Abstract
Youth sex and relationship education programs aim to improve adolescent well-being by changing their knowledge, beliefs, and attitudes regarding sex and their health. However, there is a gap in existing research linking these cognitive targets to relevant behaviors, and a particular dearth of data on links with sexual behaviors. The current study tested longitudinal links between cognitive factors related to sex (attitudes about sex, normative beliefs, risk-avoidant intentions, and confidence in refusal skills) and outcomes of sexual behaviors (recent sexual encounters, number of sexual partners, and frequency of condom use). Data were drawn from three waves of data from a panel study of US high-school students and were analyzed using cross-lagged structural equation modeling. We hypothesized direct, reciprocal links between intentions and behaviors, but this hypothesis was not supported. Instead, more conservative attitudes about sex emerged as the most consistent prospective predictor of fewer sexual encounters and sexual partners, though with small effect sizes (βs = − .08 to − .131, ps < .05). Further, bidirectional interrelationships were observed among several of the cognitive and behavioral variables over time. These results highlight attitudes about sex as a potentially useful intervention target, but also suggest that sex and relationship education curricula and evaluations should consider multiple pathways of links between cognition and behavior. Continued research is needed on causal links between adolescents’ sexual attitudes, knowledge, intentions, and behavior.
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Analysis code is available from the corresponding author upon request.
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Data are available from the corresponding author upon request.
References
Albarracín, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychological Bulletin, 127(1), 142–161.
Bastow, B., Sheeder, J., Guiahi, M., & Teal, S. (2018). Condom use in adolescents and young women following initiation of long- or short-acting contraceptive methods. Contraception, 97(1), 70–75. https://doi.org/10.1016/j.contraception.2017.10.002
Bersamin, M. M., Walker, S., Fisher, D. A., & Grube, J. W. (2006). Correlates of oral sex and vaginal intercourse in early and middle adolescence. Journal of Research on Adolescence, 16(1), 59–68. https://doi.org/10.1111/j.1532-7795.2006.00120.x
Bourdeau, B., Grube, J. W., Bersamin, M. M., & Fisher, D. A. (2011). The role of beliefs in sexual behavior of adolescents: Development and validation of an adolescent sexual expectancies scale. Journal of Research on Adolescence, 21(3), 639–648. https://doi.org/10.1111/j.1532-7795.2010.00697.x
Brull, P., Ruiter, R. A. C., Wiers, R. W., & Kok, G. (2016). Identifying psychosocial variables that predict safer sex intentions in adolescents and young adults. Frontiers in Public Health, 4(74), 1–10. https://doi.org/10.3389/fpubh.2016.00074
Buhi, E. R., & Goodson, P. (2007). Predictors of adolescent sexual behavior and intention: A theory-guided systematic review. Journal of Adolescent Health, 40(1), 4–21. https://doi.org/10.1016/j.jadohealth.2006.09.027
Cadely, H. S., Finnegan, V., Spears, E. C., & Kerpelman, J. L. (2020). Adolescents and sexual risk-taking: The interplay of constraining relationship beliefs, healthy sex attitudes, and romantic attachment insecurity. Journal of Adolescence, 84, 136–148. https://doi.org/10.1016/j.adolescence.2020.08.010
Cederbaum, J. A., Rodriguez, A. J., Sullivan, K., & Gray, K. (2017). Attitudes, norms, and the effect of social connectedness on adolescent sexual risk intention. Journal of School Health, 87, 575–583. https://doi.org/10.1111/josh.12532
Chilman, C. S. (1990). Promoting healthy adolescent sexuality. Family Relations, 39(2), 123–191. https://doi.org/10.2307/585712
DiIorio, C., Dudley, W. N., Kelly, M., Soet, J. E., Mbwara, J., & Sharpe Potter, J. (2001). Social cognitive correlates of sexual experience and condom use among 13- through 15-year-old adolescents. Journal of Adolescent Health, 29, 208–216. https://doi.org/10.1016/S1054-139X(00)00200-7
Enders, C. (2011). Missing not at random models for latent growth curve analyses. Psychological Methods, 1, 1–16. https://doi.org/10.1037/a0022640
Espada, J. P., Morales, A., Guillen-Riquelme, A., Ballester, R., & Orgiles, M. (2016). Predicting condom use in adolescents: a test of three socio-cognitive models using a structural equation modeling approach. BMC Public Health, 16(1), 1–10. https://doi.org/10.1186/s12889-016-2702-0
Feldstein Ewing, S. W., & Bryan, A. D. (2016). A question of love and trust? The role of relationship factors in adolescent sexual decision-making. Journal of Developmental and Behavioral Pediatrics, 36(8), 628–634. https://doi.org/10.1097/DBP.0000000000000190
Fishbein, M., & Ajzen, I. (1975). Beliefs, attitude, intention, and behavior: An introduction to theory and research. Addison-Wesley.
Giordano, P. C., Soto, D. A., Manning, W. D., & Longmore, M. A. (2001). Toledo Adolescent Relationships Study (TARS): Wave 1. Interuniversity Consortium for Political and Social Research.
Giordano, P. C., Manning, W. D., Longmore, M. A., & Flanigan, C. M. (2012). Developmental shifts in the character of romantic and sexual relationships from adolescence to young adulthood. In A. Booth, S. Brown, N. Landale, W. Manning, & S. McHale (Eds.), Early adulthood in a family context (pp. 133–164). Springer.
Godin, G., & Kok, G. (1996). The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion, 11(2), 87–98.
Hock-Long, L., Henry-Moss, D., Carter, M., Hatfield-Timajchy, K., Erickson, P. I., Cassidy, A., Macauda, M., Singer, M., & Chittams, J. (2013). Condom use with serious and casual heterosexual partners: Findings from a community venue-based survey of young adults. AIDS and Behavior, 17(3), 900–913. https://doi.org/10.1007/s10461-012-0177-2
Janssens, A., Blake, S., Allwood, M., Ewing, J., & Barlow, A. (2020). Exploring the content and delivery of relationship skills education programmes for adolescents: a systematic review. Sex Education, 20(5), 494–516. https://doi.org/10.1080/14681811.2019.1697661
Kirby, D. B., Laris, B. A., & Rolleri, L. A. (2007). Sex and HIV education programs: Their impact on sexual behaviors of young people throughout the world. Journal of Adolescent Health, 40, 206–217. https://doi.org/10.1016/j.jadohealth.2006.11.143
L’Engle, K. L., & Jackson, C. (2008). Socialization influences on early adolescents’ cognitive susceptibility and transition to sexual intercourse. Journal of Research on Adolescence, 18(2), 353–378. https://doi.org/10.1111/j.1532-7795.2008.00563.x
Lee, F. A., Lewis, R. K., & Kirk, C. M. (2011). Sexual attitudes and behaviors among adolescents. Journal of Prevention & Intervention in the Community, 39(4), 277–288. https://doi.org/10.1080/10852352.2011.606399
Little, T. D. (2013). Longitudinal structural equation modeling. Guilford Press.
Lyons, H. A., Manning, W. D., Longmore, M. A., & Giordano, P. C. (2015). Gender and casual sexual activity from adolescence to emerging adulthood: Social and life course correlates. Journal of Sex Research, 52(5), 543–557. https://doi.org/10.1080/00224499.2014.906032
Manning, W. D., Giordano, P. C., & Longmore, M. A. (2006). Hooking up: the relationship contexts of “nonrelationship” sex. Journal of Adolescent Research, 21(5), 459–483. https://doi.org/10.1177/0743558406291692
McElwain, A. D., Kerpelman, J. L., & Pittman, J. F. (2015). The role of romantic attachment security and dating identity exploration in understanding adolescents’ sexual attitudes and cumulative sexual risk-taking. Journal of Adolescence, 39, 70–81. https://doi.org/10.1016/j.adolescence.2014.12.005
McElwain, A., McGill, J., & Savasuk-Luxton, R. (2017). Youth relationship education: A meta-analysis. Children and Youth Services Review, 82, 499–507. https://doi.org/10.1016/j.childyouth.2017.09.036
Meier, A. M. (2003). Adolescents’ transition to first intercourse, religiosity, and attitudes about sex. Social Forces, 81(3), 1031–1052. https://doi.org/10.1353/sof.2003.0039
Montanaro, E. A., & Bryan, A. D. (2014). Comparing theory-based condom interventions: Health Belief Model versus Theory of Planned Behavior. Health Psychology, 33(10), 1251–1260. https://doi.org/10.1037/a0033969
Pearson, J. (2006). Personal control, self-efficacy in sexual negotiation, and contraceptive risk among adolescents: The role of gender. Sex Roles, 54, 615–625. https://doi.org/10.1007/s11199-006-9028-9
Pound, P., Denford, S., Shucksmith, J., Tanton, C., Johnson, A. M., Owen, J., & Campbell, R. (2017). What is best practice in sex and relationship education? A synthesis of evidence, including stakeholders’ views. British Medical Journal Open, 7(5), e014791. https://doi.org/10.1136/bmjopen-2016-014791
Prati, G., Mazzoni, D., & Zani, B. (2014). Perceived behavioral control, subjective norms, attitudes and intention to use condom: a longitudinal cross-lagged design. Psychology & Health, 29(10), 1119–1136. https://doi.org/10.1080/08870446.2014.913043
Romer, D. (2010). Adolescent risk taking, impulsivity, and brain development: Implications for prevention. Developmental Psychobiology, 52(3), 263–276. https://doi.org/10.1002/dev.20442
Rosseel, Y. (2012). lavaan: an R package for structural equation modeling. Journal of Statistical Software, 48, 1–36.
Scott, M. E., Moore, K. A., & Hickman, S. (2015). Measuring “Healthy Marriage” in the Supporting Healthy Marriage (SHM) evaluation. Child Trends.
Simpson, D. M., Leonhardt, N. D., & Hawkins, A. J. (2018). Learning about love: a meta-analytic study of individually-oriented relationship education programs for adolescents and emerging adults. Journal of Youth and Adolescence, 47(3), 477–489. https://doi.org/10.1007/s10964-017-0725-1
Strachman, A., & Impett, E. A. (2009). Attachment orientations and daily condom use in dating relationships. Journal of Sex Research, 46(4), 319–329. https://doi.org/10.1080/00224490802691801
Turchik, J. A., & Gidycz, C. A. (2012). Prediction of sexual risk behaviors in college students using the Theory of Planned Behavior: a prospective analysis. Journal of Social and Clinical Psychology, 31(1), 1–27. https://doi.org/10.1521/jscp.2012.31.1.1
Van Campen, K. S., & Romero, A. J. (2012). How are self-efficacy and family involvement associated with less sexual risk taking among ethnic minority adolescents? Family Relations, 61, 548–558. https://doi.org/10.1111/j.1741-3729.2012.00721.x
Van de Bongardt, D., Reitz, E., Sandfort, T., & Dekovic, M. (2015). A meta-analysis of the relations between three types of peer norms and adolescent sexual behavior. Personality and Social Psychology Review, 19(3), 203–234. https://doi.org/10.1177/1088868314544223
Funding
This project was funded by Grant Number 90FM0089 from the Office of Family Assistance (OFA) within the Administration for Children and Families (ACF), US Department of Health & Human Services (HHS).
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GR is the evaluator for the grant that funded the larger study, conceived of the current study, and revised the manuscript. KK designed the research questions and analysis plan for the current study, analyzed the data, and drafted the manuscript. CH drafted substantial portions of the manuscript and contributed to conceptual interpretation. JO provided manuscript revisions and contributed to conceptual interpretation. All authors read and approved of the final manuscript.
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Ethical standards for research with human subjects were followed when conducting the study. All juvenile participants provided assent, and parents were provided an opportunity to opt out, in compliance with regulations and policies for school-based curriculum research. The Institutional Review Board of the senior author’s university approved all study procedures. Longitudinal Associations among Adolescents’ Sexual Attitudes, Beliefs, and Behaviors.
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Knopp, K., Huntington, C., Owen, J. et al. Longitudinal Associations Among Adolescents’ Sexual Attitudes, Beliefs, and Behaviors. Arch Sex Behav 52, 233–241 (2023). https://doi.org/10.1007/s10508-022-02425-1
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DOI: https://doi.org/10.1007/s10508-022-02425-1