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Unformatted text preview: http://heb.sagepub.com/ Behavior Health Education & http://heb.sagepub.com/content/37/4/504 The online version of this article can be found at: DOI: 10.1177/1090198109357319 2010 37: 504 Health Educ Behav Ann Pentz Karla Dawn Wagner, Jennifer B. Unger, Ricky N. Bluthenthal, Valentina A. Andreeva and Mary and Environmental Models Injection Drug Users: A Review and Suggestions for the Integration of Cognitive Cognitive Behavioral Theories Used to Explain Injection Risk Behavior Among Published by: http://www.sagepublications.com On behalf of: Society for Public Health Education can be found at: Health Education & Behavior Additional services and information for http://heb.sagepub.com/cgi/alerts Email Alerts: http://heb.sagepub.com/subscriptions Subscriptions: http://www.sagepub.com/journalsReprints.nav Reprints: http://www.sagepub.com/journalsPermissions.nav Permissions: http://heb.sagepub.com/content/37/4/504.refs.html Citations: at BRIGHAM YOUNG UNIV on September 13, 2010 heb.sagepub.com Downloaded from 504 Cognitive Behavioral Theories Used to Explain Injection Risk Behavior Among Injection Drug Users: A Review and Suggestions for the Integration of Cognitive and Environmental Models Karla Dawn Wagner, PhD Jennifer B. Unger, PhD Ricky N. Bluthenthal, PhD Valentina A. Andreeva, PhD Mary Ann Pentz, PhD Injection drug users (IDUs) are at risk for HIV and viral hepatitis, and risky injection behavior persists despite decades of intervention. Cognitive behavioral theories (CBTs) are commonly used to help understand risky injection behavior. The authors review findings from CBT-based studies of injection risk behavior among IDUs. An extensive literature search was conducted in spring 2007. In total, 33 studies were reviewed— 26 epidemiological and 7 intervention studies. Findings suggest that some theoretical constructs have received fairly consistent support (e.g., self-efficacy, social norms), whereas others have yielded inconsistent or null results (e.g., perceived susceptibility, knowledge, behavioral intentions, perceived barriers, perceived benefits, response efficacy, perceived severity). The authors offer some possible explanations for these inconsistent findings, including differences in theoretical constructs and measures across studies and a need to examine the environmental structures that influence risky behaviors. Greater integration of CBT with a risk environment perspective may yield more conclusive findings and more effective interventions in the future. Keywords: HIV risk behavior; injection drug use; cognitive behavioral theory; literature review I. PREVALENCE OF INJECTION RISK BEHAVIOR There are approximately 13 million injection drug users (IDUs) in the world (Aceijas, Stimson, Hickman, & Rhodes, 2004), and IDUs are at risk for a number of negative health Karla Dawn Wagner, University of California, San Diego. Jennifer B. Unger, Claremont Graduate University, San Dimas, California. Ricky N. Bluthenthal, RAND Corporation, Santa Monica, California. Valentina A. San Dimas, California....
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