Att 8_Example Student Survey Items

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Assessments to Inform Program Refinement for HIV, other STD, and Pregnancy Prevention among Middle and High-School Aged Youth

Att 8_Example Student Survey Items

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Attachment 8

Example Student Survey Items







Example items

These items are taken from a variety of existing sources to provide additional examples of the types of questions that could be asked of youth. Footnotes provide the sources of items found elsewhere.



Construct

Topic

Question (Source)

Attitudes

Abstinence

  1. Do you think avoiding having sex (being abstinent) in the next six months would be…(5-point scale, very bad to very good)1

  2. Do you think avoiding having sex (being abstinent) in the next six months would be (5-point scale, very unpleasant to very pleasant)1

  3. Do you think avoiding having sex (being abstinent) in the next six months would be (5-point scale, very awful to very nice)1

Sexual behavior

  1. Do you think if you had sexual intercourse in the next six months it would be…(5-point scale, very bad to very good)1

  2. Do you think if you had sexual intercourse in the next six months it would be…(5-point scale, very unpleasant to very pleasant)1

  3. Do you think if you had sexual intercourse in the next six months it would be…(5-point scale, very awful to very nice)1

  4. Having sex would be a way to keep my boyfriend or girlfriend. (agree/disagree) 2

  5. It’s OK for people my age to have sex. (agree/disagree)2

  6. Please tell me how you feel about the following statements about relationships and becoming sexually active. [INSERT] – would you strongly agree, somewhat agree, somewhat disagree or strongly disagree? 3

    1. Once you have sex it’s harder to say no the next time.

    2. If you have been seeing someone for a while it is expected that you will have sex

    3. There is pressure to have sex by a certain age

    4. Oral sex is not as big of a deal as sexual intercourse

    5. Waiting to have sex is a nice idea but nobody really does

Prevention and Condom Use

  1. It is important to me that I avoid getting a sexually transmitted disease.(agree/disagree)2

  2. Using condoms to prevent the spread of sexually transmitted diseases is more trouble than it's worth. (agree/disagree)2

  3. Please tell me whether you agree or disagree with each of these statements. I am interested in what you think about these issues. There are no right or wrong answers. [INSERT] would you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?3

    1. It is not that big of a deal to have sex without a condom once in a while

    2. Unless you have a lot of sexual partners you don’t need to use condoms

    3. Buying condoms is embarrassing

    4. Condoms break a lot

    5. It’s hard to bring up the topic of condoms

    6. Sex without a condom isn’t worth the risk

  1. It is too much of a hassle to use a condom every time you have sex. (Strongly agree/somewhat agree/neither/somewhat disagree/strongly disagree/DK/Ref)4

Contraceptive Use

  1. Birth control is not very important. (agree/disagree)2

  2. Two people having sex should use some form of birth control, if they aren't ready for a child. (agree/disagree)2

  3. Using birth control is morally wrong. (Strongly agree/somewhat agree/neither/somewhat disagree/strongly disagree/DK/Ref)4,5

  4. It doesn’t matter when you use birth control or not; when it is your time to get pregnant, it will happen. (strongly agree/somewhat agree/neither/somewhat disagree/strongly disagree/DK/Ref)4

  5. It is mainly a woman’s responsibility to make decisions about birth control. (Strongly agree/somewhat agree/neither/somewhat disagree/strongly disagree/DK/Ref)4

  6. In general, birth control is too much of a hassle to use. (strongly agree/agree/neither agree nor disagree/disagree/strongly disagree/refused/legitimate skip/dk)5

  7. In general birth control is too expensive to buy. (strongly agree/agree/neither agree nor disagree/disagree/strongly disagree/refused/legitimate skip/dk)5

  8. It takes too much planning ahead of time to have birth control on hand it when you are going to have sex. (strongly agree/agree/neither agree nor disagree/disagree/strongly disagree/refused/legitimate skip/dk)5

  9. It [is/would be] too hard to get a [girl/boy] to use birth control with you. (strongly agree/agree/neither agree nor disagree/disagree/strongly disagree/refused/legitimate skip/dk)5

  10. For you, using birth control [interferes/would interfere] with sexual enjoyment. (strongly agree/agree/neither agree nor disagree/disagree/strongly disagree/refused/legitimate skip/dk)5

Behavioral Intent

Abstinence

  1. In the next six months, do you intend/expect/plan to avoid (abstain from) having sexual intercourse? (YES!/yes/no/NO!)1

Sexual behavior

  1. In the next six months, do you intend/expect/plan to have sexual intercourse? (YES!/yes/no/NO!)1

Prevention and Condom Use

  1. Do you feel you will use a condom if sex in the next 3 months (5-pt Likert)

  2. I plan to use a condom if sex in the next 3 months (5-pt Likert)

Contraceptive Use

  1. If you intent/expect/plan to have sexual intercourse in the next six months, do you plan on using any of the following for birth control? Select all that apply.

  1. IUD

  2. Implant

  3. Dero (the shot)

  4. NuvaRing (the ring)

  5. The patch

Getting Tested

  1. In the next year, how likely is it that you will be tested for each of the following? (very likely/somewhat likely/not too likely/not at all likely)3

    1. Get tested for HIV, the virus that causes aids

    2. Get tested for other STDs

Peer Norms

Abstinence

  1. How many of your friends think people your age should wait until they are older to have sex? (none/less than half/half/more than half/all)6

  2. Most of my friends believe people my age should wait until they are older before they have sex.(definitely yes/probably yes/probably no/definitely no)2

Sexual behavior

  1. How many of you friends have had sex? (none/less than half/half/more than half/all)5

  2. How many of your friends think it is OK for people your age to have sex with a serious boyfriend or girlfriend? (none/less than half/half/more than half/all)4

  3. Having sex is a good way to impress my friends. (agree/disagree)2

  4. Most of my friends believe it's OK for people my age to have sex with a steady boyfriend or girlfriend. (definitely yes/probably yes/probably no/definitely no)2

  5. Having sexual intercourse at my age is a cool thing for a [boy/girl] to do7

  6. Having sexual intercourse with someone besides his/her steady partner makes a [boy/girl] cool5

  7. Having sex with as many people as possible makes a [boy/girl] cool5

  8. Having sex with 2 different people on the same day makes a [boy/girl] cool5

  9. It’s cool [for girls to get pregnant/for guys to get a girl pregnant] while in high school.5

Prevention and Condom Use

  1. Most of my friends believe condoms (rubbers) should always be used if a person my ages has sex (definitely yes/probably yes/probably no/definitely/no)2

  2. Most of my friends believe condoms (rubbers) should always be used if a person my age has sex, even if the two people know each other very well. (definitely yes/probably yes/probably no/definitely/no)2

  3. How many of your friends think condoms are too much trouble to use? (none/some/most/all)8 or (none/a few/about half/most)9

  4. How many of your friends do you think have had sexual intercourse without a condom because they were high from drinking alcohol?5 or (none/a few/about half/most)9

  5. How many of your friends do you think have had sexual intercourse without a condom because they were high from drugs?5

  6. How many of your friends do you think use condoms when they have sex? (non/a few/about half/most/all)9

Contraceptive Use

  1. If you used birth control, your friends might think that you were looking for sex. (strongly agree/agree/neither agree nor disagree/disagree/strongly disagree/refused/legitimate skip/dk)5

Self-efficacy

Abstinence

Imagine you are along with someone you like very much…

  1. Could you stop them if they wanted to have sex with you (Definitely could, probably could, probably could not, definitely could not)5

  2. Could you stop yourself from having sex if the person said they would break up with you unless you had sex with them? (Definitely could, probably could, probably could not, definitely could not)5

  3. Could you stop yourself from having sex if you had been drinking alcohol? (Definitely could, probably could, probably could not, definitely could not)4

  4. Could you stop yourself from having sex if you had strong sexual feelings for someone? (Definitely could, probably could, probably could not, definitely could not)4

Sexual behavior

  1. Imagine that you met someone at a party. He or she wants to have sex with you. Even though you are very attracted to each other, you're not ready to have sex. How sure are you that you could keep from having sex?1

  1. Totally sure

  2. Kind of sure

  3. Not sure at all

  1. Imagine that you and your boyfriend or girlfriend have been going together, but you have not had sex. He or she really wants to have sex. Still, you don't feel ready. How sure are you that you could keep from having sex until you feel ready?1

  1. Totally sure

  2. Kind of sure

  3. Not sure at all

Prevention and Condom Use

  1. Imagine that you and your boyfriend or girlfriend decide to have sex, but he or she will not use a condom (rubber). You do not want to have sex without a condom (rubber). How sure are you that you could keep from having sex, until your partner agrees it is OK to use a condom (rubber)? (totally sure/kind of sure/not sure at all)1


Imagine you are alone with someone you like very much

  1. If you needed a condom, could you go to the store and buy one? (Definitely could/ probably could/probably could not/definitely could not)

  2. If you decided to have sex, could you tell the other person you wanted to use a condom? (definitely could/probably could/probably could not/definitely could not)


I am confident in my ability to… (all items use a 4-item response scale of strongly disagree, disagree, agree, strongly agree)10

  1. Find information about how to lower my risk for HIV/STI risk.

  2. Get sexual health services, such as HIV and STI testing.

  3. Find people in my community who would support my efforts to be healthy and safe.

  4. Talk to my partner(s) about safer sex.

  5. Protect myself from HIV and other STIs.

  6. Use a condom correctly.

  7. Develop a plan that reduces my risk for HIV/STI infection.

Contraceptive Use

  1. If you wanted to use birth control, how sure are you that you could stop yourself and use birth control once you were highly aroused or turned on? (very sure/moderately sure/neither sure nor unsure/moderately unsure/very unsure/I never want to use birth control/refused/legitimate skip/dk)5

  2. How sure are you that you could plan ahead to have some form of birth control available? (very sure/moderately sure/neither sure nor unsure/moderately unsure/very unsure/I never want to use birth control/refused/legitimate skip/dk)5

  3. How sure are you that you could resist sexual intercourse if your partner did not want to use some form of birth control? (very sure/moderately sure/neither sure nor unsure/moderately unsure/very unsure/I never want to use birth control/refused/legitimate skip/dk)5

Knowledge

General sexual health, puberty, and related protective factors (i.e., communication)

For the following items, choose the best answer11

  1. The female body part where a baby grows during pregnancy is the

    1. cervix.

    2. vagina.

    3. uterus.

    4. ovary.

  2. The part of the male’s body that produces sperm is the

    1. testicles.

    2. urethra.

    3. penis.

    4. prostate.

  3. Using refusal skills can help you resist negative peer pressure. All of the following are good ways to handle negative peer pressure except

    1. go along with the group so your friends will still like you.

    2. say NO in a firm voice.

    3. change the subject by coming up with something to do instead.

    4. use body language that says NO.

  4. Building healthy relationships, communicating with others, and meeting new people are things young people can do to improve their

    1. spiritual health.

    2. social health.

    3. physical health.

    4. mental and emotional health.

  5. The physical changes of puberty, such as rapid growth, increased perspiration, and underarm hair, are caused by

    1. proteins.

    2. cells.

    3. hormones.

    4. neurons.

  6. Communication is an important skill for building and maintaining relationships. To communicate well you should not

    1. make clear, simple statements.

    2. use appropriate body language.

    3. ask questions.

    4. talk over each other.

  7. All of the following are physical puberty changes that happen for both boys and girls except

    1. growing quickly and sometimes feeling clumsy.

    2. sweating more and may have body odor.

    3. getting oilier skin and can have pimples.

    4. the voice getting deeper.

  8. All of the following are qualities of an unhealthy relationship except

    1. the other person disagrees with you.

    2. the other person tries to change you.

    3. the other person lies to you.

    4. the other person doesn’t trust you.

  9. True or false?

When they have their periods, girls can keep doing everything they usually do.

    1. True

    2. False


Are the following items true or false?12

  1. All types of sex are equal in their risk for HIV/STIs.

  2. Having an STI (such as syphilis or gonorrhea) increases the chances of getting HIV.

  3. Bacterial STIs cannot be cured.

  4. Consistent and correct use of condoms reduces the risk for getting HIV/STIs.

  5. All persons who have an STI will have symptoms.

  6. Taking pre-exposure prophylaxis, or PrEP, may lower your risk for getting HIV.

  7. A person with HIV can look and feel healthy.






1 Masters, N.T., Beadnell, B.A., Morrison, D.M., Hoppe, M.J. & Gillmore, R. (2008). The opposite of sex? Adolescents thoughts about abstinence and sex, and their sexual behavior. Perspectives on Sexual and Reproductive Health, 40(2), 87-93.

2 From Sample Questions for the Fort Worth Independent School District.

3 National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes and Experiences. Henry Kaiser Foundation, 2003.

4 National Survey of Reproductive and Contraceptive Knowledge, 2009, National Campaign to Prevent Teen and Unplanned Pregnancy.

5 National Longitudinal Study of Adolescent Health (AddHealth)

6 UCSF Center for Aids Prevention Studies and ETR Associates. Student Health Questionnaire.

7 Silver & Bauman, 2006.

8 Bauman & Silver, 2002. All items have the following response options: None, Some, Most, All

9 Ekstrand ML, Siegel D, Nido V, Faigeles B, Krasnovsky F, Battle R, Cummings G, Chiment E, and Coates TJ (1996). Peer-led AIDS prevention delays sexual debut among U.S. junior high school students. http://caps.ucsf.edu/resources/survey-instruments#5

10 Get Your Life program evaluation tools (created/adapted by Advocates for Youth)

11 Taken from a knowledge tested used in sexual health education classes in a large, urban school district in the southern United States.

12 Get Your Life program evaluation tools (created/adapted by Advocates for Youth)

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