Graduation Semester and Year

2015

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Social Work

Department

Social Work

First Advisor

Diane B Mitschke

Abstract

A significant amount of progress has been made over the past decade to reduce the impact of risky sexual behavior among adolescents; however, rates of unwanted pregnancy and contraction of sexually transmitted infections remain high. Finding ways to mitigate the consequences of risky sexual behavior continues to be a focus of many working with adolescents engaging in risky behavior. This study performed a secondary analysis of data collected during a 5-year evaluation of a teen pregnancy program targeting youth ages 17-19 who were at high risk for dropping out of high school. The goals of this study were two fold: 1) Test the applicability of the Health Belief Model (HBM) for assessing both adolescent intentions to use condoms and condom use behavior, and 2) Assess the moderating effect of the Developmental Assets framework on the relationship between condom use intentions and behavior. Guided by the Health Belief Model framework, factor analyses were conducted to identify the model that best fit the data. This resulted in six factors comprised of 26 items that reflected different aspects of the HBM and predicted 63% of the variance in the model. This was followed by ordinal and logistic regressions to detect the relationship between each of the identified factors and condom use intentions, as well as between each of the identified factors and condom use behavior. The results demonstrated that Partner Efficacy, Interpersonal Barriers - Partner Trust, Structural Barriers - Accessibility, Benefits, and Physical Barriers - Comfort significantly predicted intentions to use condoms. Susceptibility was the only factor that did not produce a significant result for intentions to use condoms. Interpersonal Barriers - Partner Trust, Structural Barriers - Accessibility, and Physical Barriers - Comfort significantly predicted a positive relationship between the factor and condom use behavior. Susceptibility was found to have a significant negative relationship between susceptibility and condom use behavior, while Partner Efficacy and Benefits failed to produce significant results. Ultimately, participants who reported greater intentions to use condoms were more than twice as likely to report using a condom in the past three months. Overall developmental assets scores did not significantly demonstrate a moderating effect on the relationship between intentions and behavior. These findings confirm that the Health Belief Model in the originally hypothesized form did not fit well for this sample; however, the newly identified model demonstrated a stronger fit for this population. The development of a new model guided by the HBM may be more applicable when assessing condom use intentions with academically at-risk adolescents. While some of the factors exhibited limitations, revisions to items, inclusion of new items, and removal of weaker items may lead to an improved model and should be explored. Further examination into the role of the developmental assets should also be assessed. Implications of this study's findings for social work policy, practice and future research are discussed.

Disciplines

Social and Behavioral Sciences | Social Work

Comments

Degree granted by The University of Texas at Arlington

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