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    Sears Research Paper Sears Research Paper Document Transcript

    • Adolescent Risky Sexual Behaviors FYC 4801 Research Methods Dr. E. Baugh April 15, 2009 Ayana Barrow Stacy Johnson Shaneeka Sears 1
    • Introduction Adolescents are more susceptible to contracting HIV/AIDS, unwanted pregnancies and being exposed to new cases of sexually transmitted diseases. The opposed reason for adolescents’ attitudes and behaviors to engaging in unsafe sexual encounters have yet to be determined. The purpose for this research study is to examine adolescents’ attitudes and behaviors regarding their sexual activity and recognize, if a comprehensive program can be accountable as an intervention plan. To formulate a productive society, it is prevalent that we target this matter pertaining to societies adolescents’ who are the next generation to regulate the world. According to the Center for Disease Control (2007), “approximately 48% of high school student’s reported having sexual intercourse, and 15% of high school students have had four or more sex partners during their life.quot; Chronologically, adolescents are the next age group to reproduce and maintain order within society whenever the current generation gets older. It is unhealthy to accumulate a productive society with “Nearly half of the 19 million new cases of sexual transmitted infections (STIs) reported each year occur among adolescents and young adults aged 15-24 years, highlighting the urgent need for effective measures and intervention” (Buffardi et al., 2008). In fact, there are factors such as lack of self esteem, lack of parental involvement and lack of proper knowledge of sexual literacy that play an important role in adolescent’s risky sexual behaviors. Intervention programs are needed to educate adolescents about engaging in such risky sexual behavior. For example, “The Carrera program teaches teen’s sexual literacy, while emphasizing their potential to be successful and happy through the pursuit of education and/or stable employment” (Philliber et al., 2002, p. 244). In today’s society adolescents are affected by early initiation of sexual activity and are in need of a comprehensive program like the Carrera Program to guide them through life effectively. Statistics show “13-15% of American teens report having sexual intercourse before turning 15, the rate 2
    • climbs steeply there after” (Schofield et. al, 2008). Further research needs to be done targeting the main factors why adolescents engage in such risky sexual behaviors. Also, adolescents engaging in risky sexual behaviors should participate in comprehensive intervention programs such as the Carrera Program, which needs to be widely developed. Theoretical Orientation In current research studies the integrative model of behavior change brings together several theoretical constructs of behavior change; theories of reasoned action, behavior change, and planned behavior. These models will be used to guide the evaluation of adolescent attitudes toward risky sexual behavior (Bleakley et. al, 2009). According to the model of behavior change, behavior is primarily determined by one’s intent to perform a specific behavior as a function of how favorable they are regarding performing the behavior; perceptions by others regarding the behavior and its perceived norms, and beliefs about one’s ability to perform the behavior in the presence of barriers (Escobar-Chavez et. al, 2005). The Behavior Model of Change suggests a behavioral belief that adolescents might be having sexual intercourse to increase intimacy with their partner (Bleakley et. al, 2009). The model also examines the beliefs of theoretical reasoning and empirical evidence, that intention behavior is the primary explanatory factor in adolescent sexual behavior (Bleakley et. al, 2009). According to Schofield, the increase in sexual activity amongst adolescents is related to the onset of risky behavioral problems (Schofield et. al, 2008). For example, males encounter school dilemmas and substance abuse, whereas females experience unwanted pregnancies and sexual transmitted diseases (Schofield et. al, 2008). Adolescents’ risky sexual encounters render consequences that affect society. These risky encounters affect society because there is an increase 3
    • in the number of new HIV/AIDS cases in adolescents as well as a rise in the number of STD’s. An adolescent’s belief about specific behaviors such as peer behavior concerning vaginal sex, and the unavailability of protection, correlates with their risk behavior and the behavior influence of peers, which acts as a causation for such risky behavior (Arnett, 2007). In some cases, adolescents are influenced by their peers to engage in risky behavior. Many have yet to develop an identity and they feel the need to engage in these behaviors for social acceptance with out considering the consequences. According to planned behavior theory adolescents plan to engage in sexual activity because of curiosity. There have been several studies that have applied the model of integrative behavior change to study why adolescents are engaging in risky sexual activity (Bleakley et. al., 2009; Velicer & Prochaska, 2008). It is evident that the model of behavior change is effective in evaluating adolescents’ attitudes toward sexual risky behavior because the model postulates a pattern that improves motivation (Schwarzer, 2008). Behavior change can occur if the five discrete stages are followed: pre-contemplation, contemplation, preparation, action and maintenance. These stages along with the integrative model of behavior change, normative beliefs, and motivation to comply have a direct correlation on the success of reducing the amount of adolescents who engage in risky behavior (Schwarzer, 2008). Literary Review Research over the last five years has been geared towards studying different factors that play a vital role in adolescent’s risky sexual behavior. According to Arnett (2007), the adolescent in their social environment is conducive to engaging in sexual intercourse, because it brings students together frequently when social events are planned, which allows them to explore 4
    • and be free. Arnett (2007) gives great details about sexuality in late adolescents, the risky factors for adolescents being exposed to sexually transmitted dieses, and explains the need for sex educational courses. Although Arnett (2007) produce a small portion of information about sexually transmitted diseases for adolescents the Center for Dieses Control and Prevention (2008) provides information about different sexual transmitted dieses, the symptoms, and treatments, if treatable. According to the Center for Disease Control (2008), “39% of sexually active high school students did not use a condom during their last sexual intercourse”. Once adolescents partake in such risky sexual activity they put themselves as well as others at great risk increasing their likelihood to contract sexual transmitted diseases. In fact, “Forty-five percent report having sex before turning 17, and approximately 70% have had sex by the time they reach age 19” (Guttmacher Institute, 2006). According to the CCDC, “In 2006, an estimated 5,259 young people aged 13-24 were diagnosed with HIV/AIDS, representing about 14% of the persons diagnosed that year” (Center for Chronic Disease Prevention, 2008). Moreover “each year, there are approximately 19 million new STD infections, and almost half of them are among youth aged 15 to 24. In 2002, 12% of all pregnancies, or 757,000, occurred among adolescents aged 15-19 (Center for Chronic Disease Prevention, 2008). In the research studies of (Trotter & Alderson, 2007; Synovitz, Hebert et. al., 2005), adolescents attitudes and behaviors were the main factor, researchers focused on adolescents perspectives’ about contraceptives, identified the primary partner that makes the decision when it comes to practicing safe sex, and studies was conducted on adolescents views about sexually transmitted diseases. On the other hand, Schackman et al. (2008) wrote an informative article about prevention interventions effectiveness in clinical settings based on HIV patients. This article is useful for statistical data on HIV patients that do not know of their condition and continue to 5
    • spread the HIV/AIDS disease around. However, since the young population is more susceptible to contracting these untreatable disease and infection with the lack of proper knowledge on sexual literacy more comprehensive programs and the need of sex education is imperative. Systematically, linking other youth programs that address possible advancements and extracurricular activities can keep adolescents active and decrease the opportunity for youth to explore risky behavior (Kalmuss, Davidson et. al, 2003). For example, “Evaluations results allow the CAS- Carrera program to join the fewer than ten others that have shown an impact on teenage pregnancy or birth rates” (Philliber et. al., 2002, p. 251). In fact, teens who are involved in the Carrera Adolescence Program were “thirty percent more likely to graduate from high school or obtain a G.E.D., forty percent less likely to have ever been pregnant and thirty seven percent more likely to be enrolled in college” (Philliber et al., 2002, p. 245) Sexual education is another intervention that researchers have evaluated in search of its effectiveness for adolescents who partake in risky sexual activity. According to Lederman, Chan, and Roberts-Gray (2008), if society can teach adolescents through Sex-Ed programs the correct way to approach, await, and understand sexual intercourse we can prevent some unwanted pregnancies and the spread of sexual transmitted disease. To point out, Corbett et. al. (2006) examined the knowledge, attitudes, and behaviors regarding emergency contraception (EC) in men and women aged 18–21.This article is different compared to the other reference material, it focused on an alternative method for unprotected sex. Yet, it is still important for adolescents to learn proper methods to protect themselves if they chose not to practice abstinence. This article provides important contraceptive methods to give adolescents more of a variety to practice safe sexual techniques. All of the sources mentioned will be helpful tools in the research process to determine adolescent’s attitudes and behaviors regarding sexual intercourse. The research studies are deemed credible; they can be elaborated upon or 6
    • retouched by future researchers in the social science felid to reach a clear understanding of adolescent’s attitudes and behaviors about sexual intercourse. Variables The variables associated with this research study are gender, race/age, self-esteem, parental involvement, knowledge of proper sexual literacy, a comprehensive program and increased rates of HIV/AIDS, unwanted pregnancies and new cases of sexually transmitted diseases. In this research study, the independent variables are gender, race, lack of self-esteem, lack of parental involvement and lack of proper knowledge on sexual literacy. Gender is a factor in the independent variables because it is important to know exactly which sex- males or females play a vital role in this research study. Researchers will use gender to distinguish which sex the intervention program will be geared towards. Race/Age is a variable that helps the study distinguish which ethnic and age group deserves more attentiveness and priority to the program. Lack of self-esteem, lack of parental involvement and lack of proper knowledge on sexual literacy are variables that will be manipulated through survey questions and interview, so researchers can identify if each variable influence students’ sexual attitudes and behaviors. Also, this research study consists of an intervening variable, a comprehensive program the Carrera program. The Carrera program comprehensive approach concede with the parallel family and holistic approach, which is “integrating sexuality within a comprehensive set of support tools that emphasizes education, employment and all the other elements that make a young person whole.” (Carrera, 2006) Lack of comprehensive programs can allow other negative factors to influence adolescent’s decision- making skills. Such factors are poor self-esteem, lack of parental involvement and improper knowledge about sexual literacy can all deter students’ ethical attitudes and behaviors about their sexual relations. The dependent variable associated with this research study is increased rates of 7
    • HIV/AIDS, unwanted pregnancies and new cases of sexually transmitted diseases. This research study explains the lack of Self-esteem, parental involvement and proper knowledge of sexual literacy, intervened by the lack of comprehensive programs can identify increased rates of HIV/AIDS, unwanted pregnancies and new cases of sexually transmitted disease, which are variables that can be causally related. Research Methods In order to conduct a study on adolescence engaging in risky sexual activities the researcher used a convince sample obtained from a local public high school, which happened to be located in a poverty stricken environment. This school and its location were deemed fit to conduct this particular research study. Approval for the research to be conducted was giving by the school board, the principal and the parents of the local high school students. Once consent for the research study was received the principal and the researcher randomly selected high school students according to their student identification numbers. The first phase of the research study, participants were administered a confidential basic survey. Only students engaging in risky sexual activity were chosen to further continue in the research study. In the second phase of the research study, all students were administered a survey, they were asked about their perceptions of sex in school and their sexual intercourse practices. Participants taking the survey were asked their gender, age, and race which help to determine the particular people who were engage in risky sexual activity. Participants were asked if their activity has affected their lives negatively for example in school or at home, with family, peers, and friends. The researcher wanted to know what each student’s outlook was when engaging in risky sexual behavior. 8
    • During the interviews participants were asked their self esteem level and their knowledge about sexual literacy. According to Abbot-Chapman (2008, p. 611) “Findings reveal that the wider the range of social support, including parents, family and friends the less likely are teenagers to participate in risky behaviors such as sexual activity.” Based on this finding, researcher asked questions concerning the students social support asking them how close they where to family and friends before ever partaking in any sexual activities. Here are some of the survey questions used in the study: 1a. Have you ever engaged in risky sexual activity? Yes No 1b. If yes how frequently do you engage in such activity a. Everyday b. Monthly c. About every 6 months d. One time 2. How stable are you in making decisions about engaging in sexual intercourse? a. I depend on my friends to make my sexual related decisions b. It depends on how my sexual partner sees me. c. I can make my own decisions not relying on anyone else d. I am not sexually active, so I make an abstinence decision 3. What is your relationship like with your Parent/Guardian? Explain ____________________________________________________________ 4. How frequently do you engage in the following sexual behaviors? Please record your response by rating 4 meaning very frequently to 1 meaning you do not participate in such activities. Unprotected Sexual 4 3 2 1 intercourse Oral Sex 4 3 2 1 9
    • Sex under the influence 4 3 2 1 ex. Alcohol/drugs Sex with many partners 4 3 2 1 Once the responses from the survey and the interview were collected, the data was transcribed and examined. Based on the results from the survey and the interview, the researcher will be able to make inferences and determine a correlation between students who engage in risky sexual activity and the lifestyle they live. As for the results, the researcher hopes to provide a comprehensive intervention program to determine if it has an effect on adolescence that engage in risky sexual behaviors. Analyzing Researchers in this study will use the results from the adolescent surveys to identify if lack of self esteem, lack of parental involvement, lack of sexual literacy, comprehensive programs contribute to increase numbers of adolescents contracting HIV/AIDS, unwanted pregnancies and sexual transmitted diseases. Data will be entered into the Statistical Packaging for the Social Science (SPSS) database. The information will go through a coding procedure to input females, males, ages 13-21, African Americans, Hispanic Americans, White Americans, Latinos, Asian Americans and Native Americans, different self esteem levels, parental involvement and sexual literacy. Once results were analyzed a liner relationship was recognized on a scatter gram for low self-esteem and minimum parental involvement. The two bivariates, low self esteem and parental involvement varied together in a relation, representing a covariance relationship. This relationship provide evidence to the researchers that majority of sexual active adolescents have self esteem issues and minimum parental involvement. A control group consisted of adolescents that did not participate in a comprehensive program and the experimental group consisted of students that 10
    • participated in a comprehensive program. After the survey and interview data was collected, the experimental groups were formulated and treatment was given, a follow up case study was completed on each experimental group. Once all data was analyzed, researchers inferred that the comprehensive program is indeed an effective intervention program. “The Carrera Program statistics show quot;Females- 40% are less likely to have ever been pregnant, 50% are less likely to have ever given birth, more than twice as likely to be using Depo-Provera, a hormonal contraceptive.” (Philliber et al., 2002, p. 250) To sum it up, low self-esteem and minimum parental involvement contributed to adolescents engaging in risky sexual behavior, yet with the help of a comprehensive program as an intervention there is hope for society’s adolescents to become future leaders or productive members of society. Conclusion This research study is a very important addition to the existing literature of adolescence engaging in risky sexual behaviors. It was the first study conducted using an experimental group with a comprehensive approach program. After conducting research on adolescence engaging in risky sexual activity this study helped aid in decreasing the likely-hood of adolescence engaging in risky sexual behavior. Research found the comprehensive approach works best and it will help contribute positive knowledge to the existing research on adolescences risky sexual behaviors. Previous research only highlighted the importance and the demand of sexual education courses with inferences on safe sex practices. This study however, researches a comprehensive approach, sexual literacy, self-esteem, and parental involvement which all showed an impact on why adolescence may engage in risky sexual behaviors. 11
    • Future researchers should address the issue about the environment adolescence are consumed to and the effect of growing up in low SES or single parent headed households. Other studies can also expand on the sexual literacy, self-esteem, and parental involvement factor to describe the effects, attitudes of adolescents and their behavior patterns pertaining to their sexual relations. Also, future researchers can expound on the effect of engaging in risky sexual activity during adolescence and the effect it can have in emerging adulthood and adulthood relating the findings to the functioning of society. This research is important to existing and future sexual prevention programs. This information may be vital to parents of adolescence and health school officials. Other researchers should collect and conduct studies to expound upon this research and future studies. Researchers should elaborate on the behavior, the comprehensive approach and the success of other programs that have managed to help decrease adolescence risky sexual behaviors. The researcher plans to submit this article to the Journal of Adolescent Health. Reference Abbot-Chapman, J. (2008). Social support as a factor inhibiting teenage risk taking: View of students, parents and professionals. Journal of Youth Studies. 11(6). Arnett, J. J. (2007) Adolescence and emerging adulthood: A cultural approach. Upper Saddle River, NJ: Pearson Prentice Hall. 12
    • Carrera, M. (2006) Children’s aid society- Carrera adolescent pregnancy. Retrieved February 20, 2009 from, http://stopteenpregnancy.com/index.html Center for Disease Control and Prevention. (2008). Sexually transmitted diseases. Retrieved February 19, 2009, from http://www.cdc.gov/STD/ Centers for Disease Control and Prevention. (2007). Youth risk behavior surveillance summaries. Morbidity & Mortality Weekly Report 2008. 57(SS-4)1–131. Corbett, P., Mitchell, C., Taylor, J. & Kemppainen, J. (2006). Emergency contraception: Knowledge and perceptions in a university population. Journal of the American Academy of Nurse Practitioners, 18(4), 161-168. Retrieved April 13, 2009, from Academic Search Premier database. Bleakley, A., Fishbein, M., Hennessy, M., Jordan, A. (2009). How sources of sexual Information relate to adolescents' beliefs about sex. American Journal of Health Behavior. 33 (1) 37-48, 12p. Buffardi, A., Thomas, K., Holmes, K. & Manhart, L. (2008). Moving upstream: Ecosocial and psychosocial correlates of sexually transmitted infections among young adults in the united states. American Journal of Public Health. 98(6) 1128-1136. Retrieved February 28, 2009, from Academic Search Premier database. Buhi, E. & Goodson, P. (2007). Predictors of adolescent sexual behavior and intention: A theory- guided systematic review. Journal of Adolescent Health. 40, 4-21. Escobar-Chaves, S., Tortolero, S. & Markham, C. (2005). Impact of media on sexual attitudes and behaviors. Pediatrics. 116(1) 303-326. Guttmacher Institute. (2006). Facts on American teens’ sexual and reproductive health. Retrieved April 13, 2009, from http://www.guttmacher.org/pubs/fb_ATSRH.html Kalmuss, D., Davidson, A., Cohall, A., Laraque, D. & Cassell, C. (2003). Preventing sexual risk behaviors and pregnancy among teenagers: Linking research and programs. Perspectives on Sexual & Reproductive Health. 35(2) 87. Retrieved January 22, 2009, from Academic Search Premier database. Lederman, R., Chan, W. & Roberts-Gray, C. (2008). Parent adolescent relationship education (PARE): Program delivery to reduce risks for adolescent pregnancy and STDs. Behavioral Medicine. 33(4), 137-143. Retrieved April 1, 2009, from Academic Search Premier database. National Center for Chronic Disease Prevention and Health Promotion. (2007). Division of adolescent and school health CDC. Morbidity & Mortality Weekly Report 2008. 57(SS-4) 1–131. Retrieved February 21, 2009, from http://www.cdc.gov/HealthyYouth/sexualbehaviors/ 13
    • Philliber, S., Williams, J. K., Herrling, S. & West, E. (2002). Preventing pregnancy and improving health care access among teenagers: An evaluation of the children’s aid society-carrera program. Perspectives on Sexual and Reproductive Health. 34(5) 244-251. Schackman, B., Dastur, Z., Ni, Q., Callahan, M., Berger, J. & Rubin, D. (2008). Sexually active HIV-positive patients frequently report never using condoms in audio computer-assisted self-interviews conducted at routine clinical visits. AIDS Patient Care & STDs. 22(2), 123-129. Retrieved April 11, 2009, from Academic Search Premier database. Schofield, H., Bierman, K., Heinrichs, B. & Nix, R. (2008). Predicting early sexual activity with behavior problems exhibited at school entry and in early adolescence. Journal of Abnormal Child Psychology. 36(8), 1175-1188. Retrieved February 21, 2009, from Academic Search Premier database. Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology: An International Review. 57(1) 1-29, 29p. Synovitz, L., Hebert, E., Carlson, G. & Kelley, R. (2005). College students’ sexuality education, sexual behaviors and sexual behavioral intent. American Journal of Health Studies. 20(1/2), 47-57. Retrieved April 13, 2009, from Academic Search Premier database. Trotter, E. & Alderson, K. (2007). University students' definitions of having sex, sexual partner, and virginity loss: The influence of participant gender, sexual experience, and contextual factors. Canadian Journal of Human Sexuality. 16(1/2), 11-29. Retrieved April 13, 2009, from Academic Search Premier database. Velicer, W. & Prochaska, J. (2008). Stage and non-stage theories of behavior and behavior change: A comment on schwarzer. Applied Psychology: An International Review. 57(1) 75-83. 14