Predicting condom use in adolescents: a test of three socio-cognitive models using a structural equation modeling approach

Abstract

BackgroundThe theory of planned behavior (TPB), socio-cognitive model (SCM), and information-motivation-behavioral skills (IMB) model are effective in predicting condom use. However, the adequacy of these three theoretical models in predicting the frequency of condom use (FCU) among young people has not been compared. This cross-sectional study tested the applicability and suitability of these three models in predicting the FCU, and analyzed the relationships among the postulated constructs.MethodsSexually experienced adolescents (n = 410) aged 13–18 completed a survey assessing the TPB, SCM, and IMB model constructs. Participants were students recruited from 18 high schools, randomly selected from the north, south, east, and southeast of Spain. A structural equation modelling (SEM) analysis was applied to test TPB, SCM and IBM and constructs relationships of each model using R.ResultsThe results of SEM demonstrated that behavioral skills predict behavior via motivation as hypothesized by the IMB model, but not directly via knowledge about condom use and sexually transmitted infections (STIs). Cognitive factors, such knowledge about condom use and STIs as well as condom use self-efficacy, directly predicted the FCU when modeled as per the SCM. According to the TPB, condom use intention was the best predictor of the FCU, and condom use intention was predicted by attitudes toward condom use and subjective norms related to condom use, but perceived control was not directly or indirectly related to the FCU. Based on the data, the TPB becomes the best-fit model for predicting the FCU among young people compared to the SCM and IMB model.ConclusionsFrom a statistical perspective, the TPB seems to be the most suitable model for predicting the FCU among young people compared to the other models. Overall, key direct predictors of the FCU in adolescents included condom use intention, behavioral skills and cognitive factors, such as STIs knowledge and condom use self-efficacy. The next step should be to test integrative models that include personal, contextual, environmental, and social factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2702-0) contains supplementary material, which is available to authorized users.

Un estudio preliminar de la eficacia de un programa de promoción de la salud sexual en adolescentes con padres divorciados

“…En consecuencia, sería esperable que los adolescentes que recibieron la intervención presentaran mayor probabilidad de usar el preservativo en sus relaciones sexuales, puesto que presentan mayor nivel de conocimientos sobre el VIH y los métodos de protección, y una actitud más favorable hacia el uso del preservativo que los miembros del grupo control. Un reciente estudio empírico pone a prueba tres modelos socio-cognitivos de salud -la TAP (Ajzen, 1991;Fishbein & Ajzen, 2011), el IMH (Fisher & Fisher, 1992;Fisher et al, 1996;Fisher et al, 2002;Fisher, Fisher, & Shuper, 2009) y el MSC de Bandura (1977;1986;1994) para identificar las variables mediadoras de la eficacia de COMPAS (frente a un grupo control) para predecir el uso del preservativo en adolescentes escolarizados tras dos años de su aplicación (Espada, Morales, Guillén-Riquelme, Ballester, & Orgilés, 2016). De acuerdo con este estudio español de corte longitudinal, en el que participaron 410 adolescentes sexualmente activos entre 13-18 años, tener una actitud favorable hacia el uso del preservativo en el postest fue uno de los principales predictores de la intención de usar el preservativo a los 12 meses, y del uso del preservativo a los 24 meses de recibir el programa.…”

Multilevel Analysis on the Predictors of Safe Sexual Behavior among Girl Adolescents in Karanganyar, Central Java

“…Hasil penelitian ini juga didukung oleh penelitian yang dilakukan James dan Abieyuwa (2013) bahwa sikap seorang remaja putri untuk melakukan perilaku seksual tidak aman berpeng-aruh terhadap perilaku seksual tidak aman dari remaja putri. Espada et al (2016) menyebutkan bahwa sikap remaja berpengaruh terhadap niat remaja untuk berperilaku seksual aman. Hal senada juga disampaikan oleh Scalco et al (2017) bahwa sikap adalah salah satu faktor yang mempengaruhi perilaku individu, semakin kuat sikap positif individu untuk melakukan semakin kuat niat individu tersebut untuk melakukan perilaku tertentu tersebut.…”

“…Hasil penelitian ini sejalan dengan penelitian Espada et al (2016) bahwa persepsi kontrol perilaku remaja berpengaruh terhadap perilaku seksual aman. Persepsi kontrol perilaku memegang peranan penting dalam perilaku seseorang.…”

“…Hasil penelitian ini sejalan dengan penelitian Negeri (2014) bahwa remaja yang mendapat tekanan dari norma subyektif yaitu kelompok sebaya untuk melakukan hubungan seksual mempunyai hubungan yang signifikan untuk mempunyai perilaku seksual yang tidak aman yaitu mempunyai pasangan lebih dari satu. Espada et al (2016) juga menyebutkan bahwa norma subyektif berpengaruh terhadap niat remaja untuk berperilaku seksual aman.…”

Predicting Condom Use: A Comparison of the Theory of Reasoned Action, the Theory of Planned Behavior and an Extended Model of TPB

“…Nevertheless, the positive impact of PBC is not consistent among literature. More recently, Espada et al (2016) compared TPB and IMB in their effi cacy to predict condom and observed that PBC has had no eff ect in predicting frequency of condom use and has pointed to the importance to test integrative models that include personal, contextual, environmental and social factors. Visser and Smith (2001) observed that for those who sometimes use a condom, the most important determinants were the characteristics of the interaction between the sexual partners and the state-like characteristics of the individuals concerned.…”