International Articles
Alternative methods in the investigation of adolescents’ sexual life

https://doi.org/10.1016/S1054-139X(98)00158-XGet rights and content

Abstract

Purpose: To describe two methodological approaches to surveying adolescents’ sexual life which were combined within a national survey.

Methods: The questionnaire was designed during a 5-day workshop. Ten adolescents played the roles of imaginary adolescents involved in different situations related to sexual life. The information obtained through the analysis of these role-plays was used to establish the sequence of the questions, their content, and wording. The questionnaire was computerized so that it could be completed by the adolescents using laptop computers. Its arborescent structure, leading each respondent from one module to another, made possible the adjustment of the questions to each respondent’s stage of development and type of sexual experience.

Results: A total of 4283 teenagers (2075 girls and 2208 boys, and 4 refusals) 16–20 years were included. Only 7.6% did not fill in the whole questionnaire. By the age of 18 years, more than 50% of boys and girls were sexually active. Half of sexually active teenagers have discussed contraception issue before engaging in their first intercourse, but much fewer (14–35%) have discussed issues related to HIV transmission. During their first sexual intercourse, the majority of the respondents used a condom (girls, 63%; boys, 58%) or condom plus oral contraception (girls, 11%; boys, 17%).

Conclusion: Youth participation and role-play decrease the conceptual biases often associated with professionals’ perceptions and bring tools enabling a better exploration of circumstances and negotiations surrounding the sexual encounter. The computerized questionnaire increases confidentiality, attractiveness, easy data collection, and, above all, adjustment of the questions to the respondent’s level of experience. These methods could be more systematically used in surveys targeting sensitive issues related to adolescents’ health.

Section snippets

Use of focus group and role-playing in the development of the questionnaire

The participation of young people in the elaboration of the questionnaire, through focus groups and role-playing, was necessary to capture the contextual aspects of the adolescents’ culture (25).

During recent years, focus groups have been used in different research settings 25, 26, 27, often within qualitative research focusing on norms and attitudes 26, 28, and in some instances as a tool to improve the content of survey questionnaires 25, 27. The way focus groups were used in the present

Results

A total of 4291 pupils were involved in the study, among whom only 4 refused to answer the questionnaire. Four other questionnaires were excluded from the analysis because of questionable validity. Table 2 gives the main sociodemographic characteristics of the final sample. Owing to the length of the questionnaire, 7.6% of the participants switched off the computer before filling in the whole set of modules corresponding to their experience, usually shortly before the end of the questionnaire;

Discussion

Given the fact that the main purpose of this article was to present the methods of this survey, the discussion will concentrate on the advantages, difficulties, or biases linked with the use of focus groups and role-playing in the design of the questionnaire and with the use of a computerized format.

The participation of young people in the design of the questionnaire brought an enormous amount of usable information and certainly increased the acceptability of the survey for the respondents.

Acknowledgements

This study was performed under Contract No. 316.91.5139 from the Swiss Federal Office for Public Health.

References (39)

  • F. Narring et al.

    Demographic and behavioral factors associated with adolescent pregnancy in Switzerland

    Fam Plann Perspect

    (1996)
  • D. Hausser et al.

    The effects of the Swiss “Stop-AIDS campaign” on the sex life of Swiss adolescentsDoes a condom promoting campaign modify sexual behavior?

    Pediatrics

    (1994)
  • B. Halpern-Felscher et al.

    Relationship of alcohol use and risky sexual behaviorA review and analysis of findings

    J Adolesc Health

    (1996)
  • D.P. Orr et al.

    Factors associated with condom use by sexually active male adolescents at risk for sexually transmitted disease

    Pediatrics

    (1993)
  • D.J. Walter et al.

    Factors associated with AIDS risk behaviors among high school students in an AIDS epicenter

    Am J Public Health

    (1992)
  • R.J. DiClemente et al.

    Determinants of condom use among junior high school students in a minority, inner-city school district

    Pediatrics

    (1992)
  • E. Goodman et al.

    Acquired immunodeficiency syndrome and adolescentsKnowledge, attitudes, beliefs, and behavior in a New York City adolescent minority population

    Pediatrics

    (1989)
  • M.J. Rotheram-Borus et al.

    Sexual risk behavior, AIDS knowledge, and beliefs about AIDS among runaways

    Am J Public Health

    (1991)
  • R.W. Hingson et al.

    Beliefs about AIDS, use of alcohol and drugs and unprotected sex among Massachusetts adolescents

    Am J Public Health

    (1990)
  • Cited by (45)

    • Effect of Parent-Daughter Communication about Sex on the Use of Less Effective Contraception among Women from Ages 15-24 Years in France

      2018, Journal of Pediatric and Adolescent Gynecology
      Citation Excerpt :

      First, the truthfulness and accuracy of these young women's answers to questions about their sex lives might be questioned. Several authors who examined the methodology of studies about the initiation of sexual activity among adolescents have shown that the questions asked of adults are not always applicable to adolescents.23,24 They stress that the method of data collection matters and that a computerized questionnaire increases young people's sense of confidentiality, compared, for example, with telephone interviews.

    • Factors that adolescent males take into account in decisions about an unplanned pregnancy

      2009, Journal of Adolescence
      Citation Excerpt :

      We acknowledge that they have been placed in a simulation and that responses may differ from those given when and if the participant is confronted with a real situation. However, there is evidence that adolescents respond more honestly with computer-based assessments than face-to-face or on paper (Michaud, Narring, & Ferron, 1999). Anecdotal evidence, as witnessed by the teachers and research assistant indicates that the young men became very engrossed and emotionally involved in the simulation.

    • Condom Misuse Among Adjudicated Girls: Associations with Laboratory-Confirmed Chlamydia and Gonorrhea

      2007, Journal of Pediatric and Adolescent Gynecology
      Citation Excerpt :

      Based on formative research with this population of detained adolescents, the research team developed an assessment instrument appropriate to the study. Based on evidence from previous research11–13 we used audio-computer assisted self-interviewing to deliver the survey as this mode has been shown to decrease self-report bias. To help facilitate accurate recall yet provide a window of time long enough to be representative of true health risk behavior, a two-month recall period was used when asking adolescents about their engagement in past behaviors (unless the question specifically asked, “have you ever…”).

    View all citing articles on Scopus
    View full text