Pastuszak et al.

their ability to share information with other tournament

participants. Approximately 10% of those approached to

participate in the study declined participation, citing lack

of time as the reason for declining to participate.

Conceptual Framework

The social ecological theory (Bronfenbrenner, 1979) is a

useful framework to guide the study of the multiple corre-

lates that affect health behaviors. This model considers the

complex interplay between individual, interpersonal, com-

munity, and societal factors that can compromise or

enhance individuals’ health. Individual factors can include

age, education, income, gender, substance use, or history

of abuse. Interpersonal factors include the social networks,

partners, and family members that influence individuals’

behavior and contribute to their range of experiences.

Community factors include settings such as schools, work-

places, and neighborhoods in which social relationships

occur and can affect health. Societal factors include the

health, economic, educational, and social policies that help

maintain economic or social inequalities between groups

in society and affect health. Due to the complexity of fac-

tors that affect health, the present study used a socioeco-

logical framework to examine individual, interpersonal,

and community correlates associated with health among a

group of 18- to 25-year-old males receiving health services

at family planning clinics. Considering the poor health out-

comes of minority young males and lack of knowledge

about their health care needs, it is important to identify the

various correlates contributing to their health.

Survey Instrument

The survey utilized several measures from adolescent

risk behavior surveys, such as the National Youth Risk

Behavior Survey (CDC, 2011b). Several questions in the

study survey were previously used by the authors (Buzi,

Smith, & Weinman, 2009; Small, Weinman, Buzi, &

Smith, 2009). The multiple health facets examined in the

survey permit a greater understanding of factors influenc-

ing SRH. Following the socioecological model, the sur-

vey included the following domains: demographic

information, individual correlates, interpersonal corre-

lates, and community correlates.

Demographic Information.

The survey queried for general

demographic information, such as age, race/ethnicity, and

educational attainment.

Individual Correlates

Health knowledge

. Eight true/false questions made

up the sexual health knowledge section. The questions

asked about the effectiveness of condoms, modes of

HIV transmission, pregnancy risk, and HIV symptoms.

Knowledge is a prerequisite to sexually risky behaviors,

with the assumption being that accurate knowledge is

essential in motivating individuals to engage in protec-

tive health behaviors.

Sexual risk behaviors

. This section included 12 ques-

tions about engaging in oral, anal, and vaginal sex during

the 3 months prior to taking the survey, age at first sexual

intercourse, condom use during the last sexual encoun-

ter, type of contraceptive used, intent to use birth control

or condoms during the next sexual encounter, history of

STIs, and familiarity with and intent to consider a vasec-

tomy as a birth control method.

Perception of personal HIV/AIDS and STI risk

. Two items

asked whether participants perceive themselves to be at

risk for HIV/AIDS and STIs. Responses included five

categories: very high, high, low, very low, no chance, and

were selected to capture the extent the participants may

distort their HIV/AIDS and STI risk assessments, which

influence their engagement in sexually risky behaviors.

Sexual partnering

. Three questions about gender of

partner preference, and number of lifetime and recent sex

partners were asked.

Mental health

. Four questions about feeling low in

energy or blue during the 2 weeks prior to survey comple-

tion, body image, and self-esteem were asked.

Urologic health

. This section included nine questions

related to knowledge about testicular health, performing

self-testicular exams, and seeing a urologist.

Interpersonal Correlates

Partner communication

. One question asked whether

participants discussed the use of birth control with part-

ners prior to having sex.

Peer norms

. Two questions queried participants about

whether their friends encourage or discourage them to

use condoms and other birth control methods.

Violence

. One question asked participants about their

history of IPV, specifically hitting or being hit by their

partner.

Community Correlates

Exposure to community violence

. This was assessed by

five items asking about participants’ history of trauma or

injury, having been involved in a physical fight, carrying

a weapon for protection, being shot or stabbed, and being

affected by IPV.

at UCSF LIBRARY & CKM on February 12, 2016

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