Attachment B - Question Justification

ATTACHMENT B
QUESTION JUSTIFICATION

Other Outcome

Sexual Risk
Outcome

Intermediate
outcome

Implementation
Outcome

Covariate

Tracking

Question #

How question data will be used

Purpose

SECTION 1. YOU AND YOUR BACKGROUND

1.1

Date of Birth





1.3

Gender





Race and Ethnicity





1.4-1.5

1.2

1.6, 1.6a.
1.7, 1.8

1.9, 1.10

1.11

1.12

Grade Level

Exposure to Health Education
and Helpfulness of Source

There are marked differences in sexual
activity among teens by age, gender, and
race/ethnicity. These differences in sexual
behavior are reflected in the large
differences in reproductive outcomes such
as the pregnancy, birth and abortion rate by
teens’ age and race. (Browning et al. 2004;
Abma et al. 2004; Guttmacher 2006;
Santelli et al. 2000; Blinn-Pike 1999; Watt
and Nagy 2000)
This question is important to determine in
what grade the respondent entered the
pregnancy prevention program.



These questions will be used to assess
teens’ exposure to the messages presented
in the program (whether through the
program or outside sources). These
questions will also assess any services
received by teens in the control group.



Emotional Stress



These questions will be used to assess the
program’s effect on teens’ mental health
and emotional stress, which in turn may
affect their later health risk behaviors.

Health Promotion Orientation



This question will be used to assess the
program’s effect on teens’ health attitudes.



There is an extensive literature that shows
that positive expectations for future
education lead to delayed sex, decreased
frequency of sex, a decreased number of
partners, an increase in condom use, and
decreased pregnancy and childbearing.
(Beuhring et al., 2000, Halpern, et al.,
2000, Lanctot, et al., 2001, Moore, et al.,
1998)

Expectation for Future
Education

A-2

Other Outcome

Sexual Risk
Outcome

Intermediate
outcome

Implementation
Outcome

Covariate

Tracking

Question #

How question data will be used

Purpose

SECTION 2. FAMILY

2.1, 2.2, Household Structure/Living
2.3, 2.12a, Situation/ Marital Status of
2.12b
Parents

2.4, 2.6,
2.9, 2.11

Parent-Child Relationship
Quality

2.5, 2.10

Parents’ Employment Status

2.7, 2.8

Age of Biological Mother and
Her Oldest Child

2.13-2.16

Parental Supervision/
Monitoring



There is a well established link between
family structure and the probability that
youth will engage in sexual activity. While
some researches argue that this relationship
can be explained by mediating factors such
as mother-child relationship and mother's
attitude toward sex, others argue that there
is a direct link, independent of such
mediating factors. (Sturgeon 2008; Davis
and Friel 2001; Pearson et al. 2006)



There is an extensive literature evaluating
the relationship between parent-child
connectedness and teen sexual activity. All
but a few studies indicate that parent-child
closeness is negatively associated with
pregnancy risk, early sexual initiation,
number of sexual partners and consistent
use of contraception. (Miller et al. 2001)





These questions will be used to construct
indicators of socioeconomic status, which
will serve as control variables.
Socioeconomic status is correlated with the
probability that youth will engage in sexual
and other high-risk behaviors.
(Forste and Haas 2002; Santelli et al. 2000;
Miller et al. 2001)



These questions will be used to assess
whether the respondent’s mother had a
child as a teen, which may help predict the
respondent’s sexual risk behaviors.



These questions will be used to measure
the perceived level of parental supervision.
Parental monitoring and supervision have
been found to be inversely related to a
number of problem behaviors among
adolescents, including early sexual debut,
number of sexual partners, and pregnancy
risk. (Miller et al. 2001; Rodgers 1999; Li
et al. 2000; Sieverding et al. 2005)

A-3

Other Outcome

Sexual Risk
Outcome

Intermediate
outcome

Implementation
Outcome

Covariate

Tracking

Question #

How question data will be used

Purpose

SECTION 3. VIEWS AND PERCEPTIONS

3.1

3.2

3.3, 3.4

3.5

3.6, 3.6a

Attitudes Towards Abstinence
and Teen Sex

Future Goals and Expectations

Attitudes Towards Teen
Pregnancy

Refusal Skills

Likelihood of Pregnancy

A-4



Teens’ attitudes about sex and abstinence
are associated with the intension to have
sex and with early initiation of sexual
activity, where a more positive/less
permissive attitude towards sex serves as a
protective factor. (Buhi and Goodson 2007;
Gillmore et al. 2002; Carvajal et al. 1999;
Cleveland 2003; DiIorio et al. 2004; Meier
2003)



This measure will be used to assess the
program’s effect on their goals for the
future, which in turn may influence the
decisions they make about sexual risk
behaviors.



Teens with a more positive attitude towards
pregnancy are more likely to become
pregnant. Attitudes towards teen pregnancy
are also related to contraceptive use among
females, where those with a higher
motivation to avoid pregnancy are more
likely to use contraception. (Ryan et al.
2007; Bruckner et al. 2004; Jaccard et al.
2003)



Adolescent males who received instruction
on “how to say no to sex” as part of an
AIDS education were more likely to use a
condom, had fewer sexual partners and a
lower frequency of sexual intercourse. (Ku
et al. 1992)



These questions will be used to measure
the program’s effects on teens’ intentions
to get pregnant (for girls) or cause a
pregnancy (for boys), which in turn may
shape their future sexual risk behaviors.

Knowledge of STDs and the
3.7-3.13a, Effectiveness of Contraceptives
3.16
in Reducing Risk and Teens’
Confidence in their Knowledge

3.14, 3.15

Attitudes Towards
Contraception

3.17, 3.18

Likelihood of Contracting
STDs

3.19-3.23

Intention to Engage In/Abstain
From Sexual Activity; Intention
to use birth control

3.24-3.26 Dating Status

A-5

Other Outcome

Sexual Risk
Outcome

Intermediate
outcome

Implementation
Outcome

Covariate

Tracking

Question #

How question data will be used

Purpose



Findings on the relationship between
knowledge of STDs and prevention and
teen sexual activity are inconsistent.
However, according to Rock et al. 2005,
this might be due to the fact that prior
studies focused on objective knowledge,
and ignored teen’s confidence in their
knowledge. (Rock et al. 2005; Boyer et al.
1999; DiClemente et al. 1996; DiClemente
et al. 1992)



Positive attitude towards contraception has
been linked to an increased likelihood of
contraceptive use among sexually active
adolescents (inconsistent and consistent use
as opposed to no use). Therefore, programs
that can successfully shape teens’ attitude
towards contraception are likely to reduce
the risk of pregnancy and STDs among
sexually active youth. (Bruckner et al.
2004; Sheeran et al. 1999; Ryan et al.
2007)



These measures will be used to assess the
program’s effect on teens’ perceived
likelihood of contracting STDs, which in
turn may predict their future involvement
in sexual risk behaviors.



Intention to engage in sexual activity is the
single most stable predictor of initiation of
sexual intercourse and of participation in
sexual behavior. (Buhi and Goodson 2007)



Dating during early adolescence is
associated with an increased likelihood of
sexual initiation in adolescence. At the
same time more than half of sexually active
teens had at least one sexual experience
outside of a romantic relationship
(Thornton 1990; Cooksey et al. 2002;
Manning et al. 2005).

3.27

Other Outcome

Sexual Risk
Outcome

Intermediate
outcome

Implementation
Outcome

Covariate

Tracking

Question #

How question data will be used

This question will be used to identify teens
with and without prior sexual experience.
Sexually inexperienced teens will receive
an alternate version of Section 4 of the
questionnaire and will not be asked about
sexual activity.



Ever Had Sex

Purpose

SECTION 4&5. EXPERIENCES AND BEHAVIORS – SEXUALLY ACTIVE (only questions that do not appear in the
version for non-sexually active teens are listed below)
4.1



Confirmation - sexual activity

4.2-4.4,
4.14, 4.15, Initiation of Sexual Activity
4.19, 4.21



4.5,4.7,
4.9, 4.17,
4.22

Frequency of Sexual Activity



4.6, 4.16,
4.20

Number of Sexual Partners



4.8, 4.10,
4.11, 4.12, Contraceptive Use
4.18, 4.23
4.13
5.1 -5.2d
5.3
5.4-5.6

These are the primary outcome measures
for the study. They will be used to control
for baseline sexual experiences.
Furthermore, baseline sexual activity will
be used to stratify the sample and to allow
differential program impact among the
sexually experienced and inexperienced
teens at baseline.



Strictly Sexual Relationship



Pregnancy



Spoken To a Doctor About
Sexual Health



STDs



Confirming that respondents are
completing the correct Part B.

SECTION 4&5. EXPERIENCES AND BEHAVIORS – NON-SEXUALLY ACTIVE (only questions that do not appear in
the version for sexually active teens are listed below)
4.1

Confirmation - No Sexual
Activity



A-6

Confirming that respondents are
completing the correct Part B.

4.2, 4.3

4.4, 4.5

4.9-4.10

Perceived Embarrassment for
Teen Virgins/Teen Pregnancy

Importance of
Boyfriend/Girlfriend with Peers

Access to Electronic Media

Parental Monitoring of Use of
4.13-4.15
Electronic Media

4.16

Perceived Frequency of
Sexting Among Teens

A-7

Other Outcome

Sexual Risk
Outcome

Intermediate
outcome

Reasons Not to Have Sex

Religious Beliefs

4.12

Implementation
Outcome

Graduation Expectations

4.6-4.8

4.11

Covariate

Tracking

Question #

How question data will be used

Purpose



This measure will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



These measures will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



These measures will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



These measures will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



This measure will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



This measure will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



These measures will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



There is a rich body of research pointing to
a strong association between teens’
behavior and the behavior or the perceived
norms of their peers.

4.17- 4.20

5.1, 5.2

Frequency of and Reasons For
Sexting

Perception of Adult Caring

5.3-5.5

Physical Safety

5.6-5.7

Involvement in Extracurricular
Activities

Other Outcome

Sexual Risk
Outcome

Intermediate
outcome

Implementation
Outcome

Covariate

Tracking

Question #

How question data will be used

Purpose



The relationship between the use of
technology among youth and sexual
behavior is an emerging topic of interest
that has not yet been heavily researched.
Questions will be asked of non-sexually
active youth to examine this relationship,
and identify potential pathways leading to
the transition from non-sexually active to
sexually active, and factors affecting the
rate of that transition.



These measures will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



These measures will be used to provide
additional information on the
characteristics of youth who remain
abstinent.



These measures will be used to provide
additional information on the
characteristics of youth who remain
abstinent.

SECTION 6. ALCOHOL AND DRUG USE – both sexually active and non-sexually active

6.1- 6.3

Alcohol



6.4, 6.5

Drug Use



A-8

The consumption of cigarettes, alcohol and
drug use among adolescents is associated
with early initiation of sexual activity as
well as sexual risk taking. While much of
the association can be explained by
common risk factors that predispose teens
to both alcohol misuse and risky sexual
behavior, there exists a direct link between
alcohol consumption and post-drinking
risky sexual behavior. This direct link is
strongest among teens who expect alcohol
consumption to lead to risky sex. (Tapert
et al. 2001, Li et al. 2001, Boyer et al.
1999; Fergusson and Lynskey 1996; Sen
2002; Dermen 1998 et al.; Santelli et al.
2001)

Other Outcome

Sexual Risk
Outcome

Intermediate
outcome

Implementation
Outcome

Covariate

Tracking

Question #

How question data will be used

Purpose

SECTION 7. FRIENDS AND RELATIONSHIPS – both sexually active and non-sexually active

7.1

Peer pressure



7.2

Peer support



A-9

There is a rich body of research pointing to
a strong association between teens’
behavior and the behavior or the perceived
norms of their peers. While some of this
observed relationship is the result of teens
selecting peers who have similar values, a
weaker, but stable relationship remains
after taking into account the selection
process. These questions will allow us to
identify teens under a possible positive or
negative influence of their peers as well as
the level of involvement with friends.
(Jaccard et al. 2005; Buhi and Goodson
2007; Kinsman et al. 1998; Sieving et al.
2006)

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