Form 4 youth follow-up survey

MITRE Pregnancy Prevention in Adolescents

Youth Follow-Up Survey

April 2020

• This document presents the items MITRE will use in the follow-up surveys to evaluate contracted programs’ impact on youth knowledge, attitude, beliefs, intentions, and behavior.

• For the first follow-up survey, the phrase “since you took the last survey” is used to specify the timeframe in question. For the 3-month follow-up survey, the phrase “in the past 3 months” will be used. The list of items below reflects the wording of the first follow-up survey. Beyond the temporal specification, there are no other wording or content differences between the first follow-up and 3-month follow up survey.

• The list of items is organized by category and does not necessarily reflect the ordering of items in the final survey instrument.

• Skip and display patterns are noted in square brackets. MITRE plans to administer the survey electronically to automate skip and display patterns.

• MITRE will facilitate translation services for contracted programs that serve a population literate in a language other than English.

DEMOGRAPHIC INFORMATION/FAMILY/ENVIRONMENT/BACKGROUND

Follow-up Item #	Baseline Item #	Item	Source	Classification/Notes
D1	D1	What is your date of birth? MARK (X) ONE MONTH AND ONE YEAR	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #1.1 Part A	Age—In follow-up surveys the combination of date of birth and biological sex are used as confirmatory identifiers. Responses will be checked against records to ensure that the data administrator entered the correct participant ID number into the survey.
D2	D3	Are you a…? MARK (X) ONE □ Male □ Female	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #1.3 Part A	Biological sex—In follow-up surveys the combination of date of birth and biological sex are used as confirmatory identifiers. Responses will be checked against records to ensure that the data administrator entered the correct participant ID number into the survey.
D3	D25	Transition: The next questions are about relationships, abstinence, birth control, and sexually transmitted diseases. Since you took the last survey, have you received information or learned about any of the following? MARK (X) ONE FOR EACH QUESTION Yes, No a. Relationships, dating, marriage, or family life b. Abstinence from sex c. Methods of birth control d. Where to get birth control e. Sexually transmitted diseases, also known as STDs f. How to talk to your partner about whether to have sex or whether to use birth control g. How to say no to sex h. How babies are made	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0990-0382) Engender Health Survey Item #1.7 Part A Modifications made: Changed time frame from past 12 months to since the last survey	Previous exposure to sexual health information
D4	NA	Since you took the last survey, has your living situation changed? For instance, do you now live in a different place or live with different people?	MITRE-created item for follow-up surveys	Living arrangement
D5	NA	[Display if response to D4 is yes] What has changed about your living situation since you took the last survey? (Check all that apply.) You live with different people You live in a different place	MITRE-created item for follow-up surveys	Living arrangement
D6	NA	[Display if response to D4 is yes] Are any of the following statements true? You are now homeless You now live in a residential facility, detention center, or another type of facility You were homeless when you took the last survey but now you are not You were living in a residential facility, detention center, or another type of facility when you took the last survey but now you do not	MITRE-created item for follow-up surveys	Living arrangement

BEHAVIOR (B)

Follow-up Item #	Baseline Item #	Item/Scale	Source	Classification/Notes
B1	B1	Since the last survey, how much have you talked to your parent(s) or guardian(s) about the following topics? Using condoms Using other forms of birth control, like birth control pills Sexually transmitted diseases (STDs) HIV/AIDS Getting pregnant/getting someone else pregnant Waiting to have sex until you’re older or sexual abstinence Since the last survey, how much have you talked to your best friend about the following topics? Using condoms Using other forms of birth control, like birth control pills Sexually transmitted diseases (STDs) HIV/AIDS Getting pregnant/getting someone else pregnant Waiting to have sex until you’re older or sexual abstinence Since the last survey, have you had a boyfriend/girlfriend or someone you liked “more than friends” who you have talked to or hung out with? Yes (We will call this person a dating partner for the next question) No (Skip to end of survey) In the past year, how much have you talked to your dating partner about the following topics? Using condoms Using other forms of birth control, like birth control pills Sexually transmitted diseases (STDs) HIV/AIDS Getting pregnant/getting someone else pregnant Waiting to have sex until you’re older or sexual abstinence [Response options for all sub-scales: Never talked about this, Talked about this 1 time, Talked about this 2 or 3 times, Talked about this 4 to 6 times, Talked about this 7+ times]	Adolescent Sexual Communication Scale (Widman & Stewart, 2020) Modifications made: Added mention of guardian(s) to the parent sub-scale Changed time frame from past year months to since the last survey	Protective behaviors- communication with parents
B2	B2	How many times since you took the last survey has a boyfriend or girlfriend done these things to you? 22b Said things to hurt your feelings on purpose 22c Insulted you in front of others 22e Would not let you do things with other people 22f Threatened to start dating someone else 22i Did something just to make you jealous 22j Blamed you for bad things they did 22k Threatened to hurt you 22l Made you describe where you were every minute of the day 22n Put down your looks Pushed, grabbed, shoved, or kicked you 23a Called you names, put you down, or said really mean things to you on Snapchat, Instagram, Facebook or other social media and messaging apps 23b Called your cellphone or sent you messages when you didn’t want them to, just to make you mad 23c Sent you messages that asked you to engage in sexual acts when you didn’t want to 23d Spread rumors about you on Snapchat, Instagram, Facebook or other social media and messaging apps 23e Used your posts or messages on Snapchat, Instagram, Facebook or other social media and messaging apps to harass you or put you down 23g Shared private or embarrassing pictures or videos of you on Snapchat, Instagram, Facebook or other social media and messaging apps 23h Used Snapchat, Instagram, Facebook or other social media and messaging apps to threaten to hurt you physically How many times since you took the last survey have you done these things to a boyfriend or girlfriend? 24b Said things to hurt their feelings on purpose 24c Insulted them in front of others 24e Would not let them do things with other people 24f Threatened to start dating someone else 24i Did something just to make them jealous 24j Blamed them for bad things you did 24k Threatened to hurt them 24l Made them describe where they were every minute of the day 24n Put down their looks Pushed, grabbed, shoved, or kicked them 25a Called them names, put them down, or said really mean things to them on Snapchat, Instagram, Facebook or other social media and messaging apps 25b Called their cellphone or sent them messages when they didn’t want you to, just to make them mad 25c Sent them messages that asked them to engage in sexual acts when they didn’t want to 25d Spread rumors about them on Snapchat, Instagram, Facebook or other social media and messaging apps 25e Used their posts or messages on Snapchat, Instagram, Facebook or other social media and messaging apps to harass them or put them down 25g Shared private or embarrassing pictures or videos of them on Snapchat, Instagram, Facebook or other social media and messaging apps 25h Used Snapchat, Instagram, Facebook or other social media and messaging apps to threaten to hurt them physically [Response options for all sub-scales: Never, 1-3 times, 4-9 times, 10 or more times]	Evaluation of the Safe Dates Project (OMB No.: 0920-0783) Youth Dating Survey Items 22, 23, 24, 25 Item stem wording taken from Miller et al. (2015) Teen Dating Violence Measures- Perpetration and Victimization Modifications made: Changed personal pronouns from first to second person to be consistent with other items in this survey. Deleted 22 & 24 a, d, g, h, m, o. Added “Pushed, grabbed, shoved, or kicked you/them.” Deleted 23 & 25 f. Re-worded references to social media and messaging apps to reference current popular apps. Changed time frame from past 6 months to since the last survey	Risk behaviors- dating violence
B3	B3	The next question asks about cigarette smoking. Since you took the last survey, have you smoked cigarettes, even once? Yes No	Added by MITRE Modifications made: Changed time frame from past 30 days to since the last survey	Risk behaviors- drug and alcohol use
B4	B4	The next question asks about electronic vapor products, such as JUUL, Vuse, MarkTen, blu, KandyPens, PaxEraPro, and APX Vape. Electronic vapor products include e-cigarettes, e-cigars, e-hookahs, marijuana vape pens, hookah pens, and mods.  Since you took the last survey, have you used an electronic vapor product, even once? Yes No	Introductory text is from Item #34 2019 National YRBS (OMB No.: 0920-0493) Question added by MITRE Modifications made: Changed time frame from past 30 days to since the last survey	Risk behaviors- drug and alcohol use
B5	B5	The next question asks about drinking alcohol. This includes drinking beer, wine, wine coolers, and liquor such as rum, gin, vodka, or whiskey. For this question, drinking alcohol does not include drinking a few sips of wine for religious purposes. Since you took the last survey, have you drank alcohol, even once? Yes No	Introductory text is from Item #41. 2019 National YRBS (OMB No.: 0920-0493) Question added by MITRE Modifications made: Changed time frame from past 30 days to since the last survey	Risk behaviors- drug and alcohol use
B6	B6	The next question asks about marijuana use. Marijuana also is called pot, weed, or cannabis. Since you took the last survey, have you used marijuana? Yes No	Introductory text is from Item #45. 2019 National YRBS (OMB No.: 0920-0493) Question added by MITRE Modifications made: Changed time frame from lifetime to since the last survey	Risk behaviors- drug and alcohol use
B7	B7	The next question asks about synthetic marijuana use. Synthetic marijuana also is called Spice, fake weed, K2, King Kong, Yucatan Fire, or Skunk. Since you took the last survey, have you used synthetic marijuana? Yes No	Introductory text from item Item #48, 2019 National YRBS (OMB No.: 0920-0493) Question added by MITRE Modifications made: Changed time frame from lifetime to since the last survey	Risk behaviors- drug and alcohol use
B8	B8	The next question asks about the use of prescription pain medicine without a doctor’s prescription or differently than how a doctor told you to use it. For this question, count drugs such as codeine, Vicodin, OxyContin, Hydrocodone, and Percocet. Since you took the last survey, have you taken prescription pain medicine without a doctor’s prescription or differently than how a doctor told you to use it? Yes No	Introductory text from item #49, 2019 National YRBS (OMB No.: 0920-0493) Question added by MITRE Modifications made: Changed time frame from lifetime to since the last survey	Risk behaviors- drug and alcohol use
B9	B9	The next question asks about other drugs. Since you took the last survey, have you used cocaine, heroin, methamphetamines, ecstasy, or hallucinogenic drugs like LSD, acid, or mushrooms? Yes No	Question added by MITRE Modifications made: Changed time frame from lifetime to since the last survey	Risk behaviors- drug and alcohol use
B10	B10	The next set of questions are about your sexual history. By sex, we mean vaginal, oral, or anal sex. Please remember that your answers are strictly confidential. Since you took the last survey, have you had any kind of sex? MARK (X) ONE □ Yes □ No	2019-2020 NHANES (OMB No.: 0920-095) Item # SXQ.615 Modifications made: Changed time frame from lifetime to since the last survey	Sexual behavior
B11	B12	[Display only if response was Yes for B10] Since you took the last survey, have you had vaginal sex, also called sexual intercourse? This is when a man puts his penis into a woman’s vagina. MARK (X) ONE □ Yes □ No	2019 National YRBS (OMB No.: 0920-0493) Item #58 Modifications made: Changed time frame from lifetime to since the last survey, defined sexual intercourse as “when a pan puts his penis into a woman’s vagina”	Sexual behavior
B12	B15	[Display only if response was Yes for B11] Since you last took the survey, did you have sexual intercourse without using a condom? Yes No	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Concordance Item #4.12 Part B1 Modifications made: Changed time frame from past 3 months to since the last survey	Sexual behavior
B13	B16	[Display only for females, and if response was Yes for B11] The next question is about your use of the following methods of birth control: Birth control pills The shot (like, Depo Provera) The patch The ring (like, NuvaRing) IUD (like, Mirena or Paragard) Implants (like, Implanaon) Since you last took the survey, did you have sexual intercourse without using any of these methods of birth control? Yes No	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Concordance Item #4.13 Part B1 Modifications made: Deleted “condoms” from the list and will add display logic so this question is only for girls who have previously had sex. Added diaphragms to list. Made response choice yes/no. Modifications made: Changed time frame from past 3 months to since the last survey	Sexual behavior
B14	B18	Oral sex is when someone puts his or her mouth on another person’s penis or vagina, or lets someone else put his or her mouth on their penis or vagina. Since you last took the survey, have you had oral sex? MARK (X) ONE □ Yes □ No	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #4.14 Part B1 Modifications made: Changed time frame from past 3 months to since the last survey. Kept definition	NA
B15	B19	[Display only if response for Yes for B14] Since you took the last survey, did you have you oral sex without using a condom or dental dam? Yes No	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Concordance Item #4.18 Part B1 Modifications made: Added “and dental dam”. Changed time frame from past 3 months to since the last survey	Sexual behavior
B16	B21	Anal sex is when a male puts his penis in someone else’s anus, or their butt, or someone lets a male put his penis in their anus or butt. Since you took the last survey, did you have anal sex? MARK (X) ONE □ Yes □ No	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #4.21 Part B1 Kept definition text. Changed time frame from past 3 months to since the last survey
B17	B22	[Display only if response was Yes for B16] Since you took the last survey, did you have anal sex without using a condom? MARK (X) ONE □ Yes □ No	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Concordance Item #4.22 Part B1 Modifications made: Changed time frame from past 3 months to since the last survey	Sexual behavior
B18	B23	FOR GIRLS ONLY—Since you took the last survey, have you been pregnant? MARK (X) ONE □ Yes □ No FOR BOYS ONLY – Since you took the last survey, have you gotten someone pregnant? MARK (X) ONE □ Yes □ No	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #4.24c Part B1 and Item #4.25b Part B1 Modifications made: Changed time frame from ever to since the last survey. Deleted introductory phrase, “To the best of your knowledge.” Deleted final phrase, “even if no child was born.”	Pregnancy outcome
B19	B24	Since you took the last survey, have you been tested by a doctor or nurse for a sexually transmitted disease, or STD, like gonorrhea, Chlamydia, syphilis, or HIV? MARK (X) ONE □ Yes □ No	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #4.27 Part B1 Modifications made: Changed time frame from 12 months to since the last survey.	Sexual health behavior
B20	B25	Since you took the last survey, have you been told by a doctor or other health professional that you had a sexually transmitted disease, or STD? MARK (X) ONE □ Yes □ No □ Don’t know	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #4.28 Part B1 Modifications made: Changed time frame from 12 months to since the last survey.	STD outcome

INTENTIONS (I)

Follow-up Item #	Baseline Item #	Item	Source	Justification/Notes
I1	I1	Do you intend to have oral sex in the next year? MARK (X) ONE □ Yes, definitely □ Yes, probably □ No, probably not □ No, definitely not	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Concordance Item #3.15 Part A	Sexual behavior intentions
I2	I2	Do you intend to have sexual intercourse in the next year? MARK (X) ONE □ Yes, definitely □ Yes, probably □ No, probably not □ No, definitely not	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Concordance Item #3.16 Part A	Sexual behavior intentions
I3	I3	[Not displayed if “No, definitely not” is response for I2] If you have sexual intercourse in the next year, do you intend to use a condom? MARK (X) ONE □ Yes, definitely □ Yes, probably □ No, probably not □ No, definitely not	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Concordance Item #3.17 Part A	Sexual behavior intentions
I4	I4	[Only display for females; Not displayed if “No, definitely not” is response for I2] The next question is about your intention to use other methods of birth control, NOT including condoms: Birth control pills The shot (like, Depo Provera) The patch The ring (like, NuvaRing) IUD (like, Mirena or Paragard) Implants (like, Implanaon) If you have sexual intercourse in the next year, do you intend to use any of these other methods of birth control? □ Yes, definitely □ Yes, probably □ No, probably not □ No, definitely not	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Concordance Item #3.18 Part A	Sexual behavior intentions
I5	I5	How likely is it that you will do each of the following things? MARK (X) ONE Not at all likely, A little likely, Somewhat likely, Very likely a. Graduate from high school? b. Go to a technical or vocational school after high school? c. Go to college? d. Graduate from a 2-year or community college program? e. Graduate from a 4-year college program?	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #1.11 Part A	Educational intentions

KNOWLEDGE (K)

Follow-up Item #	Baseline Item #	Item	Source	Classification/Notes
K1	K1	The next series of questions is about condoms, birth control pills, pregnancy and sexually transmitted diseases, also called STDs. If a condom is used correctly, how much can it decrease the risk of pregnancy? MARK (X) ONE □ Not at all □ A little □ A lot	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #3.5 Part A Modifications made- Removed “don’t know” as a response option because of follow-up certainty question.	Knowledge- condoms
K2	K2	How confident are you that your answer is correct? MARK (X) ONE □ Not at all confident □ A little confident □ Somewhat confident □ Very confident	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #3.5a Part A	Change in certainty
K3	K3	If a condom is used correctly, how much can it decrease the risk of getting HIV, the virus that causes AIDS? MARK (X) ONE □ Not at all □ A little □ A lot □ Don’t know	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #3.6 Part A	Knowledge- condoms
K4	K4	If a condom is used correctly, how much can it decrease the risk of getting Chlamydia and gonorrhea? MARK (X) ONE □ Not at all □ A little □ A lot □ Don’t know	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0970-0360) Baseline Item #3.7 Part A	Knowledge- condoms
K5	K5	A condom can be used more than once. True False	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0990-0382) OICA Follow-Up Survey Item #2.5c	Knowledge- condoms
K6	K6	A sexually active girl can become pregnant if she forgets to take her birth control pills for several days in a row. True False	Evaluation of Adolescent Pregnancy Prevention Approaches (OMB No.: 0990-0382) OICA Follow-Up Survey Item #2.5a	Knowledge- birth control
K7	K7	A person who has Genital Herpes must have open sores to give the infection to his or her sexual partner. True False	Sexually Transmitted Disease- Knowledge Questionnaire (STD-KQ; Jaworski & Carey, 2007) Item #21	Knowledge- STD/HIV transmission
K8	K8	If a person had Gonorrhea in the past he or she is immune (protected) from getting it again. True False	Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ; Jaworski & Carey, 2007) Item #24	Knowledge- STD/HIV transmission
K9	K9	Showering, or washing one’s genitals/private parts, after sex keeps a person from getting HIV. True False	Brief HIV Knowledge Questionnaire (HIV-KQ-18; Carey & Schroder, 2002) Item #5	Knowledge- STD/HIV transmission
K10	K10	A person can get HIV from oral sex. True False	Brief HIV Knowledge Questionnaire (HIV-KQ-18; Carey & Schroder, 2002) Item #17	Knowledge- STD/HIV transmission

ATTITUDES AND BELIEFS (A)

Follow-up Item #	Baseline Item #	Item/Scale	Source	Classification/Notes
A1	A1	In your opinion, how likely or unlikely is it that each of the following things would happen to you personally if you were to have sexual intercourse? (If you’ve never had sexual intercourse, please try to imagine and make your best guess.) [Items will be displayed in randomized order] Get pregnant or get someone pregnant Enjoy it Get a sexually transmitted disease Feel guilty Be more popular Have fun Nothing about my life would change Get into trouble with your parents Get a bad reputation Feel more loved and wanted Lose your self-respect Feel more attractive Keep your boyfriend or girlfriend from breaking up with you Feel pleasure Feel closer to your partner Disappoint people who are important to you Feel satisfied Get HIV/AIDS Feel excited Feel more grown up [Response options: very unlikely, somewhat unlikely, somewhat likely, very likely]	Adolescent Sexual Expectancies Scale (ASEXS; Bourdeau et al., 2011)	Expectancy beliefs about the consequences of sexual behavior
A2	A2	Please fill in the answer for each question that best describes how you feel. I believe people my age should wait until they are older before they have sex. I believe it’s OK for people my age to have sex with a steady boyfriend or girlfriend. I believe condoms (rubbers) should always be used if a person my age has sexual intercourse. I believe condoms (rubbers) should always be used if a person my age has sexual intercourse, even if the girl uses hormonal birth control. I believe condoms (rubbers) should always be used if a person my age has sexual intercourse, even if the two people know each other very well. I believe condoms (rubbers) should always be used if a person my age has anal sex. I believe condoms (rubbers) or dental dams should always be used if a person my age has oral sex. [Response options: Definitely Yes, Probably Yes, Probably No, Definitely No] The following questions ask you about your friends and what they think. Even if you’re not sure, mark the answer that you think best describes what they think. Most of my friends believe people my age should wait until they are older before they have sex. Most of my friends believe it’s OK for people my age to have sex with a steady boyfriend or girlfriend. Most of my friends believe condoms (rubbers) should always be used if a person my age has sexual intercourse. Most of my friends believe condoms (rubbers) should always be used if a person my age has sexual intercourse, even if the girl uses hormonal birth control. Most of my friends believe condoms (rubbers) should always be used if a person my age has sexual intercourse, even if the two people know each other very well. Most of my friends believe condoms (rubbers) should always be used if a person my age has anal sex. Most of my friends believe condoms (rubbers) or dental dams should always be used if a person my age has oral sex. [Response options: Definitely Yes, Probably Yes, Probably No, Definitely No] What do you think about condoms? Please tell us how much you agree or disagree with the following statements. It would be embarrassing to buy condoms (rubbers) in a store. I would feel uncomfortable carrying condoms (rubbers) with me. It would be wrong to carry a condom (rubber) with me because it would mean that I’m planning to have sex. [Response options: I strongly agree, I kind of agree, I kind of disagree, I strongly disagree]	Sexual Risk Behavior Beliefs and Self-Efficacy Scales (Basen-Engquist et al., 2011) Modifications made to Your Beliefs scale: changed sex to sexual intercourse in items 3, 4, and 5. Added items 6 and 7. Changed original ordering of items. Modifications made to What do your friends believe? scale: Same changes that were made to Your Beliefs scale.	Addresses: Attitudes about sexual intercourse Norms about sexual intercourse Attitudes about condom use Norms about condom use Barriers to condom use

References

Basen-Engquist, K., Masse, L. C., Coyle, K., Kirby, D., Parcel, D., Banspach, S., Nodora, J. (2020). Sexual risk behavior beliefs and self-

efficacy scales. In R. R. Milhausen, J. K. Sakaluk, T. D. Fisher, C. M. Davis, W. L. Yarber (Eds.), Handbook of Sexuality-Related Measures (4^th ed., pp. 381-384). New York, NY: Routledge.

Bourdeau, B., Grube, J. W., Bersamin, M. M., Fisher, D. A. (2011). The role of beliefs in sexual behavior of adolescents: Development

and validation of an Adolescent Sexual Expectancies Scale (ASEXS). Journal of Research on Adolescence, 21(3), 639-648.

Carey, M. P. & Schroder, K. E. E. (2002). Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS

Education and Prevention, 14(2), 172-182.

Jaworski, B. C. & Carey, M. P. (2007). Development and psychometric evaluation of a self-administered questionnaire to measure

knowledge of sexually transmitted diseases. AIDS and Behavior, 11(4), 557-574.

Widman & Stewart. (2020). Adolescent Sexual Communication Scale. In R. R. Milhausen, J. K. Sakaluk, T. D. Fisher, C. M. Davis, W. L.

Yarber (Eds.), Handbook of Sexuality-Related Measures (4^th ed., pp. 251-253). New York, NY: Routledge.