIV risk (MMOHR) as...

This article draws on clinical, cognitive, and health psychology literature to explore a range of barriers to sexual risk behavior change. It is divided into 5 sections, each of which presents obstacles and solutions to address them. The first 4 sections are organized around antecedent factors commonly addressed in models of risk behavior. Barriers...

This article draws on clinical, cognitive, and health psychology literature to explore a range of barriers to sexual risk behavior change. It is divided into 5 sections, each of which presents obstacles and solutions to address them. The first 4 sections are organized around antecedent factors commonly addressed in models of risk behavior. Barriers...

scrutinize [the] image of the peer group in light of studies of adolescent peer relations and health behavior / [provides] an overview of . . . transformations [in peer relations that routinely occur in this stage in life], consider each in more detail in terms of its linkage to adolescent health and implications for health-related behavior / 3 maj...

We examined perceived risk of contracting HIV using assessments of likelihood and worry in a probability sample of unmarried heterosexuals. Perceptions of the likelihood of contracting HIV and worry about HIV were only modestly correlated (r = .23), suggesting that they are different constructs. Far more respondents expressed worry (43%) than expre...

Reviews factors influencing agreement between self-reported smoking and biological assessments of smoking among adolescents, a population in which pressure to misreport smoking is likely to be strong. 28 studies in which self-report is compared with a biological indicator are included. 4 factors are identified that may limit agreement between self-...

The National AIDS Behavioral Survey (1990-1992) of heterosexual adults (18-49 years) measured human immunodeficiency virus (HIV) risk factors, condom use, and HIV antibody testing, with a focus on major "high-risk" cities. A longitudinal survey was conducted. There was little reduction in the overall prevalence of HIV risk factors in the national o...

Data from the National AIDS Behavioral Survey were used to examine the social distribution of extramarital sex and risk for human immunodeficiency virus (HIV) infection among married individuals in the United States. Of 1686 married respondents living across the United States, 2.2% reported extramarital sex; of 3827 married respondents living in 23...

In this study we examined multiple partners in a household probability sample of heterosexuals. Thirty-seven percent reported 2 or more partners in the past year, and 6% reported 5 or more partners. Significant interactions among gender, ethnicity, and relationship status revealed complex relations. African American men without a primary partner we...

We examined risk factors for HIV and changes in condom use among heterosexual adults (N = 987) over three waves of data from the AIDS in Multi‐Ethnic Neighborhoods (AMEN) cohort survey (1988–89, 1989–90, 1991–92). We found that respondents had maintained increases in condom use reported at Wave 2, but the overall picture is one of condom use having...

In this study we examined multiple partners in a household probability sample of heterosexuals. Thirty-seven percent reported 2 or more partners in the past year, and 6% reported 5 or more partners. Significant interactions among gender, ethnicity, and relationship status revealed complex relations. African American men without a primary partner we...

This study examined the role of self-esteem and peer group membership in risk behavior among 183 8th graders in a multiethnic school. The hypothesis was that domain-specific rather than global self-esteem would be associated with "crowd" membership that in turn would be related to risk behavior. Data were gathered through informant interviews and i...

This study examined the role of self-esteem and peer group membership in risk behavior among 183 8th graders in a multiethnic school. The hypothesis was that domain-specific rather than global self-esteem would be associated with “crowd” membership that in turn would be related to risk behavior. Data were gathered through informant interviews and i...

We examined correlates of condom use among heterosexual whites, blacks, and Hispanics (ages 20-45 years) with an human immunodeficiency virus (HIV) risk factor in a community-based longitudinal sample (San Francisco; n = 716). Lag models were used to examine hypothesized antecedents of condom use at wave 2. High levels of condom use were associated...

Examined correlates of condom use in a longitudinal sample of 716 White, Black, and Hispanic heterosexuals (aged 20–44 yrs) with an HIV risk factor in San Francisco. The AIDS in Multi-Ethnic Neighborhoods (AMEN) survey examined the distribution of HIV infection and HIV risk behaviors across groups defined by race, gender, and sexual orientation. Hi...

The National AIDS Behavioral Surveys collected data between June 1990 and February 1991 on the prevalence of multiple sex partners and condom use among 2, 166 blacks living in cities with a high prevalence of AIDS cases. Almost one-fifth (19%) of respondents report having had two or more partners in the year preceding the survey. More men (30%) tha...

Among a sample of 1,334 urban heterosexuals aged 18-25 from the 1990-1991 National AIDS Behavioral Surveys, 24% report having had more than one sexual partner during the past year. Young men are more than twice as likely as young women, and unmarried respondents are eight times as likely as married respondents, to have multiple partners. A multiple...

Data from a random sample of 4,658 heterosexual Hispanics from 23 high-risk cities in the 1990-1991 National AIDS Behavioral Surveys reveal that 11% of Hispanics have had multiple partners in the past year--17% of men and 4% of women. The study shows a higher proportion of multiple sexual partners in the past year among Hispanic men who are unmarri...

Among a sample of 1,334 urban heterosexuals aged 18-25 from the 1990-1991 National AIDS Behavioral Surveys, 24% report having had more than one sexual partner during the past year. Young men are more than twice as likely as young women, and unmarried respondents are eight times as likely as married respondents, to have multiple partners. A multiple...