Healthy Oakland Teens Description and Explanation of Study Instrument
A questionnaire based on findings from earlier surveys was developed and pilot tested on junior high school students. The content and wording of the survey was modified based on pilot study results and participant feedback and used in the present study to assess demographic characteristics, HIV/AIDS/STD-related knowledge, attitudes, and beliefs, sexual behaviors and drug and alcohol use. The final instrument included 102 items at pretest and 97 items at follow-up, and required approximately 40 minutes to complete. The instrument contained the following sections that were used to develop scales.
Sexual behaviors were assessed including dating, kissing, deep kissing, breast touching, and genital touching. These individual-item measures were dichotomous assessments for lifetime behaviors and for practices during the past two months. Those students who had experienced sexual intercourse were asked about their lifetime and prior two months practice of vaginal, anal, and oral sex.
Demographics, including gender, age, ethnicity, and the primary language spoken at home were measured. Socioeconomic status was assessed by examining the proportion of students who participated in the school district’s free lunch program.
An AIDS -related knowledge score was created by adding the number of correct answers to 11 true-false questions regarding AIDS transmission, general medical aspects of AIDS, and knowledge of preventive behaviors. Examples of items included, “Only people who look sick can spread the AIDS virus,” “A person can get the AIDS virus even if he or she has sexual intercourse just one time without a condom,” and “Birth control pills prevent a woman from getting the AIDS virus.” (scale range 0 to 11, seventh grade baseline mean=7.9, Cronbach’s alpha=.64).
The perceived costs and benefits of preventive behaviors scale combines statements about the negative and positive aspects of condom use. Examples of items include “It would really bother me to stop having sexual intercourse to put on a condom,” “Condoms would be too much trouble to use,” and “Condoms slip off easily.” Responses are in the Likert format ranging from “definitely” to “definitely not” (range 0 to 21, seventh-grade baseline mean=11.1, Cronbach’s alpha=.43; for negative aspect items only, six items, Cronbach’s alpha=.47). We decided to retain this scale even though it has a relatively low reliability, since perceived barriers have previously been shown to be related to sexual behaviors and were specifically targeted in our intervention.
The perceived peer norms scale used the CDC’s national survey of adolescent AIDS-related attitudes (CDC, 1988). This scale measures the perceived prevalence of risk behaviors among the friends of adolescents, using Likert response options. Examples of items include, “How many of your friends do you think have had sexual intercourse?” and “How many of your friends think condoms are too much trouble to use?” A high score indicates that friends are believed to have the lowest risk behaviors and attitudes regarding condom use (five items, range 0 to 20, seventh grade baseline mean=15.1, Cronbach’s alpha =.62)
The attitudes regarding sexually active students scale consists of three statements referring to sexually active boys and girls (for a total of six statements), “Having sexual intercourse makes a boy (a girl) popular,” “Having sexual intercourse at my age is a `cool’ thing for a boy (a girl) to do,” and “Having sexual intercourse with someone besides his (her) steady partner makes a boy (a girl) ‘cool’ or popular.” Students responded on a 4 point Likert format scale ranging from “strongly agree” to “strongly disagree.” (Six item scale, range 0 to 18, seventh-grade baseline mean=13.5, Cronbach’s alpha=.88)
The partner norms scale combines three items regarding attitudes toward a sexual partner who suggested using a condom, (i.e. “If the person I was about to have sex with suggested using a condom, I would feel like that person cared about me,”), (3 items, range 0 to 9, seventh grade baseline mean=7.3, standardized Cronbach’s alpha=.69)
The self-efficacy scale measures confidence in one’s ability to refuse unsafe situations or use of a condom in appropriate situations. Examples of items include “I would refuse to have sexual intercourse without a condom,” and “I would use a condom even if I were drunk or high.” A high score reflects the strongest refusal and condom use self-efficacy (range 0-15, seventh grade baseline mean=11.2, Cronbach’s alpha=.62)
Alcohol consumption. Students were asked at what age they had consumed their first drink (open-ended), their frequency of drinking and their frequency of getting “really drunk” (7 response categories ranging from “never” to “almost every day”). Questions about marijuana smoking included the age at first use, frequency of use, and frequency of getting “really high.” These questions used the same format as for alcohol consumption.