Reducing Adolescent Sexual Risk: A Theoretical - ETR Associates

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negative physical and emotional reactions associatedwith those behaviors.When using roleplays, several steps should be followedto maximize improvement in self-efficacy:1. Clearly describe the components of the skills.2. Model the skills in a roleplay.3. Provide individual practice through roleplays ingroups of two to four in which everyone practices(e.g., telling a partner a personal limit, avoidingor refusing undesired sex or insisting on usingcondoms).4. Start the roleplays with a plausible scenario forthe youth and then follow the scenario with afully scripted roleplay in which both actors (theperson pressuring to have sex and the personresisting having sex) simply read scripts.5. During the roleplays in small groups, haveobservers in each group use a checklist to see ifthe important components of effective skills areemployed.6. Repeat the roleplay practice with different scenariosuntil teens master the skills.7. Start with easier situations and move to increasinglydifficult situations.8. Move from scripts with lines for both people inthe roleplay to scripts in which the person pressuringto have sex reads his/her lines, whilethe person resisting has to create his/her ownresponses.In the roleplaying activities that involve refusing tobe in situations that might lead to sex or refusing tohave sex, several elements of effective refusals arecommonly taught:• Saying “no”• Repeating the refusal• Explaining why• Using direct words• Using proper body language• Using a clear, confident voice• Being assertive (saying what you think, how youfeel or what you want without hurting the otherperson)• Looking the other person directly in the eyes• Using delaying tactics• Changing the topic• Suggesting an alternative• Showing the partner you care and building therelationship• Walking away, if necessaryWhile roleplaying practice may be designed primarilyto increase self-efficacy and skills, when youthcontinually see other youth like themselves successfullyavoiding situations that might lead to sex,refusing undesired sex or insisting on using condoms,these roleplays also may improve their perceptionsof peer norms about the acceptance of avoidingundesired sex or using condoms.Self-efficacy to obtain condoms and contraception.To increase self-efficacy to obtain condomsor other forms of contraception, teens can identifystores or clinics that provide condoms and contraceptivesand “investigate” each source, assessing theease of getting there, comfort of being there, cost,etc. (see Activity 5-5: Addressing Barriers to UsingCondoms). And finally, teens can actually go to oneor more location in small groups, find and assesscondoms in the store, or interview clinic staff aboutobtaining contraceptives. These activities involvemastery of some of the steps needed to obtaincondoms or contraceptives, as well as modeling andpossible persuasion. They also may reduce anxietyabout obtaining condoms or contraceptives.Self-efficacy to use condoms correctly. At leasttwo activities have been commonly implemented toincrease the ability to use condoms correctly. In thefirst activity, teachers first demonstrate how to use acondom properly and then give condoms to studentsto practice the same behaviors individually (seeActivity 7-5: Using Condoms Correctly).In the second activity, each of the steps for usingcondoms is correctly written on a separate sheet of88 Reducing Adolescent Sexual Risk: A Theoretical Guide for Developing and Adapting Curriculum-Based Programs
paper (e.g., the air should be squeezed out of thereservoir tip before putting the condom on) and students,holding these sheets of paper, arrange themselvesin correct chronological order. The first teamto arrange themselves in the proper order wins thecontest (see Activity 7-4: Condom Line-Up). Thisactivity is used when state regulations or communityvalues might prevent the use of the first activity.How has self-efficacy been measured?In Table 7-5 are items that have been used to measureadolescents’ self-efficacy to abstain from sexualactivity or to use condoms or contraception. Onceagain, they are illustrative, not comprehensive.Table7-5Examples of Items That Have Been Used to Measure Self-Efficacy 10Each item with a + – sign represents a positive perception and a protective factor, while each item with a signrepresents a negative perception and a risk factor. Thus, within each scale, items with a + sign should be scored inthe opposite direction of those with a – sign.Positive orNegativeFactor Self-efficacy to abstain from sex+ I have the ability to abstain from sex until married.+I+My+My+If+If+If+IfPositive orNegativeFactorcan abstain from sex until I’m finished withhigh school.boy/girlfriend cannot pressure me intohaving sex.friends will not pressure me into having sex.someone I liked a lot wanted me to have sex, Iam sure I could say “no.”someone I liked a lot wanted me to have sex, Iam sure I could say “no” without hurting his/herfeelings.someone I liked a lot wanted me to have sex andthreatened to break up with me unless I had sex, Iam sure I could say “no.”someone I liked a lot wanted me to have sex andI had been drinking alcohol, I am sure I could say“no.”Perceived self-efficacy in using condomsor contraception+ It would not be too hard for me to buy condoms.10 Most of these items are based on actual questions used to measurefactors in previous research. These items specify more precisely someof the factors that are related to behavior and can therefore be helpfulwhen designing programs to address the proximal sexual factors. Theyalso can be used to create items for questionnaires in survey research.Positive orNegativeFactor+It+If+If+If+IfPerceived self-efficacy in using condomsor contraception (Continued)would not be too hard for me to carry a condomand have it with me if I needed it.I decided to have sex with someone, I amsure that I could talk to my partner about usingcondoms.I decided to have sex with someone, I amsure that I could get my partner to agree to usecondoms.I decided to have sex with someone but did nothave a condom, I am sure that I could stop myselffrom having sex until I got a condom.my partner refused to use condoms, I couldrefuse to have sex.+If I decided to have sex with someone but did nothave any form of contraception, I am sure that Icould stop myself from having sex until one of uscould get an effective method of contraception.+ I am sure that I could use a condom correctly.+I am sure that I could use a condom correctly evenwhen highly aroused.+I am sure that I could use a condom correctly everytime I have sex.+I am sure that I could use a condom every time,even with my girl/boyfriend.+I am sure that I could use a condom even if I haddrunk alcohol or used drugs.+I am sure that I could use or take contraceptionconsistently and correctly.Chapter 7 Increasing Self-Efficacy and Skills 89
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Reducing AdolescentSexual RiskA The
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ETR Associates (Education, Training
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AcknowledgmentsThis book evolved ou
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Activities, Boxes and FiguresActivi
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1 IntroductionThis book was created
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• Children of teenage mothers are
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Table1-2 The 17 Characteristics of
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Each of the following chapters focu
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“determinants,” “behaviors,
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model, provide evidence regarding h
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to avoid unwanted sex and then synt
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Figure2-3 An Example of a Logic Mod
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Table2-2Learning Objectives to Redu
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Table2-2Learning Objectives to Redu
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Table2-3Learning Objectives to Incr
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3 Increasing KnowledgeKeys to Incre
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Table3-1Number of Studies Reporting
Page 47 and 48: Box3-1Types of Activities to Increa
Page 49 and 50: partner does not mind using a condo
Page 51 and 52: methods more often. For example, th
Page 53 and 54: 4ImprovingPerceptions of Risks—Bo
Page 55 and 56: 1. Do teens’ perceptions of risk
Page 57 and 58: a. Presentations and discussions of
Page 59 and 60: Table4-5Examples of Items That Have
Page 61 and 62: Pregnancy Risk Activity and Follow-
Page 63 and 64: STD Handshake(Continued)Important C
Page 65 and 66: 5AddressingAttitudes,Values and Bel
Page 67 and 68: Theories ofAttitude ChangeAttitudes
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Page 71 and 72: • When arguments are presented by
Page 73 and 74: that it is possible to improve thes
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Page 77 and 78: Table5-4Examples of Survey Items fr
Page 79 and 80: Table5-4Examples of Survey Items fr
Page 81 and 82: Activity 5-2Dreams, Goals and Value
Page 83 and 84: Activity 5-4“Dear Abby”Descript
Page 85 and 86: 6CorrectingPerceptionsof Peer Norms
Page 87 and 88: Is there a gap between perceptions
Page 89 and 90: 3. Use concepts, language, symbols,
Page 91 and 92: Table6-4Examples of Items That Have
Page 93 and 94: 7 Increasing Self-Efficacy and Skil
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Page 101 and 102: Activity 7-1Lines That People Use t
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Page 114 and 115: Activity 8-1Description of Activity
Page 117 and 118: 9IncreasingParent-ChildCommunicatio
Page 119 and 120: ehavior may be quite complex (Jacca
Page 121 and 122: 5. Give students multiple homework
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Page 125 and 126: Activity 9-1Description of Activity
Page 127 and 128: Activity 9-3Human Sexuality Board G
Page 129 and 130: 10 ConclusionsKeys to Reducing Sexu
Page 131 and 132: Figure10-1Assessing Factors in Curr
Page 133 and 134: sexual minority youth and pressure
Page 135 and 136: Table10-1Instructional Principles I
Page 137: Table10-1Instructional Principles I
Page 140 and 141: Incidence The number of new cases o
Page 143 and 144: ResourcesThree kinds of resources a
Page 145 and 146: Science-Based Practices: A Guide fo
Page 147 and 148: National Longitudinal Study of Adol
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Changing Social Normshttp://www.etr
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Advocates for Youth, Young Women of
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ReferencesAbelson, R., and Prentice
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Coyle, K. (2006). All4You2! Prevent
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Lapsey, D.K. (1993). Toward an inte
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Weed, S.E., Olsen, J.A., DeGaston,
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