# Presentation: 660952

## Youth Assets and Sexual Intercourse

**11****th**** Annual Maternal and Child Health Epidemiology Annual Meeting, **
**Miami, Florida, **
**December 2005**

## 	Acknowledgment: This project was supported under a cooperative agreement from the Centers for Disease Control and Prevention (CDC) through the Association of Schools of Public Health (ASPH) Grant Number U36/CCU300430 and under Cooperative Agreement Number U88/CCU612534 from the Centers for Disease Control and Prevention awarded to the Oklahoma Institute for Child Advocacy.

## Investigators

- Roy F. Oman, PhD
- College of Public Health, University of Oklahoma Health Sciences Center
- Sara K. Vesely, PhD
- College of Public Health, University of Oklahoma Health Sciences Center
- Cheryl Aspy, PhD
- College of Family and Preventive Medicine, University of Oklahoma Health Sciences Center
- Eleni Tolma, PhD
- College of Public Health, University of Oklahoma Health Sciences Center
- Lorrie Gavin, PhD
- CDC, Division of Reproductive Health
- Trisha Mueller, MPH
- CDC, Division of Reproductive Health

## Background

- Prevention of teen pregnancy through an asset-building approach to youth development
- Assets may help to prevent youth from participating in sexual intercourse

## Background (continued)

- Nine assets
- Developed/conceptualized using data from:
- Needs assessment
- Focus groups
- Literature searches

## Background (continued)

- Research Question:
- 	Are youth who possess assets significantly less likely to be sexually active?

## Methods

- Sampling Strategy
- Census tracts were stratified and randomly selected to achieve a sample of:
- 200 African American Higher SES (6 Tracts) 4
- 200 African American Lower SES (28 Tracts) 5
- 200 Non-Hispanic White Higher SES (43 Tracts) 3
- 200 Non-Hispanic White Lower SES (55 Tracts) 5
- 200 Hispanic All levels SES (26 Tracts) 3

**Notes:**
Number inside parenthesis is the number of tracts that fit the stratification category.  
Number outside the parenthesis is the actual number of tracts that we sampled within the stratification category.  

## Methods (continued)

- Every building in the randomly selected census blocks was enumerated (e.g., house vs. business)
- If block had more than 70 households – then 70 or less households were randomly chosen to be enumerated

## Methods (continued)

- Final disposition determined for every enumerated residence:
- 	- Completed interview
- 	- No youth in residence
- 	- Refused to participate
- 	- House uninhabited
- 	- Business
- 	- Etc.

## Methods (continued)

- Interview Methods
- One parent and one teenager from each household
- Youth and parent interviewer simultaneously in separate rooms of household using a computer-assisted data entry system
- Youth self-administered the risk behavior portion of the questionnaire using headphones and computer entry

**Notes:**
These procedures minimized missing data, insured respondent confidentiality, and reduced non-compliance due to reading ability.

## Methods (continued)

- Interview Methods (continued)
- 1-hour interview
- 200 youth items
- 80 parent items
- “Broken Windows” Survey
- Objective assessment of neighborhood environment

**Notes:**
These procedures minimized missing data, insured respondent confidentiality, and reduced non-compliance due to reading ability.

## Methods (continued)

- Assessed whether the adolescent had ever had sexual intercourse:
-  Have you ever had sexual intercourse ("done it", "had sex", "made love", "gone all the way")?

## Methods (continued)

- Assets
- Aspirations for the Future
- Constructive Use of Time
- Religion
- Groups/Sports
- Responsible Choices
- Community Involvement
- Good Health Practices (Exercise/Nutrition)
- Family Communication
- Peer Role Models
- Non-Parental Adult Role Models

## Methods (continued)

- Individual logistic regression analyses
- controlling for demographic variables
- youth assets were the independent variables
- “never had sexual intercourse” was the dependent variable

## Results

- N =1,111 youth/parent paired interviews
- 2,222 participants
- Youth demographics
- Mean age = 14.3 1.6 years
- 53% female
- Race/Ethnicity
- 39% White
- 28 % Hispanic
- 24% African-American
- 19% Other

## Results (continued)

| Table 1 – Frequencies and Chi-Square Values for Youth and Parent Demographics and Never Had Sexual Intercourse |  |  |  |
| --- | --- | --- | --- |
|  | No. | % Has NOT had sexual intercourse | P-Value |
| Youth Age
          12-13
          14-15
          16-17 | 384
417
280 |  
93.2
 77.2
  56.81 | <0.001 |
| Youth Race
          Non-Hispanic African-American
          Non-Hispanic Caucasian
          Hispanic
          Other | 

255
418
305
103
 | 
67.8
80.9
80.0
81.6 | <0.001 |
| 1Significant trend (p<0.05) |  |  |  |

## Results (continued)

| Table 1 – Continued |  |  |  |
| --- | --- | --- | --- |
|  | No. | % Has NOT had sexual intercourse | P-Value |
| Parent Income
          < $35,000
          $35,000 to $62,000
          > $62,000 | 
532
328
221
 | 73.3
79.9
 84.61 | 0.002 |
| Family Structure
          Two Parent
          One Parent | 
751
330 | 
80.7
70.6 | <0.001 |
| Parent Education
          Both parents < than high school education
          1 parent had high school, GED, or some            
          college
          1 parent had at least a bachelors degree | 
178
603
300 | 
77.5
73.8
 85.31 | <0.001 |
| 1Significant trend (p<0.05) |  |  |  |

## Results (continued)

- Seven assets were significantly related (*p*<.05) to youth never having had sex
- Odds ratios ranged from 1.57 to 3.93 indicating that youth with an asset were significantly more likely to never have had sex compared to youth who lacked the same asset

## Results (continued)

| Table 2 – Relationship Between Youth Assets and Adolescent Never Had Sexual Intercourse: Unadjusted and Adjusted Odds Ratios (OR) with 95% Confidence Intervals (CI) from Individual Multiple Logistic Regression Models |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- |
| Youth Asset |  | Unadjusted |  | Adjusted |  |
|  | N | OR | 95% CI | OR | 95% CI |
| Non-Parental Adult Role Models | 1073 |   1.70* | (1.16, 2.50) | 1.58* | (1.03, 2.43) |
| Peer Role Models | 1081 |   2.34* | (1.75, 3.13) | Interaction |  |
| Family Communication | 1081 |   2.29* | (1.71, 3.06) |   2.03* | (1.47, 2.80) |
| Use of Time (Groups/Sports) | 1074 | 1.27 | (0.93, 1.74) | 1.21 | (0.85, 1.72) |
| *p ≤ 0.05 |  |  |  |  |  |

## Results (continued)

| Table 2 – Continued |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- |
| Youth Asset |  | Unadjusted |  | Adjusted |  |
|  | N | OR | 95% CI | OR | 95% CI |
| Use of Time (Religion) | 1081 |       1.86* | (1.39, 2.48) |    1.72* | (1.24, 2.38) |
| Good Health Practices (Exercise/Nutrition) | 1081 | 1.64* | (1.21, 2.21) | 1.38 | (0.99, 1.92) |
| Community Involvement | 1081 | 1.91* | (1.18, 3.11) |  1.78* | (1.04, 3.01) |
| Aspirations for the Future | 1081 | 2.82* | (1.76, 4.50) |   2.22* | (1.29, 3.80) |
| Responsible Choices | 1081 | 1.88* | (1.34, 2.35) |   2.17* | (1.48, 3.18) |
| Total Assets  | 1072 |  1.33* | (1.23, 1.44) |   1.28* | (1.17, 1.40) |
| *p ≤ 0.05 |  |  |  |  |  |

## Results (continued)

| Table 3 – Adjusted Odds Ratios (OR) with 95% Confidence Intervals (CI) from Multiple Logistic Regression Model for Peer Role Models and Youth Race |  |  |  |
| --- | --- | --- | --- |
|  |  | Adjusted |  |
|  | N | OR | 95% CI |
| Non-Hispanic African-American | 255 | 1.13 | (0.62, 2.08) |
| Non-Hispanic Caucasian | 418 |   3.79* | (2.12, 6.75) |
| Hispanic | 305 | 1.82 | (0.96, 3.45) |
| Other | 103 |   3.93* | (1.06, 14.54) |
| *p ≤ 0.05 |  |  |  |

## Discussion

- Youth assets are associated with a lower likelihood of youth participating in sexual intercourse.
- The more assets the better- cumulative effect.
- Peer role models particularly important for white youth and youth of “other” races.
- Native American, Asian/Pacific Islander, Multi-racial

## Implications

- Strengthening or increasing the number of specific assets youth possess may be an effective strategy for interventions to reduce youth sexual risk behavior.
- Non-Parental Adult Role Models
- Peer Role Models
- Family Communication
- Use of Time (Religion)
- Community Involvement
- Aspirations for the Future
- Responsible Choices