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Knopp K, Huntington C, Owen J, Rhoades GK. Longitudinal Associations Among Adolescents' Sexual Attitudes, Beliefs, and Behaviors. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:233-241. [PMID: 36169774 DOI: 10.1007/s10508-022-02425-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
Youth sex and relationship education programs aim to improve adolescent well-being by changing their knowledge, beliefs, and attitudes regarding sex and their health. However, there is a gap in existing research linking these cognitive targets to relevant behaviors, and a particular dearth of data on links with sexual behaviors. The current study tested longitudinal links between cognitive factors related to sex (attitudes about sex, normative beliefs, risk-avoidant intentions, and confidence in refusal skills) and outcomes of sexual behaviors (recent sexual encounters, number of sexual partners, and frequency of condom use). Data were drawn from three waves of data from a panel study of US high-school students and were analyzed using cross-lagged structural equation modeling. We hypothesized direct, reciprocal links between intentions and behaviors, but this hypothesis was not supported. Instead, more conservative attitudes about sex emerged as the most consistent prospective predictor of fewer sexual encounters and sexual partners, though with small effect sizes (βs = - .08 to - .131, ps < .05). Further, bidirectional interrelationships were observed among several of the cognitive and behavioral variables over time. These results highlight attitudes about sex as a potentially useful intervention target, but also suggest that sex and relationship education curricula and evaluations should consider multiple pathways of links between cognition and behavior. Continued research is needed on causal links between adolescents' sexual attitudes, knowledge, intentions, and behavior.
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Affiliation(s)
- Kayla Knopp
- Department of Psychiatry, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | | | - Jesse Owen
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
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Zhang K, Chen S, Zhu S, Fang Y, Zou H, Cai Y, Cao B, Cao H, Chen Y, Hu T, Wang Z. Multifaceted Determinants of Sexual Intercourse with Non-Regular Female Sex Partners and Female Sex Workers among Male Factory Workers in China-A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16008. [PMID: 36498089 PMCID: PMC9736560 DOI: 10.3390/ijerph192316008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
With a stratified multi-stage sampling approach, 1361 male factory workers in the Longhua district of the Shenzhen Municipality of China were selected to investigate the multifaceted determinants of sexual intercourse with non-regular female sex partners (NRP) and female sex workers (FSW) among them. The results showed that 24.5% and 21.2% of participants had sexual intercourse with NRP and FSW in the past 6 months, respectively. More specifically, at the individual level, perceived higher job stress and maladaptive coping styles were linked with a higher likelihood of having sexual intercourse with NRP and FSW (adjusted odds ratios [AOR] ranged from 1.06 to 1.17). At the interpersonal level, those who had higher exposure to information related to sexual intercourse with NRP or FSW were more likely to have sex with these female sex partners (AOR: 1.08 & 1.11). At the social structural level, perceived social norms supporting multiple sex partnerships were linked with a higher likelihood of having sexual intercourse with NRP and FSW (AOR: 1.10 & 1.11). No interaction effects were found between the variables at different levels. Providing pre-employment training to clarify roles and job duties, introducing adaptive coping strategies, and addressing misconceptions of social norms are useful strategies to reduce sexual intercourse with NRP or FSW.
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Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Siyu Chen
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Shiben Zhu
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
- Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
| | - Yong Cai
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen 518060, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Yaqi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China
| | - Zixin Wang
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Leeper E, Sinha S, Roelse M, Huntington C, Owen J, Rhoades GK, Stanley SM. A Latent Class Analysis of Predictors for Engaging in Sex: A Study with Ethnically Diverse High School Students. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:1-16. [PMID: 35451914 DOI: 10.1080/0092623x.2022.2064947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual activity occurs among a large portion of young adults and adolescents, including high school students. While about 40% of high school students nationwide have engaged in sexual intercourse, more information is needed about how individual characteristics may relate to larger patterns of adolescent sexual behavior. This exploratory study utilized a latent class analysis (LCA) to identify clusters of high school students (N = 801) based on demographic characteristics, sexual refusal skills, healthy relationship skills, sociosexuality, internalizing symptoms, alcohol use, various forms of social support (i.e., parents, friends, teachers), and sexual activity at baseline to predict their sexual behavior at a 6-month follow-up. Four unique latent classes were identified based on these baseline predictors. Distinctions in the profiles of high schoolers varied significantly by internalizing symptoms, race/ethnicity, sexually conservative attitudes, and social support in the prediction of adolescent sexual activity at 6-months. This study contributes to the investigation of demographic, social, psychological, attitudinal, and behavioral factors that may distinguish high school students from one another in terms of their longitudinal rates of sexual activity.
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Affiliation(s)
- Emily Leeper
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Sree Sinha
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Meghan Roelse
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Charlie Huntington
- Center for Marital and Family Studies, Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Jesse Owen
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Galena K Rhoades
- Center for Marital and Family Studies, Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Scott M Stanley
- Center for Marital and Family Studies, Department of Psychology, University of Denver, Denver, Colorado, USA
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Cederbaum JA, Lee WJ, Okine L, Duan L, Lee JO. Using the Theory of Reasoned Action to examine grandparent and maternal substance use on the cannabis use of children of teen mothers. Drug Alcohol Depend 2021; 228:109019. [PMID: 34509738 PMCID: PMC8713458 DOI: 10.1016/j.drugalcdep.2021.109019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Parental cannabis use is associated with increased risks of cannabis use among offspring, yet few studies have explored the mechanisms influencing intergenerational continuity in cannabis use. To understand the mechanism by which intergenerational cannabis use is influenced, this work explores cannabis use across three generations using a family expansion of the Theory of Reasoned Action (TRA). METHODS Data come from the Young Women and Child Development Study which began when teen mothers were pregnant and followed mother-child dyads for 17 years (N = 240). Constructs include cannabis use of grandparents, mothers, and teens, and TRA constructs of behavioral and normative beliefs, intention, and behavior. Hypotheses were tested using Structural Equation Modeling. RESULTS Grandfather's cannabis use was significantly linked to mother's normative beliefs (β = .22, p = .006), but not attitudes (β = .12, p = .182). Teen mothers' attitude was associated with intention (β = .79, p < .001); intention predicted cannabis behavior (β = .61, p < .001). Teen mothers' cannabis use was predictive of adolescent's attitude (β = .21, p = .002); attitude predicted intention (β = .73, p < .001) and intention predicted behavior (β = .60, p < .001). DISCUSSION Parents play an influential role in the cannabis use behaviors of adolescents. Future work should consider interventions that target both parent and adolescents, increasing knowledge and skills related to parent-child communication, parental monitoring, and positive parental role modeling to reduce intergenerational continuity of cannabis use.
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Affiliation(s)
| | - Woo Jung Lee
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Lucinda Okine
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Lei Duan
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Jungeun Olivia Lee
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
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Haruna H, Okoye K, Zainuddin Z, Hu X, Chu S, Hosseini S. Gamifying Sexual Education for Adolescents in a Low-Tech Setting: Quasi-Experimental Design Study. JMIR Serious Games 2021; 9:e19614. [PMID: 34636739 PMCID: PMC8548970 DOI: 10.2196/19614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 01/09/2021] [Accepted: 05/31/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Sexual education has become increasingly important as unhealthy sexual practices and subsequent health risks become more prevalent during adolescence. Traditional sex education teaching methodologies are limiting for digital natives exposed to various digital technologies. Harnessing the power of technology applications attractive to the younger generation may be a useful approach for teaching sex education. OBJECTIVE The aim of this study was to improve sexual health knowledge and understanding of the problems associated with unhealthy sexual practices and address sexual and reproductive health challenges experienced in a low-tech setting. METHODS A participatory design approach was used to develop the digital gamified methodology. A sample of 120 secondary school students aged 11-15 were randomly assigned to either experimental or control group for each of the 3 teaching approaches: (1) gamified instruction (actual serious games [SG] in teaching); (2) gamification (GM; making nongames, such as game-like learning); and (3) traditional teaching (TT) methods. RESULTS The SG and GM approaches were more effective than TT methods in teaching sexual health education. Specifically, the average scores across groups demonstrated an increase of mean scores from the pre- to posttest (25.10 [SD 5.50] versus 75.86 [SD 13.16]; t119=41.252; P<.001 [2 tailed]). Analysis of variance indicated no significant differences across groups for pretest scores (F2,117=1.048, P=.35). Significant differences across groups were evident in the posttest scores. Students in the SG and GM groups had higher average scores than the TT group (F2,117=83.98; P<.001). Students reported increased learning motivation, attitude, know-how, and participation in learning (P<.001) when using SG and GM approaches. CONCLUSIONS Digital health technologies (particularly teaching and learning through gamified instruction and other novel approaches) may improve sexual health education. These findings may also be applied by practitioners in health care settings and by researchers wishing to further the development of sex education.
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Affiliation(s)
- Hussein Haruna
- Writing Lab, Institute for the Future of Education, Tecnologico de Monterrey, Monterrey, Mexico.,Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong
| | - Kingsley Okoye
- Writing Lab, Institute for the Future of Education, Tecnologico de Monterrey, Monterrey, Mexico
| | - Zamzami Zainuddin
- Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong
| | - Xiao Hu
- Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong
| | - Samuel Chu
- Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong
| | - Samira Hosseini
- Writing Lab, Institute for the Future of Education, Tecnologico de Monterrey, Monterrey, Mexico.,School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
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Yang S, Jike C, Pei R, Liu D, Yu G, Wang J, Zhong S, Jike E, Jia P, Wang Z. Perceptions of social norms played an important role in the occurrence of casual sex among Yi minority residents in China: a population-based study. AIDS Care 2021; 34:908-915. [PMID: 34011235 DOI: 10.1080/09540121.2021.1929814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Liangshan is one of the areas severely affected by both HIV and poverty in China. We investigated associations between perceptions of social norms related to casual sex and the occurrence of casual sex in lifetime among Yi minority people. Participants were Yi minority people aged 15-49 years old living in Liangshan. Of the participants, 11.8% were confirmed to be HIV-positive. About half of the participants (46.6%) had engaged in casual sex in their lifetime. All six perceptions of social norms were significantly associated with the presence of casual sex in lifetime. They were acceptable of belife: (1) casual sex in general (OR: 15.03), (2) not to use condom during casual sex (OR: 1.58), (3) a Yi woman to have more than one sex partner(OR: 4.54), (4) a Yi man to have more than one sex partner(OR: 4.51), (5) premarital sex with casual sex partner (OR: 4.29), and (6) extra-marital sex with casual sex partner (OR: 3.23). Casual sex may play an important role in facilitating HIV transmission among Yi minority people. Future interventions should consider making use of the Yi clan system to change perceptions of social norms related to casual sex.
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Affiliation(s)
- Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China
| | - Chunnong Jike
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, People's Republic of China
| | - Rong Pei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Gang Yu
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, People's Republic of China
| | - Ju Wang
- Liangshan Prefecture Center for Disease Prevention and Control, Xichang, People's Republic of China
| | - Shiyong Zhong
- Butuo County Center for Disease Prevention and Control, Butuo, People's Republic of China
| | - Ersha Jike
- Butuo County Center for Disease Prevention and Control, Butuo, People's Republic of China
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China.,Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Zixin Wang
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
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Flesia L, Cavalieri F, Angelini S, Bottesi G, Ghisi M, Tonon E, Roldan AP, Di Nisio A, Garolla A, Ferlin A, Foresta C. Health-Related Lifestyles, Substance-Related Behaviors, and Sexual Habits Among Italian Young Adult Males: An Epidemiologic Study. Sex Med 2020; 8:361-369. [PMID: 32389594 PMCID: PMC7471067 DOI: 10.1016/j.esxm.2020.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/05/2020] [Accepted: 03/24/2020] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Young adult males are more likely to demonstrate health-risk behaviors than other individuals. The use of specific data about health-risk behaviors within this population might be important to promote effective preventive psychosocial and educational programs and interventions. AIM To provide a detailed description of health-related lifestyles, substance-related behaviors, and sexual habits that can negatively affect fertility, sexual sphere, and health in a large sample of Italian young adult males. METHODS A sample comprising 2,170 males aged 18-21 years, attending the last year of high school, was administered an online questionnaire made up of 39 multiple-choice questions. The questionnaire explored health-related lifestyles, substance-related behaviors, and sexuality and sexual habits. Descriptive analyses were conducted. MAIN OUTCOME MEASURE The outcome measures included data about health-related lifestyles, substance-related behaviors, and sexuality and sexual habits reported by Italian young adult males. RESULTS Health-related lifestyles: 92.9% of the sample reported practicing some physical activity during the week. 90.3% declared a Mediterranean diet and 8.1% a hyperproteic diet. Substance-related behaviors: 33.8% of the sample reported having smoked tobacco at least once in their lives; among them, 71% reported current daily smoking. 40.2% declared drinking alcohol from 5 to 7 days in a week. 32.9% of the sample reported currently using a substance. Sexuality and sexual habits: 97.1% of the sample self-defined themselves as heterosexual. 73.3% of participants rated their knowledge about sexuality as "excellent/good," 58.7% about sexually transmitted infections. Only 4.8% reported having had a seminal liquid examination. Half of the sample (52.2%) declared having had sexual intercourses, in the largest proportion protected sex. 14.7% of the sample reported having at least one sexual dysfunction. 88.6% of participants reported having used pornography, 18.7% every day. CONCLUSION The present study highlighted the need to empower the number and efficacy of preventive interventions to promote health-related behaviors among Italian young male population. Flesia L, Cavalieri F, Angelini S, et al. Health-Related Lifestyles, Substance-Related Behaviors, and Sexual Habits Among Italian Young Adult Males: An Epidemiologic Study. Sex Med 2020;8:361-369.
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Affiliation(s)
- Luca Flesia
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy.
| | - Francesca Cavalieri
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Stefano Angelini
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Enrico Tonon
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Agustina Perez Roldan
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | | | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
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Evaluating the Short-term Impact of Media Aware Parent, a Web-based Program for Parents with the Goal of Adolescent Sexual Health Promotion. J Youth Adolesc 2019; 48:1686-1706. [PMID: 31304562 DOI: 10.1007/s10964-019-01077-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 06/28/2019] [Indexed: 12/28/2022]
Abstract
Parents can significantly impact their adolescent child's sexual and relationship decision-making, yet many parents are not effectively communicating with their teens about these topics. Media are sexual socialization agents for adolescents, which can encourage early or risky sexual activity. Media Aware Parent is a web-based program for parents of adolescents that was designed to improve adolescent sexual health by providing parents with the skills to have high-quality communication with their child about sex and relationships as well as to mediate their media usage. This web-based randomized controlled trial was conducted in 2018-2019 with parent-child pairs (grades 7, 8, or 9; N = 355) from across the United States. Parent participants identified as mostly female (75%), white/Caucasian (74%); and non-Hispanic (92%). The youth sample was more balanced in terms of gender (45% female) and more diverse with respect to race (66% white) and ethnicity (86% non-Hispanic). Twenty-eight percent of the families identified as a single parent household, and 35% of the youth were eligible for free school lunch. The present study assessed the short-term effects of Media Aware Parent on parent-adolescent communication, adolescent sexual health outcomes, and media-related outcomes across a one-month timeframe. Parents were randomly assigned to the intervention (Media Aware Parent) or active control group (online access to medically-accurate information on adolescent sexual health). The intervention improved parent-adolescent communication quality as rated by both parents and youth. Youth were more likely to understand that their parent did not want them to have sex at this early age. Youth reported more agency over hook-ups, more positive attitudes about sexual health communication and contraception/protection, and more self-efficacy to use contraception/protection, if they decide to have sexual activity. The intervention improved media literacy skills in both parents and youth, and resulted in youth being more aware of family media rules. Parents gave overwhelming positive feedback about Media Aware Parent. The results from this pretest-posttest study provide evidence that Media Aware Parent is an effective web-based program for parents seeking to enhance parent-adolescent communication and media mediation, and positively impact their adolescents' sexual health outcomes.
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