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.
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.
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.
The survey queried for general
demographic information, such as age, race/ethnicity, and
. 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.
. Three questions about gender of
partner preference, and number of lifetime and recent sex
partners were asked.
. 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.
. This section included nine questions
related to knowledge about testicular health, performing
self-testicular exams, and seeing a urologist.
. One question asked whether
participants discussed the use of birth control with part-
ners prior to having sex.
. Two questions queried participants about
whether their friends encourage or discourage them to
use condoms and other birth control methods.
. One question asked participants about their
history of IPV, specifically hitting or being hit by their
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