The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62018

Tricia M. Michels, MPH¹, Rhonda Kropp, BSc BSN MPH², and Bonnie L. Halpern-Felsher, PhD¹. (1) Dept. of Pediatrics, Division of Adolescent Medicine, University of California, San Francisco, 3333 California St., Ste. 245, Box 0503, San Francisco, CA 94118, 415-609-8198, tmichel@itsa.ucsf.edu, (2) Project Director, UCSF Division of Adolescent Medicine, UCSF, 195 Clearview Ave., apt. 1816, Ottawa, ON K1Z 6S1, Canada

Background: Despite our continued emphasis on conveying risk information to youth, we know very little about how teens incorporate risk information in their decisions or whether such messages have any effect on their behavior. We also need to understand the flip side of the decision equation—perceived benefits. The present study investigates what combination of cognition, values, peer influences, risk and benefit perceptions, and consideration of options dominate young adolescents’ decisions regarding sexual activity and safer sex. Method: We conducted in-depth interviews with 9th-graders (N = 30), using a semi-structured guide. Both qualitative and quantitative analyses were utilized. Results: Our results support the hypotheses that (1) adolescents actively make decisions regarding sexual activity and safer sex; (2) teens consider options, risks, and benefits of their behavior; (3) teens ascribe different values to various sources of information on sexual risk-taking; and (4) adolescents’ reflections of past experiences influence future risk-taking and intentions. The social networks of these teens provide little support for discussing sexual decision-making. Adolescents thinking abstractly about sex are more likely to consider consequences such as pregnancy and sexually transmitted infections, while teens engaging in sexual behavior focus on enhancing sexual experiences and reflect on their changing self-perception. Conclusion: These findings have broad implications for how we communicate with adolescents regarding sexual decision-making. Health messages for teens must take into account developmental distinctions among adolescents who are not contemplating sex at all, teens who are thinking abstractly about sexual activities, and teens who are already engaging in sexual behavior.

Learning Objectives:

• Describe three developmental stages in adolescents, specifically with regard to sexual decision-making.
• Identify two pitfalls of health messages that are not appropriately tailored to adolescents' decision-making readiness and capabilities.
• Discuss creative new directions for health messages aimed at teens at different developmental stages.

Keywords: Risk Communication, Decision-Making

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.