Youth Empowerment Information, Data Collection, and Exploration on Avoidance of Sex (IDEAS)-Pre-Test

Part 2 Youth IDEAS Survey Pretest Protocol: Survey and Debrief Topic Guide

Contents

Protocol for welcoming participants 2

YOUTH SURVEY PART 2 with debrief prompts 6

debrief wrap-up 46

Protocol for welcoming participants

1. CHECK IN EACH PARTICIPANT

   • NOTE TIME IN IF ANYONE LATE

   • HAND OUT SURVEY PACKET, INSTRUCT THEM TO PLEASE WAIT TO OPEN THEM

   • ONCE EVERYONE HAS ARRIVED, START THE GROUP INTRODUCTION

2. GROUP INTRODUCTION: Thanks for helping us out today by sharing your opinions about our survey. My name is [NAME], and these are my colleagues, [NAMES]. We work for a company called Mathematica. Mathematica is conducting a national survey, sponsored by the U.S. Department of Health and Human Services to learn more about the views of teens age 14-18, young adults age 19-24, and parents of teens on teen sexual risk behaviors, as well as opinions and experiences about sex education.

We’re here today because we want to test out the survey with you. You can help us make sure the questions are clear, and to get a sense of how long it takes to complete the survey. Your feedback will help us improve the questions we ask and the instructions we provide to people who participate in the study. We consider each of you an expert in how well our survey works for people your age and thank you again for your help.

OVERVIEW OF DAY: The pretest will take about 1.5 hours total today. The first step will be for you to fill out the actual survey.

When you’re done, we’d like to take a look at your survey to see if you marked anything as confusing. That way we can ask for your feedback to make the survey better. We’ll ask for your feedback in a small group for about 45-60 minutes, asking you particular questions about how easy the survey was to understand and fill out. While we will review your answers to see if you had any notes about questions, we will NOT specifically ask you to reveal any of your answers to anyone in the group.

We will be checking the time a lot today because one of our goals in running this pretest is to determine how long the different steps take. Please don’t let our checking the time make you feel rushed or under any pressure. Please take all the time you need to complete the survey.

3. Before you begin the survey, I need to tell you that your participation is completely voluntary and, I’d like to be sure you are aware of a few things before we begin.

1. First, you can skip any question you do not want to answer in the survey and you can decide not to answer any question during our discussion afterwards.

2. Second, your responses will not be shared with anyone outside of the study team.

3. Third, when we write about what we learned from you today we will NOT use your name with any of the information you provide in the survey or in our discussion.

We will be recording the group discussion and will be taking notes as a back-up. This is to ensure that we remember all of your thoughts and ideas when we make improvements to the survey. As a reminder, we will not share this recording with anyone unrelated to the project, and will destroy it once the study is finished.

Does anyone have any questions at this point?

4. USE SCRIPTED INTRODUCTION:

Now, please take the survey out of the packet. Do not begin until we tell you to. On the front page we will ask you to record the time that you begin the survey. When you are done, please raise your hand and someone from the team will come around to mark your completion time and collect the completed survey.

As you fill out the survey, please use the highlighter or pen to mark any words that you do not understand or that seem out of date. If you think using different words in a question would make it less confusing or more relatable, please write that down.

In the margins, please also leave us notes about:

-Any questions you thought were confusing.

-Anything you want to ask about how to answer a question.

When we collect your survey, we will briefly look at them to see if we should ask some questions during the discussion. We won’t focus on your answers to individual questions. We will give your surveys back to you after we are done so that you can have them for the discussion.

We will wait until everyone completes to begin the small group discussion. If you finish before others, you can use the time to use the restroom or take a break.

You may notice that the question numbering is out of order. That was intentional, so you do not have to worry about that as you complete the survey.

This survey will later be programmed as a web survey. There are several questions that will only get asked based on answers given at prior questions and this will happen automatically in the programming of the survey. Since this pretest is on paper and we don’t have the benefit of having the computer skip us automatically, we have tried to show these skips in red text at the start of some of the questions. If the red text at the start of the question fits your prior responses, you should answer the question. Otherwise, you should leave the question blank and go to the next question.

Do you have any questions before we begin?

Okay, it is [TIME]. Please write that on the front cover and start.

5. HAVE PARTICIPANTS BEGIN. TIME HOW LONG IT TAKES EACH PARTICIPANT TO FINISH THE SURVEY, WRITING THE FINISH TIME ON THE FRONT COVER.

6. WHEN PARTICIPANT IS DONE WITH THE SURVEY, WRITE FINISH TIME ON THE FRONT COVER. COLLECT PACKET.

ASK THE RESPONDENTS FOR THEIR SURVEYS SO YOU CAN REVIEW AND RECORD COMMENTS ON THE DEBRIEF GUIDE BELOW. NOTE ANY QUESTIONS THEY MARKED/COMMENTED ON AND ANY QUESTIONS THEY LEFT BLANK THAT SHOULD HAVE BEEN ANSWERED. WHEN YOU ARE DONE, GATHER THE GROUP BACK TOGETHER AND RETURN THEIR COPIES OF THE SURVEY (JUST FOR DEBRIEF).

7. TIME DEBRIEFING. WRITE START AND FINISH TIME ON THE FRONT COVER OF THIS DEBRIEFING GUIDE, WITH DATE AND SESSION TIME. DO NOT GO OVER TIME.

BEGIN DISCUSSION. SESSIONS ARE BEING AUDIORECORDED. CHECK THAT RECORDING HAS BEGUN.

1. Some of the topics we talk about today may be things you don’t talk about a lot with your friends or family. If we ask anything that you don’t want to answer or that makes you feel uncomfortable – please just let me know and we can skip that question.

2. I will use the copy I made with notes from your surveys as a reference for the rest of our time today. Please know we are not concerned about your personal answers to the survey questions. As we go through specific questions, if you feel that you have to reveal your response in order to answer, and you do not feel comfortable doing so, you do not have to answer the question. My goal for today is to get your feedback on how these questions were worded and what your thought process was when you answered these questions, not what your actual answers were.

3. Do you have any questions before we begin?

SURVEY DEBRIEFING QUESTIONS:

We are now going to walk through section by section. I have specific questions, but please let me know as we are going through if there were questions that you had.

Before we begin, does anyone want to share their overall thoughts on the survey? Did anything stick out to you in particular?

OMB Control No: 0970-0355

Expiration Date: 05/31/2021

YOUTH SURVEY PART 2

Youth Empowerment IDEAS

Youth Survey Part 2

Ages 14-18

THE PAPERWORK REDUCTION ACT OF 1995

Public reporting burden for this collection of information is estimated to average 90 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The collection of this information is voluntary and responses will be kept private to the extent allowed by law. The OMB number for this information collection is 0970-0355 and the expiration date is 05/31/2021.

PRETEST

Part 2

SECTION A – DEMOGRAPHICS

A2. How old are you?

YEARS

A3. Are you Hispanic or Latino?

 Yes 1

 No 0

A4. What is your race?

Select one or more

 American Indian or Alaska Native 1

 Asian 2

 Black or African American 3

 Native Hawaiian or Pacific Islander 4

 White 5

A5. What sex were you assigned at birth?

Select one only

 Male 1

 Female 2

 Don’t know 3

 Prefer not to answer 4

A6. Which of the following do you currently think of yourself as?

Select one only

 Male 1

 Female 2

 Something else 3

 Prefer not to answer 4

A7. People are different in their sexual attraction to other people. Which best describes your feelings? Are you . . .

Select one only

 Only attracted to females 1

 Mostly attracted to females 2

 Equally attracted to females and males 3

 Mostly attracted to males 4

 Only attracted to males 5

 Questioning/not sure 6

These next few questions are about the people you live with now. When answering these questions, please think about the place you consider to be your main home right now, the place where you spend the most time. If you spend about equal time in two homes, such as with each of your parents who do not live together, answer about the home you consider to be your main one.

A8. Which of the following best describes the relationship between your biological mother and biological father?

Select one only

 They are married to each other 1

 They were married to each other but are now separated or divorced 2

 They were never married to each other 3

 One or both of my biological parents has died 4

 Don’t know 5

NO RESPONSE M

A9. Who lives with you in your home?

Select one or more

 Your biological mother 1

 Your biological father 2

 An adoptive mother 3

 A stepmother 4

 A foster mother 5

 A second mother 6

 An adoptive father 7

 A stepfather 8

 A foster father 9

 A second father 10

 Your parent’s partner, boyfriend, or girlfriend 11

 Any grandmothers 12

 Any grandfathers 13

 Any brothers or sisters 14

 Any aunts, uncles, or other relatives 15

 Your spouse 16

 Your boyfriend or girlfriend 17

 Your children or your partner’s children 18

 Any other people you are not related to 19

A10. In the last 12 months, were you ever employed at a job for pay? Please include full time, part time, and a temporary or summer job.

 Yes 1 GO TO A11

 No 0 GO TO A12a

ONLY ANSWER IF YOU WERE EMPLOYED AT A JOB FOR PAY IN THE PAST 12 MONTHS

A11. In the last 12 months, did you work all full-time, all part-time, or some of each?

Select one only

 All full time 1

 All part time 2

 Some of each 3

A12a. The next questions are about religion. What religion are you now, if any?

Select one only

 None 0

 Atheist 1

 Agnostic 2

 Catholic 3

 Jewish 4

 Southern Baptist 5

 Baptist 6

 Methodist or African Methodist 7

 Lutheran 8

 Presbyterian 9

 Episcopal or Anglican 10

 Church of Jesus Christ of Latter Day Saints (LDS/Mormon) 11

 Other 99

ONLY ANSWER IF YOU SELECTED “OTHER” FOR THE RELGION YOU ARE NOW AT A12a

A12b. What religion are you now?

Select one only

 Assemblies of God 12

 Church of Nazarene 13

 The Church of God 14

 The Church of God (Cleveland, TN) 15

 The Church of God in Christ 16

 7th Day Adventist 17

 United Pentecostal Church 18

 Pentecostal Assemblies 19

 Jehovah’s Witness 20

 Christian, another denomination not listed 21

 Christian, no specific denomination 22

 Unitarian Universalist 23

 Greek Orthodox 24

 Other Orthodox 25

 Muslim 26

 Buddhist 27

 Hindu 28

 Other (Please describe) 99

A13. About how often do you attend religious services?

Select one only

 More than once a week 1

 Once a week 2

 2-3 times a month 3

 Once a month (about 12 times a year) 4

 3-11 times a year 5

 Once or twice a year 6

 Never 7

A14. Currently how important is religion in your daily life?

Select one only

 Very important 1

 Somewhat important 2

 Not important 3

A15. In which state do you live?

STATE

A16. In which town or city do you live?

TOWN OR CITY

A17. What is your current ZIP Code?

ZIP CODE

 Don’t know d

C8. These next questions are about your education. Are you currently enrolled in school? If you are homeschooled instead of attending a public or private school for some or all classes, please select “yes.”

Select one only

 Yes 1

 Yes, but my school is currently on break 2

 No 0

C9. Do you have a high school diploma, a high school equivalency certificate (such as a GED or HiSET), both, or neither?

 High school diploma only 1

 High school equivalency only 2

 Both 3

 Neither 4

ONLY ANSWER IF YOU ARE CURRENTLY IN SCHOOL AND HAVE NOT COMPLETED HIGH SCHOOL/GED

C10. What type of school are you currently enrolled in?

 Private, Catholic 1

 Private, religious, but not Catholic 2

 Private, not religious 3

 Public or charter school 4

 Homeschool for some or all classes 5

 Other (Please describe) 99

ONLY ANSWER IF YOU ARE CURRENTLY IN SCHOOL AND HAVE NOT COMPLETED HIGH SCHOOL/GED

C11. What grade are you currently in?

Select one only

 5th grade 1

 6th grade 2

 7th grade 3

 8th grade 4

 9th grade 5

 10th grade 6

 11th grade 7

 12th grade 8

ONLY ANSWER IF YOU ARE CURRENTLY ENROLLED IN SCHOOL AND HAVE COMPLETED HIGH SCHOOL/GED

C12. Which type of school are you currently enrolled in?

Select one only

 Business, technical, or vocational school after high school 1

 2-year college (community or junior college) 2

 4-year college or university 3

 Graduate or professional school (for example MA or PhD program, or medical or law school) 4

 Other (Please describe) 99

ONLY ANSWER IF YOU ARE NOT CURRENTLY ENROLLED AND HAVE NOT COMPLETED HIGH SCHOOL/GED

C13. What is the highest grade in school that you have completed?

Select one only

 8th grade or lower 1

 9th grade 2

 10th grade 3

 11th grade 4

 12th grade (but did not graduate or receive a high school equivalency certificate or alternative certificate) 5

SECTION E – KNOWLEDGE OF YOUTH SEXUAL RISK BEHAVIORS

In this part of the survey we will ask questions about knowledge about youth sexual risk behaviors, attitudes and opinions related to sex education classes and questions about your own experiences. The first section is about your knowledge of youth sexual risk behaviors.

These questions ask about sexual activity, pregnancy, birth control, such as condoms, pills, the patch, the shot, the ring, IUD, or an implant, and HIV/AIDS and other sexually transmitted diseases (also known as STDs or STIs).

E1. About how many high school age youth do you think have had sex?

Select one only

 More than 3/4 1

 Between 1/2 and 3/4 2

 Between 1/4 and 1/2 3

 Less than 1/4 4

Without looking at the response options, in your own words, how many high school age youth do you think have had sex?

Did our response options make it easier or harder to answer?

How did you define sex in this question?

E2. What do you think is true about teen sex today, compared to teen sex 25 years ago?

Select one only

 A larger percentage of teens are having sex today compared to 25 years ago 1

 About the same percentage of teens are having sex today compared to 25 years ago 2

 A smaller percentage of teens are having sex today compared to 25 years ago 3

E3. Which of the following methods of birth control is the most effective at preventing pregnancy, if it is used consistently and correctly? Your best guess is fine.

Select one only (RANDOMIZE ORDER OF RESPONSES)

 Not having vaginal sex (abstinence) 1

 Birth control pills 2

 Condoms 3

 An IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon) 4

PLEASE EXCLUDE RESPONSE SELECTED IN E3

E4. Which is the second most effective method at preventing pregnancy, if used consistently and correctly? Your best guess is fine.

Select one only

 Not having vaginal sex (abstinence) 1

 Birth control pills 2

 Condoms 3

 An IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon) 4

PLEASE EXCLUDE RESPONSES SELECTED IN E3 AND E4

E5. Which is the third most effective method at preventing pregnancy, if used consistently and correctly? Your best guess is fine.

Select one only (SHOW RESPONSES IN SAME ORDER AS E3)

 Not having vaginal sex (abstinence) 1

 Birth control pills 2

 Condoms 3

 An IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon) 4

Was this question understandable? Was there anything you were confused or wondering about?

IF NOT UNDERSTANDABLE: Do you have any ideas on how we could ask this more clearly?

How confident do you feel in your responses here? (OR, How easy or hard to you think this will be for people your age to answer?)

The next statements are about sexually transmitted diseases, also known as STDs or STIs, including HIV/AIDS.

Please select whether you think the following statements are true, false, or you don’t know.

E6. You can get an STD or STI from having oral or anal sex.

Select one only

 True 1

 False 2

 Don’t Know 3

E7. An IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon) can reduce the risk of getting an STD or STI.

Select one only

 True 1

 False 2

 Don’t know 3

E8. Birth control pills can decrease the risk of STDs or STIs.

Select one only

 True 1

 False 2

 Don’t know 3

E9. Condoms can decrease the risk of STDs or STIs.

Select one only

 True 1

 False 2

 Don’t know 3

SECTION F – EXPOSURE AND OPINIONS ABOUT SEX EDUCATION

The next questions are about any classes, sessions, or programs you may have had on sex education. These are classes that cover things like pregnancy, waiting to have sex, birth control, such as condoms, pills, the patch, the shot, the ring, IUD, or an implant, and sexually transmitted diseases (also known as STDs or STIs).

F1. Did you ever have sex education as part of [a class or program in school]/your home school]?

 Yes 1

IF YOU HAVE NEVER HAD SEX EDUCATION IN SCHOOL

GO TO F9.

 No 0

ONLY ANSWER IF YOU HAD SEX EDUCATION IN SCHOOL AND ARE NOT HOMSCHOOLED

F2. Who led or taught the sex education class or program in school?

Select one or more

 A teacher from your school (such as a health teacher, biology teacher or gym teacher) 1

 A school counselor or school nurse 2

 An adult who is not a teacher at your school 3

 A student who was trained to lead or teach the class 4

 Don't know d

F3. In what grades did you have sex education in school?

Select one or more

 5th grade or below 1

 6th grade 2

 7th grade 3

 8th grade 4

 9th grade 5

 10th grade 6

 11th grade 7

 12th grade 8

How easy or difficult was it to answer this question?

Did you need to guess?

ONLY ANSWER IF YOU HAD SEX EDUCATION IN SCHOOL

F4. How much do you agree or disagree with the following statement? The sex education I had in school prepared me to make good decisions about sex.

Select one only

 Strongly agree 1

 Agree 2

 Disagree 3

 Strongly disagree 4

Can you talk me through how you came up with your answer to this one?

ONLY ANSWER IF YOU HAD SEX EDUCATION IN SCHOOL

F5. Did the sex education you had in school discuss any of the following topics?

	SELECT ONE ONLY
	Yes	No	Don’t Remember
a. Birth control, such as condoms, birth control pills, the patch, the shot, the ring, IUD, or an implant	1 	0 	d 
b. Effectiveness of birth control for preventing HIV/AIDS and other STDs or STIs	1 	0 	d 
c. Effectiveness of birth control for preventing pregnancy	1 	0 	d 
d. Where or how to get birth control	1 	0 	d 
e. How to use a condom	1 	0 	d 
f. How to use other methods of birth control	1 	0 	d 
g. Female and male reproductive systems (including information about sex organs and the menstrual cycle or period)	1 	0 	d 
h. How pregnancy occurs	1 	0 	d 
i. How to avoid pregnancy	1 	0 	d 
j. How to avoid getting HIV/AIDS and other STDs or STIs	1 	0 	d 
k. Having healthy romantic relationships (dating and marriage)	1 	0 	d 
l. Developing communication skills	1 	0 	d 
m. Consequences of having sex as a teen	1 	0 	d 
n. Consequences of pregnancy as a teen	1 	0 	d 
o. Waiting to have sex until after you graduate from high school	1 	0 	d 
p. Waiting to have sex until you are married	1 	0 	d 
q. How to say no to sex	1 	0 	d 
r. Strategies for avoiding unwanted sex	1 	0 	d 
s. How to make sex pleasurable	1 	0 	d 
t. How to talk to your partner about sex and using birth control	1 	0 	d 
u. How to talk to your parents about sex	1 	0 	d 
v. How alcohol or drugs might affect decisions about having sex	1 	0 	d 
w. Setting goals and making plans for your future	1 	0 	d 
x. The importance of consent (both partners agreeing) before engaging in sex	1 	0 	d 
y. How to get out of unhealthy romantic relationships	1 	0 	d 
z. Having sex as a teen is okay	1 	0 	d 
aa. Other topic (Please describe)	1 	0 	d 

How easy or difficult was it to answer this question?

In your own words, without looking over the list, what did you discuss in sex education classes?

Were there any responses in this list that seemed odd to you or that you had trouble understanding?

F6. Thinking back to the sex education you received in school, did you hear any of the following messages?

SELECT ONE ONLY

	Yes	No	Don’t Remember
a. Avoiding sex as a teen can help you reach your goals	1 	0 	d 
b. Avoiding sex as a teen is best, but if you do decide to have sex, birth control and protection from STDs/STIs should be used	1 	0 	d 
c. Having sex as a teen can be a positive thing	1 	0 	d 

Thinking back to the sex education you received, were there other main messages that we are missing here?

What does “messages” mean to you?

ONLY ANSWER IF YOU HAD SEX EDUCATION IN MIDDLE SCHOOL GRADES (5th-8th)

F7. Some sex education classes in middle schools teach about abstinence (not having sex), some teach about birth control and sexually transmitted diseases, and some teach about both. Which of the following best describes the main focus of your middle school sex education class or classes?

 Teaching you to abstain from sex (not have sex) 1

 Teaching you about birth control and sexually transmitted diseases 2

 A combination of teaching you to abstain from having sex and teaching you about birth control and sexually transmitted diseases 3

 Something else was the main focus of the sex education class 4

 Don’t remember 5

ONLY ANSWER IF YOU HAD SEX EDUCATION IN HIGH SCHOOL GRADES (9th-12th)

F8. Some sex education classes in high schools teach about abstinence (not having sex), some teach about birth control and sexually transmitted diseases, and some teach about both. Which of the following best describes the main focus of your high school sex education class or classes?

Select one only

 Teaching you to abstain from sex (not have sex) 1

 Teaching you about birth control and sexually transmitted diseases 2

 A combination of teaching you to abstain from having sex and teaching you about birth control and sexually transmitted diseases 3

 Something else was the main focus of the sex education class 4

 Don’t remember 5

F9. Sex education can include a variety of topics. For each of the following topics, do you think the topic is appropriate for middle school students – that is, grades 6 through 8 – high school students – that is, grades 9 through 12 – both age groups, or neither age group?

SELECT ONE ONLY

	Appropriate for middle school students	Appropriate for high school students	Appropriate for both middle and high school students	Not appropriate for middle or high school students
a. Birth control, such as condoms, birth control pills, the patch, the shot, the ring, IUD, or an implant	1 	2 	3 	4 
b. Effectiveness of birth control for preventing HIV/AIDS and other STDs or STIs	1 	2 	3 	4 
c. Effectiveness of birth control for preventing pregnancy	1 	2 	3 	4 
d. Where or how to get birth control	1 	2 	3 	4 
e. How to use a condom	1 	2 	3 	4 
f. How to use other methods of birth control	1 	2 	3 	4 
g. Female and male reproductive systems (including information about sex organs and the menstrual cycle or period)	1 	2 	3 	4 
h. How pregnancy occurs	1 	2 	3 	4 
i. How to avoid pregnancy	1 	2 	3 	4 
j. How to avoid getting HIV/AIDS and other STDs or STIs	1 	2 	3 	4 
k. Having healthy romantic relationships (dating and marriage)	1 	2 	3 	4 
l. Developing communication skills	1 	2 	3 	4 
m. Consequences of having sex as a teen	1 	2 	3 	4 
n. Consequences of pregnancy as a teen	1 	2 	3 	4 
o. Waiting to have sex until after you graduate from high school	1 	2 	3 	4 
p. Waiting to have sex until you are married	1 	2 	3 	4 
q. How to say no to sex	1 	2 	3 	4 
r. Strategies for avoiding unwanted sex	1 	2 	3 	4 
s. How to make sex pleasurable	1 	2 	3 	4 
t. How to talk to your partner about sex and using birth control	1 	2 	3 	4 
u. How to talk to your parents about sex	1 	2 	3 	4 
v. How alcohol or drugs might affect decisions about having sex	1 	2 	3 	4 
w. Setting goals and making plans for your future	1 	2 	3 	4 
x. The importance of consent (both partners agreeing) before engaging in sex	1 	2 	3 	4 
y. How to get out of unhealthy romantic relationships	1 	2 	3 	4 
z. Having sex as a teen is okay	1 	2 	3 	4 
aa. Other topic (Please describe)	1 	2 	3 	4 

A number of topics are covered in this question.

Do any topics seem like they don’t belong?

Can you think of any topics that are missing?

F10. Did you ever have or are you currently taking any sex education outside of school? This could be at a place of worship, community center, after school program at school, clinic or some other place outside of the normal school day.

 Yes 1

 No 0

SECTION G – SEXUAL RISK BEHAVIORS

Section G asks some very sensitive questions. As we go through the debrief here, remember, you do not need to tell us how you answered these. We are just interested on how easy/hard it was to answer them and how you think people your age will understand the items. Also, it’s okay if you don’t know what some of the words mean. You can tell us if you didn’t know what something was.

The following questions are about sex. Oral sex is when someone stimulates another’s genitals with the mouth. Vaginal sex is when a male puts his penis into a female's vagina. Anal sex is when a male puts his penis in another’s anus, butt, or rectum.

Please remember that these questions are for research purposes only and that no one, including your parents, will ever see your answers.

G1. Have you ever had sex? By sex we mean oral sex, vaginal sex, or anal sex.

SELECT ONE ONLY

	Yes	No
a. Oral sex	1 	0 
b. Vaginal sex	1 	0 
c. Anal sex	1 	0 

IF YOU SAID NO TO ALL TYPES IN G1a-c GO TO G22.

DO NOT ANSWER G2 THROUGH G21.

IF YOU SAID YES TO ANY G1a-c, GO TO G2.

IF YOU HAVE NEVER HAD ANY TYPE OF SEX(ORAL, VAGINAL, OR ANAL), GO TO PAGE XX QUESTION G22.

DO NOT ANSWER G2 THROUGH G21.

ONLY ANSWER IF YOU EVER HAD ANY KIND OF SEX (ORAL, VAGINAL, OR ANAL)

G2. During your life, with how many people have you had oral, vaginal, or anal sex with?

YOUR RESPONSE CAN BE FOR ANY OF THE TYPES OF SEX YOU SAID “YES” TO AT G1

Select one only

 1 person 1

 2 people 2

 3 people 3

 4 people 4

 5 people 5

 6 or more people 6

ONLY ANSWER IF YOU EVER HAD ANY KIND OF SEX (ORAL, VAGINAL, OR ANAL)

G3. When you have sex how often do you use condoms?

Select one only

 All of the time 1

 Most of the time 2

 Some of the time 3

 Never 4

ONLY ANSWER IF WHEN YOU HAVE SEX YOU USE CONDOMS MOST OF THE TIME SOME OF THE TIME OR NEVER

G3a. Below are some reasons people may not use condoms. What are the reasons that you have not used condoms when having sex?

Select one or more

 Condoms are against your personal values or religious beliefs to use 1

 Condoms are embarrassing to buy 2

 You don’t know how to use condoms 3

 You don’t think sex feels as good when a condom is used 4

 Your partner did not want to use one 5

 It is too hard to stop “in the moment” to use a condom 6

 Condoms are too expensive 7

 You or your partner didn’t have one with you 8

 You did not feel comfortable asking your partner to use one 9

 You are having sex with just one partner 10

 You or your partner(s) are using other birth control 11

 You and/or your partner(s) have been tested for STD/STIs 12

 You or your partner(s) are using other birth control 13

 Something else (Please describe) 14

ONLY ANSWER IF YOU HAVE HAD VAGINAL SEX

G4. When you have sex how often do you use other forms of birth control, not including condoms?

Select one only

 All of the time 1

 Most of the time 2

 Some of the time 3

 Never 4

ONLY ANSWER IF YOU HAVE HAD MORE THAN ONE KIND OF SEX

G5. Thinking back to the first time you had sex, what kind of sex did you have?

Select one or more

 Oral sex 1

 Vaginal sex 2

 Anal sex 3

ONLY ANSWER IF YOU HAVE EVER HAD ANY KIND OF SEX (ORAL, VAGINAL, OR ANAL)

G6. How old were you when you had sex for the first time?

Select one only

 14 years old or younger 1

 15 years old 2

 16 years old 3

 17 years old 4

 18 years old 5

ONLY ANSWER IF YOU HAVE EVER HAD ANY KIND OF SEX (ORAL, VAGINAL, OR ANAL)

G7. The first time you had sex, how would you describe your relationship with the other person?

Select one only

 Married 1

 Engaged 2

 Living together, but not engaged 3

 In a committed relationship or exclusively dating someone 4

 Going out with the person once in a while 5

 Just friends 6

 Someone I did not really know well 7

 Something else 99

Let’s take a look at these response options. Thinking of people your age, do you think these options accurately describe different relationships? Are any confusing?

How about the fourth option, “in a committed relationship or exclusively dating someone”? What does that phrase mean to you?

ONLY ANSWER IF YOU HAVE EVER HAD ANY KIND OF SEX (ORAL, VAGINAL, OR ANAL)

G8a. Which would you say comes closest to describing how much you wanted that first sexual experience to happen?

Select one only

 I really didn’t want it to happen at that time 1

 I had mixed feelings - part of me wanted it to happen at that time and part of me didn't 2

 I really wanted it to happen at that time 3

ONLY ANSWER IF YOU HAVE EVER HAD ANY KIND OF SEX (ORAL, VAGINAL, OR ANAL)

G8b. Thinking back to the first time you had sex, which comes closest to how you feel about it now?

Select one only

 I wish I had waited longer 1

 It was the right time to have sex 2

 I wish I had had sex earlier 3

ONLY ANSWER IF YOU HAVE EVER HAD ANY KIND OF SEX (ORAL, VAGINAL, OR ANAL)

G9. Thinking about the first time you had sex, how much influence did each of the following have on your decision to have sex?

SELECT ONE ONLY

	A lot	Some	Not much	No influence
a. You were curious about what sex was like	1 	2 	3 	4 
b. You hoped it would make your relationship stronger	1 	2 	3 	4 
c. The other person wanted to	1 	2 	3 	4 
d. Many of your friends had already done it	1 	2 	3 	4 
e. You were drinking or using other drugs at the time	1 	2 	3 	4 
f. You were in love with the person	1 	2 	3 	4 
g. You were/are planning to marry the person	1 	2 	3 	4 
h. Sex you had seen on TV, the internet, or the movies	1 	2 	3 	4 
i. You felt prepared and knowledgeable about birth control and protection from STIs	1 	2 	3 	4 
j. You wanted to get it over with	1 	2 	3 	4 
k. You did it to make someone else jealous or angry	1 	2 	3 	4 
l. You were married	1 	2 	3 	4 

If someone your age had engaged in more than one type of sex, what kind or kinds of sex do you think they would consider when answering this question? Why is that?

In your own words, what do you think “influence” means in this question? Can you think of a word or phrase that would be easier to understand?

Are there reasons that you think are missing from this list for people your age?

ONLY ANSWER IF YOU HAVE HAD VAGINAL SEX

G10. The first time you had vaginal sex, what method did you or the other person use to prevent pregnancy, if any?

Select one or more

 No method was used 1

 Birth control pills 2

 Condoms 3

 An IUD (such as Mirena or ParaGard) or implant (Nexplanon) 4

 A shot (such as Depo-Provera), a patch (such as Ortho Evra), or birth control ring (such as NuvaRing) 5

 Withdrawal or pulling out 6

 Natural family planning or fertility awareness methods 7

 Some other method 8

 Not sure or don’t remember 9

Let’s look at option 7. What does “natural family planning” mean to you?

How about “fertility awareness methods”?

What do you think the term “timing based on the menstrual cycle” means?

How about “the calendar or rhythm method”?

What words or phrases would be easiest to understand for option 7? Why is that?

ONLY ANSWER IF YOU EVER HAD ANY KIND OF SEX

G11. Do your parents know you have had sex?

 Yes 1 GO TO G12

 No 0 GO TO G13

 Don’t know d GO TO G13

ONLY ANSWER IF PARENTS KNOW YOU HAVE HAD SEX

G12. What do your parents think about the fact that you have had sex?

Select one only

 Strongly approve 1

 Approve 2

 Neither approve nor disapprove 3

 Disapprove 4

 Strongly disapprove 5

 Don’t know d

How easy or hard do you it would be for people your age to answer this?

ONLY ANSWER IF YOU HAVE HAD VAGINAL SEX

G13. Have you ever had a baby or fathered any children?

 Yes 1

 No 0

 Don’t know d

The next few questions are about the last 6 months.

ONLY ANSWER IF YOU HAVE HAD ANY KIND OF SEX

G14. Have you had oral sex, vaginal sex, or anal sex in the last 6 months?

 Yes 1 GO TO G17

 No 0 GO TO G15

ONLY ANSWER IF YOU HAVE HAD SEX BEFORE, BUT NOT IN LAST 6 MONTHS

G15. Which of the following best describes why you did not have sex in the last 6 months?

 You decided you did not want to have sex, even if you had the chance 1 GO TO G16a

 You would have liked to have had sex, but did not have the chance 2 GO TO G21

How easy or hard do you think it would be for someone your age to answer this question?

IF YOU ANSWERED G15=2, SKIP To G21.

DO NOT ANSWER G16-G20.

ONLY ANSWER IF YOU DECIDED YOU DID NOT WANT TO HAVE SEX, EVEN IF YOU HAD THE CHANCE

G16a. How important to you is each of the following reasons why you have not had sex in the last 6 months?

SELECT ONE ONLY

	Not important at all	Not too important	Somewhat important	Very important
a. My family’s values or religious beliefs	1 	2 	3 	4 
b. My own personal values or religious beliefs	1 	2 	3 	4 
c. It would make me feel bad about myself	1 	2 	3 	4 
d. Because I want to wait until I am in a long-term relationship	1 	2 	3 	4 
e. Because I want to wait until marriage	1 	2 	3 	4 
f. I don't want to be judged negatively by my peers	1 	2 	3 	4 
g I feel I am too young to have sex	1 	2 	3 	4 
h. I feel that sex gets in the way of achieving the goals I have for myself	1 	2 	3 	4 
i. I don't want to get pregnant or get my partner pregnant	1 	2 	3 	4 
j. I don't want to get an STD or STI	1 	2 	3 	4 
k. I’m in a relationship, but we are not ready yet	1 	2 	3 	4 
l. I had a bad experience with sex	1 	2 	3 	4 
m. I haven’t found the right person yet	1 	2 	3 	4 
n. I didn’t like sex	1 	2 	3 	4 
o. I wish I had waited longer to have sex	1 	2 	3 	4 
p. I am not ready for the emotions involved with having sex	1 	2 	3 	4 
q. Other reason (Please describe)	1 	2 	3 	4 

We have this list of reasons for not having sex in a couple places in Section G. Let’s look at here. Take a minute to read through the list.

Let’s look at response option p. What does this mean to you?

Were there any response options in this list of reasons to not have sex that stood out to you? Why is that? Do you think we should phrase anything differently to make the question easier to answer?

ONLY ANSWER IF YOU SELECTED ANY REASONS IN G16A WERE “SOMEWHAT IMPORTANT” OR “VERY IMPORTANT”; SKIP IF ALL NOT IMPORTANT AT ALL SELECTED IN G16A

G16b. Which is the most important reason to you for not having sex?

Select one only

 My family’s values or religious beliefs 1

 My own personal values or religious beliefs 2

 It would make me feel bad about myself 3

 Because I want to wait until I am in a long-term relationship 4

 Because I want to wait until marriage 5

 I don't want to be judged negatively by my peers 6

 I feel I am too young to have sex 7

 I feel that sex gets in the way of achieving the goals I have for myself 8

 I don't want to get pregnant or get my partner pregnant 9

 I don't want to get an STD or STI 10

 I’m in a relationship, but we are not ready yet 11

 I have had a bad experience with sex 12

 I haven’t found the right person yet 13

 I didn’t like sex 14

 I wish I had waited longer to have sex 15

 I am not ready for the emotions involved with having sex 16

 Something else (Please describe) 99

IF YOU HAVE NOT HAD SEX IN THE LAST 6 MONTHS, NOW SKIP TO G21

ONLY ANSWER IF YOU HAVE HAD SEX IN THE LAST 6 MONTHS

G17. Thinking back to the most recent time you had sex, what kind of sex did you have?

Select one or more

 Oral sex 1

 Vaginal sex 2

 Anal sex 3

ONLY ANSWER IF YOU HAVE HAD SEX IN THE LAST 6 MONTHS (ORAL, VAGINAL, OR ANAL)

G18. The most recent time you had sex, how would you describe your relationship with the other person?

Select one only

 Married 1

 Engaged 2

 Living together, but not engaged 3

 In a committed relationship or going steady 4

 Going out with the person once in a while 5

 Just friends 6

 Someone I did not really know 7

 Something else (Please describe) 99

ONLY ANSWER IF YOU HAVE HAD SEX IN THE LAST 6 MONTHS (ORAL, VAGINAL, OR ANAL)

G19. Which would you say comes closest to describing how much you wanted your most recent sexual experience to happen?

Select one only

 I really didn’t want it to happen at that time 1

 I had mixed feelings - part of me wanted it to happen at that time and part of me didn't 2

 I really wanted it to happen at that time 3

ONLY ANSWER IF YOU HAVE HAD VAGINAL SEX IN THE LAST 6 MONTHS (ORAL, VAGINAL, OR ANAL)

G20. The most recent time you had vaginal sex, what method did you or the other person use to prevent pregnancy, if any?

Select one or more

 No method was used 1

 Birth control pills 2

 Condoms 3

 An IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon) 4

 A shot (such as Depo-Provera), a patch (such as Ortho Evra), or birth control ring (such as NuvaRing) 5

 Withdrawal or pulling out 6

 Natural family planning or fertility awareness methods 7

 Some other method 8

 Not sure or don’t remember 9

G21. Have you ever had sex with someone you did not really know well?

Select one only

 Yes 1

 No 0

ONLY ANSWER IF YOU HAVE HAD SEX, BUT NOT IN THE LAST 6 MONTHS

G21a. How likely is it that you will have sex in the next year?

Select one only

 Very unlikely 1

 Unlikely 2

 Likely 3

 Very likely 4

IF YOU HAVE EVER HAD ANY KIND OF SEX (ORAL, VAGINAL, OR ANAL), GO TO QUESTION G30.

DO NOT ANSWER G22 THROUGH G29.

ONLY ANSWER IF YOU HAVE NEVER HAD SEX

G22. People have different reasons for not having sex. Which of the following is true for you?

 You decided you don’t want to have sex, even if you had the chance 1 GO TO G23

 You would like to have had sex, but have not had the chance 2 GO TO G25

ONLY ANSWER IF YOU HAVE NEVER HAD SEX AND YOU DO NOT WANT TO

G23. How important to you is each of the following reasons for not having sex?

SELECT ONE ONLY

	Not at all important	Somewhat important	Very important
a. My family’s values or religious beliefs	1 	2 	3 
b. My own personal values or religious beliefs	1 	2 	3 
c. It would make me feel bad about myself	1 	2 	3 
d. Because I want to wait until I am in a long-term relationship	1 	2 	3 
e. Because I want to wait until marriage	1 	2 	3 
f. I don't want to be judged negatively by my peers	1 	2 	3 
g. I feel I am too young to have sex	1 	2 	3 
h. I feel that sex gets in the way of achieving the goals I have for myself	1 	2 	3 
i. I don't want to get pregnant or get my partner pregnant	1 	2 	3 
j. I don't want to get an STD or STI	1 	2 	3 
k. I’m in a relationship, but we are not ready yet	1 	2 	3 
l. I have had a bad experience being intimate with someone	1 	2 	3 
m. I haven’t found the right person yet	1 	2 	3 
n. I am not ready for the emotions involved with having sex	1 	2 	3 
o. Other reason (Please describe)	1 	2 	3 

ONLY ANSWER IF YOU SELECTED “SOMEWHAT IMPORTANT OR VERY IMPORTANT” TO ANY CHOICES AT G23; SKIP IF ALL NOT IMPORTANT AT ALL SELECTED IN G23

G24. Which is the most important reason to you for not having sex?

Select one only

 My family’s values or religious beliefs 1

 My own personal values or religious beliefs 2

 It would make me feel bad about myself 3

 Because I want to wait until I am in a long-term relationship 4

 Because I want to wait until marriage 5

 I don't want to be judged negatively by my peers 6

 I feel I am too young to have sex 7

 I feel that sex gets in the way of achieving the goals I have for myself 8

 I don't want to get pregnant or get my partner pregnant 9

 I don't want to get an STD or STI 10

 I’m in a relationship, but we are not ready yet 11

 I have had a bad experience being intimate with someone 12

 I haven’t found the right person yet 13

 I am not ready for the emotions involved with having sex 14

 Something else (Please describe) 99

ONLY ANSWER IF YOU HAVE NEVER HAD SEX

G25. How likely is it that you will have sex in the next year?

Select one only

 Very unlikely 1

 Unlikely 2

 Likely 3

 Very likely 4

What type or types of sex—oral, anal, vaginal, or all—do you think people your age think about when answering this question?

ONLY ANSWER IF YOU ARE CURRENTLY ENROLLED IN GRADES 5-10 AND HAVE NEVER HAD SEX

G26. How likely is it that you will have sex before you finish high school?

Select one only

 Very unlikely 1

 Unlikely 2

 Likely 3

 Very likely 4

ONLY ANSWER IF YOU HAVE NEVER BEEN MARRIED AND NEVER HAD SEX

G27. How likely is it that you will wait until you are married before you have sex?

Select one only

 Very unlikely 1

 Unlikely 2

 Likely 3

 Very likely 4

ONLY ANSWER IF YOU HAVE NEVER HAD ANY KIND OF SEX

G28. In the past 6 months, have you touched someone’s private parts? Private parts are the parts of the body covered by underwear or a bra.

 Yes 1

 No 0

ONLY ANSWER IF YOU HAVE NEVER HAD ANY KIND OF SEX

G29. In the past 6 months, other than a doctor or a nurse, have you let someone touch your private parts?

 Yes 1

 No 0

ALL RESPONDENTS ANSWER G30-G33

G30. In the past 6 months, have you sent messages with nude, sexually suggestive, or explicit pictures to someone?

 Yes 1

 No 0

G31. In the past 6 months, have you requested messages with nude, sexually suggestive, or explicit pictures from others?

 Yes 1

 No 0

Can you please rephrase questions G30 and G31 in your own words?

In questions G30 and G31, do you think the term “sexting” would be easier or harder to understand?

Why is that?

G32. In the past 6 months, have you watched or looked at pictures of sex online?

 Yes 1

 No 0

In your own words, what does this question mean to you?

How easy or difficult was it for you to understand the question?

Can you think of a way to ask this question that could be easier for people your age to understand?

G33. How much of an influence is each of the following] on your decisions about sexual activity?

SELECT ONE ONLY

	A lot	Some	Not much	No influence	Does not apply to my life
a. Your parent(s)/guardian(s)	1 	2 	3 	4 	na 
b. Your friends	1 	2 	3 	4 	na 
c. Your brother(s)/sister(s)	1 	2 	3 	4 	na 
d. Your boyfriend or girlfriend	1 	2 	3 	4 	na 
e. A teacher or counselor	1 	2 	3 	4 	na 
f. Your religious leader	1 	2 	3 	4 	na 
g. Some other adult you think of as a role model	1 	2 	3 	4 	na 
h. Pictures or videos about sex you watched online or on TV	1 	2 	3 	4 	na 
i. Sex education in school	1 	2 	3 	4 	na 
j. Your own beliefs and values	1 	2 	3 	4 	na 

What did you consider when you read the term “sexual activity” in this question?

What if the question used the term “sex” instead of sexual activity?

What is the same or different between the two terms?

Do you think the question would be easier or harder to answer if it ask about “decisions about sex”? Why is that?

Option f says “your religious leader.” Who came to mind when you read that option?

Can you think of a different way of asking about that person that would be easier to understand?

THANK YOU!

You have reached the end of the survey.

Please let the survey administrator know you are finished.

How did it feel to end the survey on these questions related to sex? How do you think others your age will feel?

Is there anything you would like to discuss?

Debrief Wrap-up:

Please take a moment to look back through the survey. During our discussion we did not go over every question. Do you have any additional comments about questions we did not talk about? Did we miss anything in our discussion that you would like to mention now?

1. When you are done with the discussion, collect all materials from the participantS.

2. Return the participantS to the main meeting place. thank them for their time and participation.

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