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Inconsistent findings regarding the predictive validity of perceptions of risk for a sexually transmitted disease (STD) and HIV may be related to the use of nonspecific measures. The objective of this study was to determine whether more specific measures of perceptions of risk for STDs and HIV are associated with intentions to use a condom. We interviewed 490 male and female adolescents, 14 to 19 years old, from a free municipal STD clinic. Controlling for whether a condom was used at last sex, the association between perceptions of risk for an STD and HIV with a casual sex partner and intentions to use a condom with a casual sex partner was significant ([[beta].sub.HIV] = .14, p < .01, and [[beta].sub.STD] = .20, p < .01), as was the association between perceptions of risk for an STD and HIV with a main sex partner and intentions to use a condom with a main sex partner ([[beta].sub.HIV] = .31, p < .001, and [[beta].sub.STD] = .32, p < .001). This supports the continued inclusion of this construct in models of sexual and other health-related behaviors.

This article examines the relationship between personal experience with risk and subsequent risk judgements in young adults and adolescents. Findings indicate that subjects who have experienced a risky behavior or natural disaster are less likely to believe that they could be harmed by related negative outcomes than inexperienced individuals.

Objectives. This study determined how often primary care physicians ask adolescents about smoking. Methods. We surveyed a stratified random sample of community-based, board-certified California physicians, using a mailed questionnaire. Results. Overall, physicians (n = 343; 77% response rate) screened younger adolescents for regular smoking during 71.4% (95% confidence interval [CI] = 67.9, 74.9) of routine physical exams and older adolescents during 84.8% (95% Cl = 82.3, 87.4) of such visits. For acute-care visits, the screening rates were 24.4% (95% Cl = 20.6, 28. 1) for younger and 40.2% (95% Cl = 36.4, 44.0) for older adolescents. Physicians asked 18.2% (95% Cl = 15.2, 21.3) of younger and 35.6% (95% Cl = 32.0, 39.1) of older adolescents about experimental smoking. Screening varied by specialty. Conclusions. These data imply that physicians are missing opportunities to screen adolescents for smoking. (Am J Public Health. 1997;87: 1341-1345)

Many adolescents and their families fail to keep their medical appointments, thereby negatively affecting the efficiency of the medical care and practice. In a prospective observational study conducted in a medical clinic, 166 randomly selected lower-middle and middle class adolescents were asked about their beliefs regarding their follow-up appointment and the constructs of the Health Belief Model. Forty-eight percent of the adolescents did not keep their appointments. A strong correlation was shown between social class and appointment-keeping. Neither parental involvement nor age had any effect on whether the adolescent kept his or her follow-up appointment. Such a failure is a barrier to care, so the reasons for missed appointments should be ascertained, and clinicians should work with adolescents to help them understand the adverse consequences of their failure to keep appointments., Study objectives. To identify the sociodemographic and Health Belief Model predictors of follow-up appointment-keeping behavior. Design. Prospective observational study. Settings. General adolescent medical clinic. Patients and measurements. Sequential sample of 166 adolescents (aged 12 to 20 years, mean = 15.9 years) enrolled in the clinic. The population was 75% female; the racial-ethnic distribution of the sample was 37.9% black, 29.8% white, 11.2% Asian, 14.3% Hispanic, and 6.8% "other" background. Subjects&apos; social class was primarily lower-middle (60.5%) and middle class (28.6%). A subsample was randomly assigned to be interviewed about their beliefs concerning their follow-up appointment and the constructs of the Health Belief Model. Results. Forty-eight percent of the total sample failed to keep their follow-up appointment. There was a significant positive correlation between social class and appointment keeping (F = 5.07; df = 5,110; P = .026). Neither race-ethnicity nor who made the appointment were found to be associated with follow-up appointment-keeping. The only construct of the Health Belief Model found to be significantly associated with appointment keeping was the number of potential negative outcomes resulting from noncompliance perceived by the subject (F = 6.85; df = 1,74; P = .011). Conclusions. Clinicians must work with adolescents to improve their understanding of the potential negative outcomes associated with noncompliance to improve appointment-keeping behavior. Pediatrics 1993;92:20-23; adolescent, appointinent-keeping, health care.

Trust is an essential component of romantic relationships. It is not understood how youth respond to a relationship stressor, which may impact trust, such as perceiving to be at risk for a sexually transmitted infection or their partner has other sex partners. We used a system science approach to examine feedback between trust and prorelationship behaviors within adolescent relationships. A prospective cohort of clinic-recruited young women (N = 122), aged 16–19 years, completed daily questionnaires on partner-specific feelings and risk perceptions for 18 months. Relationship stressor defined as either perceiving the risk of sexually transmitted infection from a partner or partner had other sex partners. Prorelationship behaviors were more time spent with partner, sex with partner, and/or gift from partner. Time-lagged generalized estimating equation models were used to examine whether a relationship stressor is associated with a decrease in trust and whether prorelationship behaviors changed following the stressor. Experiencing a stressor was associated with threefold increased odds of having a decrease in trust in the same week (odds ratio [OR] = 3.30, 95% confidence interval [CI]: 2.30–4.72). Trust increased significantly the week following the stressor (OR = 2.09, 95% CI: 1.54–2.85). An increase in trust relative to the week of the stressor was associated with a 65% increase in prorelationship behavior in the week following the stressor (OR = 1.65, 95% CI: 1.20–2.26). Data uniquely show that trust is impacted following a relationship stressor and that youth increase prorelationship behaviors following a drop in trust. The findings suggest that adolescents prioritize maintaining trust, which may impact engagement in protective health behaviors. [ABSTRACT FROM AUTHOR]