Adolescents' pornography viewing frequency and its relationship with condom attitudes.

Background This study examined adolescent pornography viewing and its' relationship with condom attitudes. Methods Data were from 457 adolescents aged 13-18years old who completed an online survey assessing pornography viewing frequency and condom attitudes. Results Many adolescents in our sample had viewed pornography in the past year (n =188, 41%), with pornography viewing frequency being higher among older adolescents (P =0.02), those who have had sex in the past year (P =0.001), and those who identified as White (P =0.01), LGB+ (P =0.05), and male (P =0.001). Adolescents who viewed pornography more frequently had more negative condom attitudes (r =-0.18, P Conclusions A substantial proportion of adolescents in our sample viewed pornography and those who view more frequently had more negative condom attitudes. Results indicate a need for experimental studies examining this relationship and interventions addressing pornography literacy among adolescents.

Longitudinal Change in Appearance-Related Social Media Consciousness and Depressive Symptoms: A Within-Person Analysis during Early-to-Middle Adolescence.

Online appearance preoccupation may put adolescents at risk of developing mental health challenges, perhaps especially during early-to-middle adolescence. A random intercept cross-lagged panel model assessed within-person associations between appearance-related social media consciousness and depressive symptoms over three time-points with three months between waves. The sample (n = 1594) included U.S. adolescents aged 11-15 (Mage = 13; 47% girls, 46% boys, 7% another gender; 37% Latine, 33% White, 18% Black, 7% Asian). Within-person increases in appearance-related social media consciousness were associated with subsequent increases in depressive symptoms, but not vice versa. There was no evidence of gender differences and results were robust to controlling for both time on social media and offline self-objectification. Thus, online appearance concerns precede mental health challenges during early and middle adolescence.

Parents' attitudes towards the content of sex education in the USA: Associations with religiosity and political orientation.

While most parents support their adolescents receiving school-based sex education, there is variability in which sex education topics receive the most support from parents. Conservative political orientation and greater religiosity have been independently associated with parents' lack of support for school-based sex education; however, no studies have examined the intersection of these two factors. The three goals of this study were to: 1) identify how specific sexual education topics cluster together to form content areas; 2) examine if religiosity and political orientation are uniquely associated with these content areas; and 3) examine if political orientation moderates the relationship between parents' religiosity and their perceived importance for the specific sex education content areas. Participants were a national sample of 881 US parents. The sex education topics clustered into three content areas: Factual Knowledge (e.g., STI transmission), Practical Skills (e.g., how to access condoms), and Pleasure and Identity (e.g., pleasurable aspects of sex). Politically conservative and more religious parents reported the lowest perceived importance for each content area. Importantly, these main effects were qualified by a significant interaction: parents who reported both political conservativism and high levels of religiosity reported the lowest perceived importance for these three content areas being taught.

PACT: Developing and Evaluating a Digital Sexual Consent Program for Youth.

Understanding affirmative sexual consent is crucial for violence prevention and health promotion, yet few adolescents receive adequate consent education. The current study aimed to evaluate the acceptability and preliminary efficacy of a brief online program designed to teach adolescents information and skills about communicating and interpreting affirmative sexual consent (PACT: Promoting Affirmative Consent among Teens) in a randomized controlled trial with a national sample of 833 U.S. adolescents (ages 14-16; 42% White, 17% Asian, 17% Black, 13% Latinx; 53% girls, 31% boys, 12% non-binary; 45% heterosexual; 29% sexually active). PACT, grounded in health behavior change and persuasion theories, was developed using feedback from youth advisors and usability testers. Participants considered the program generally acceptable. Compared to youth who completed a control program, PACT was efficacious at shifting three measures of affirmative consent cognitions (i.e., knowledge, attitudes, self-efficacy) from baseline to immediate posttest. Youth who completed PACT also demonstrated more accurate affirmative consent knowledge at 3 months post-baseline. PACT's effects on consent cognitions were generally similar among youth with various gender, racial/ethnic, and sexual identities. We discuss next steps for this program, including the possibilities of expanding to include additional concepts and tailoring to address the unique needs of specific youth.

National trends and disparate access to formal and informal sex education among youth involved with the child welfare system in the USA.

This study aimed to understand whether youth involved with the child welfare system in the USA are receiving formal and informal sex education. Data come from the Second National Survey of Child and Adolescent Wellbeing, a nationally representative sample of children and adolescents in contact with child protective services. Participants included young people (n=1093, aged 11-21) involved with the child welfare system. Participants reported whether they had received formal sex education about a) abstinence only; b) contraceptives/condoms only; c) abstinence and contraceptives/condoms; or d) none. They also reported whether they knew where to access family planning services. We examined the prevalence of sex education experiences and differences in sex education access and knowledge based on participants' pregnancy history and sociodemographic characteristics. Only half (49%) of participants had received any form of formal sex education. Pregnant youth were less likely to have received any sex education compared to non-pregnant youth (p=.045). 72% of adolescents who had received sex education about contraceptives/condoms reported knowing where to access family planning services compared to only 46% of adolescents who had not received sex education about contraceptives/condoms (p=.014). There is a pressing need for comprehensive sex education among young people involved with the child welfare system in the USA.

A longitudinal assessment of adolescents' sexual communication with parents, best friends, and dating partners.

Sexual health communication in adolescence is important for sexual well-being. With limited empirical work utilizing longitudinal methodologies, this study aimed to investigate how the frequency of sexual communication with parents, peers, and dating partners changes across adolescence and varies based on sex, race/ethnicity, and sexual orientation. Participants included 886 U.S. adolescents (54.4% females; 45.9% White, 22.6% Hispanic/Latinx, 21.6% Black/African American) surveyed yearly from middle school through 12th grade. Growth curve models were used to estimate trajectories of the frequency in communication. Results showed curvilinear trajectories for adolescents' sexual communication with their parents, best friends, and dating partners over time. Although all three trajectories showed curvilinear patterns, sexual communication with parents and best friends increased earlier in adolescence and leveled off, while sexual communication with dating partners was lower in early adolescence and showed a steep increase across adolescence. Communication trajectories significantly diverged depending on adolescents' sex and race/ethnicity but not their sexual orientation. This study provides the first evidence of developmental changes over time in adolescent sexual communication with parents, best friends, and dating partners. Developmental implications for adolescents' sexual decision making are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Evaluation of a Brief Online Sexual Health Program for Adolescents: A Randomized Controlled Trial.

Adolescents are at increased risk of acquiring sexually transmitted infections (STIs) and experiencing unintended pregnancy. In particular, adolescents from marginalized communities experience significant sexual health disparities compared to their more advantaged peers. Digital sexual health programs, such as HEART (Health Education and Relationship Training), may be effective in reducing these risks and addressing these disparities. HEART is a web-based intervention focused on the promotion of positive sexual health outcomes, such as sexual decision-making skills, sexual communication skills, sexual health knowledge, and sexual norms and attitudes. The current study evaluates the efficacy of HEART, and examines whether effects were moderated by gender, socioeconomic status (SES), race, English as a second language, and sexual orientation to ensure the program is effective for diverse groups of adolescents. Participants were 457 high school students (Meanage=15.06, 59% girls, 35% White, 78% heterosexual, 54% receive free or reduced-price lunch). Students were randomized to HEART or an attention matched control and assessed at pretest and immediate posttest. HEART was effective in increasing sexual assertiveness, sexual communication intentions, HIV/STI knowledge, condom attitudes, and safer sex self-efficacy compared to the control condition. There were no significant interactions by gender, SES, race, English as a second language, or sexual orientation, suggesting the program worked equally well for all groups of youth. The findings of this study suggest that HEART may be a promising avenue for the promotion of positive sexual health outcomes for diverse groups of youth.

Sexual self-efficacy and sexual communication among adolescent girls: moderated mediation results from a randomized controlled trial.

OBJECTIVE: Guided by the Operating Conditions Framework, the goal of this study was to identify how and for whom an online sexual health program called Health Education and Relationship Training (HEART) worked. DESIGN: Data come from a randomized controlled trial among 198 U.S. high school girls who completed HEART or an attention-matched control. We conducted mediation and moderated mediation models to determine if sexual self-efficacy was a mediator and if program acceptability and sexual activity status were moderators of HEART efficacy. MAIN OUTCOME MEASURE: Sexual communication skills were assessed with a behavioral role-play task. RESULTS: HEART significantly improved sexual communication skills. These effects were fully mediated through sexual self-efficacy. Specifically, HEART improved sexual self-efficacy which in turn increased sexual communication skills. Also, when participants liked the program more, the effect of HEART on sexual self-efficacy was stronger. Further, among girls who had engaged in sexual activity, sexual self-efficacy was significantly associated with sexual communication skills. CONCLUSION: This study provides insights into the mechanisms of behavior change underlying HEART. Results highlight the need to further 'unpack' the effects of other sexual health programs, as we showed that programs may work better under certain conditions.

Internal Consent, Affirmative External Consent, and Sexual Satisfaction Among Young Adults.

Sexual satisfaction is an important part of sexual health. Recently, efforts have been underway to better understand what factors contribute to positive sexual experiences among young adults. One factor may be sexual consent. This study aimed to explore individual and interactive effects of two distinct, but related dimensions of sexual consent - internal consent and affirmative external consent - on young adults' feelings of sexual satisfaction following their most recent sexual intercourse experience. Participants were 294 young adults (ages 18-25, Mage = 23.7; 59% women) recruited from Amazon's MTurk. Results showed that each dimension of consent had a significant, unique relationship with satisfaction, and that the two dimensions of consent alone accounted for half of the variance in satisfaction. Additional analyses showed that there are specific components of both internal and affirmative external consent (e.g., safety/comfort; arousal; consent/want; communicator/initiator cues) that may be most influential in driving this relationship. As both consent dimensions greatly contribute to positive sexual experiences, researchers attempting to promote sexual wellbeing may be wise to attend to both internal and external consent.

Behavioral Measures to Assess Adolescent Sexual Communication with Partners: A Scoping Review and Call for Further Studies.

Sexual communication with partners is important for adolescents' sexual and socioemotional well-being. Behavioral assessments of partner sexual communication capture the complex and nuanced process of communication and are commonly used with adults, yet the existing literature among adolescents overwhelmingly relies on self-report measures. In the current paper, we reviewed the literature on adolescent partner sexual communication, identifying 14 studies including 2,043 participants (M age = 16) that used behavioral assessments (i.e., dyadic observations, role-plays with confederates, role-plays with vignettes). We also identify key gaps in the current literature: First, only one study recruited couples; studies that assessed dyadic interactions largely relied on confederates. Second, assessments often assumed that participants engaged in heterosexual sex, and no studies specifically recruited LGBTQ+ adolescents. Third, behavioral tasks often involved assumptions of participants' sexual goals (e.g., desire to refuse sex) and focused almost exclusively on sexual refusal and condom negotiation. Additionally, coding schemes lacked standardization and micro-analytic strategies (e.g., coding change over time). Finally, observational methods have been almost exclusively used to assess intervention efficacy, rather than to understand associations between behaviorally-assessed communication skills and sexual outcomes or self-reported communication in basic research. We discuss recommendations for future research, including regular use of behavioral observation methods with diverse samples, to triangulate across multiple methodologies and identify correspondence between behavioral and self-report measures.

Multilevel Barriers to Sexual Health Behavior Among Vulnerable Adolescent Girls in the USA.

Introduction: Most sexual health interventions focus on individual-level predictors of sexual behavior. Given the considerable influence of environmental factors on adolescent girls' sexual health, current interventions may be insufficient to promote safer sex. In this study, we aimed to understand adolescent girls' anticipated barriers to engaging in safer sex behavior after completing a brief, web-based sexual health intervention called HEART. Methods: This study used qualitative interviews with 50 adolescent girls who were recruited from community-based organizations that serve vulnerable youth. All participants were 12 to 19 years old (mean age=15.62, SD=1.83), and identified with a marginalized racial/ethnic group (58% Black; 18% Latinx; 24% Asian, biracial, or multiracial). Further, 24% identified as LGBTQ+, and 58% were sexually active. Results: Guided by the social ecological model, we delineate six unique barriers to safer sex discussed by adolescents: partner manipulation, slut shaming, unclear sexual values, present time orientation, embarrassment, and access to sexual and reproductive health services. Discussion: We conclude with recommendations for addressing these barriers to optimize adolescent girls' sexual health.

Psychometric properties and factor structure of the appearance-related social media consciousness scale among emerging adults.

Appearance-related social media consciousness (ASMC) is the persistent awareness of one's attractiveness on social media. The ASMC Scale, recently developed for use with adolescents (Choukas-Bradley et al., 2020), provides a promising tool for systematically examining ASMC and associations with mental health. The current study examined the psychometric properties of the ASMC Scale among emerging adult men and women. Participants for Study 1 were 428 emerging adults (M age = 21.9) from five Anglophone, industrialized countries (U.S., U.K., Canada, Australia, New Zealand). Results from Study 1 provide evidence that the 13-item ASMC Scale has a unidimensional structure, strong internal consistency, measurement invariance across gender, and convergent validity (i.e., associations with related offline appearance concerns and cognitions) and incremental validity (i.e., associations with depressive symptoms and disordered eating, above and beyond time spent on social media). Participants from Study 2 were 296 U.S. college students (M age = 18.6). Results from Study 2 confirmed the factor structure and further demonstrated the convergent and incremental validity (above and beyond both time spent on social media and offline appearance concerns) of the ASMC Scale. Findings suggest that the ASMC Scale can be used among emerging adults, aiding future research investigating social media experiences and mental health.

Sexual Communication between Adolescent Partners: A Scoping Review and Directions for Future Research.

Sexual communication between adolescent partners is an important component of sexual health and wellbeing. Over 40 years of research on adolescent sexual communication has yielded rich information, yet there remain gaps in our understanding of the communication process. The purpose of this scoping review was to synthesize the body of research on adolescent sexual communication to identify how communication has been conceptualized, how researchers have measured communication, and what theoretical frameworks have been applied across the literature. We identified 198 assessments of sexual communication across 119 quantitative studies. This work included 127,489 adolescents (Mage = 15.97) from 15 countries (81.5% U.S.-based). Most studies relied on self-reports (93.4%) and surveyed only one member of a couple (97.5%). The definition of sexual communication was highly varied across the literature: in half of assessments (52.0%) sexual communication was operationalized as a behavior-the verbal or nonverbal exchange of messages about sex-whereas the remaining half of assessments captured social-cognitive aspects of communication (e.g., communication self-efficacy, fear/anxiety). There was also a tendency for investigators to create their own idiosyncratic instruments: half of studies (48.9%) used instruments created by the research team with limited or no discussion of reliability/validity. Regarding the topic of communication, a third of assessments (33.8%) focused exclusively on condom communication and another quarter (24.0%) focused on other safer-sex issues (e.g., STDs, abstinence). Notably absent were studies focused on communication surrounding consent or sexual pleasure. Also absent was a guiding conceptual model or theory that could unify this body of work. Overall, results highlight gaps and inconsistencies in how partner sexual communication has been conceptualized, measured, and theorized about in previous work. We provide several recommendations for future theory-building efforts as well as rigorous, multimethod empirical investigations of adolescent sexual communication that would further our understanding of this important aspect of adolescent sexual wellbeing.

Examining the efficacy of STD testing public health messages tailored to youth's regulatory focus.

Only 25% of sexually active youth have ever been tested for sexually transmitted diseases (STDs). One potential strategy to increase testing is to target youth with health messages tailored to their regulatory focus. People have a dominant regulatory focus and tend to be either more concerned with the risks of unhealthy choices (prevention-focused) or the benefits of healthy choices (promotion-focused). Theoretically, when someone is targeted with a message that matches their regulatory focus, the message will be more effective. Among 380 sexually active youth, we examined whether matching STD testing messages to youth's regulatory focus strengthens the efficacy of the message for improving STD testing stigma, self-efficacy, and intentions. We evaluated participants' regulatory focus and then assigned them to watch either a prevention-focused or promotion-focused video encouraging STD testing. Among prevention-focused youth, those who watched the prevention-focused video had more stigmatizing attitudes toward STD testing than those who watched the promotion-focused video. Post hoc analyses confirmed the robustness of these findings for our stigma outcome and revealed a similar pattern for self-efficacy: youth who were more prevention-focused and received the prevention-focused video had lower STD testing self-efficacy. Our results for testing intentions were not significant. Interventionists should consider making STD testing messages for youth promotion-focused. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Longitudinal associations between appearance-related social media consciousness and adolescents' depressive symptoms.

INTRODUCTION: Frequent social media use among adolescents is associated with depressive symptoms, though prior work has overwhelmingly used cross-sectional designs and focused on "screen time." Subjective social media experiences, such as the concern with one's physical appearance on social media, may be more relevant to adolescents' depressive symptoms than mere frequency of use. Appearance-related social media consciousness (ASMC) is the preoccupation with one's physical attractiveness in social media photos and has been associated with depressive symptoms above and beyond frequency of social media use in prior cross-sectional work. METHODS: In this brief report, we assessed this association longitudinally over 1 year within a diverse sample of highschool adolescents in the Southeastern US (n = 163, M age = 16.19; 55.8% girls; 44.8% White, 23.9% Black, 26.4% Hispanic/Latinx; 49.7% received free or reduced-price lunch). RESULTS: Baseline ASMC was associated with higher depressive symptoms 1 year later, even when controlling for time spent on social media. Although girls reported higher levels of ASMC, associations were similar for adolescent boys and girls. No evidence was found that heightened depressive symptoms at baseline were associated with higher ASMC 1 year later. CONCLUSIONS: The findings highlight the importance of physical appearance concerns on social media-above and beyond the frequency of use-in the development of depressive symptoms among adolescents. Implications for future research to examine the role of subjective social media experiences in adolescents' depressive symptoms are discussed.

Validated HIV Knowledge Scales for Use with Adults and Adolescents: A Systematic Review.

HIV knowledge - the information a person possesses about HIV - is essential for the prevention and management of HIV. Therefore, the accurate measurement of HIV knowledge is important for both science and practice. This systematic review identifies extant HIV knowledge scales that have been validated with adolescent and adult populations and summarizes the state of this research. We searched seven electronic databases, which resulted in 6,525 articles. After title/abstract and full-text review, 27 studies remained and underwent qualitative review of reported scale psychometric properties. Many studies were conducted in the last decade (n = 12), reflecting advances in scientific knowledge of HIV. Five were exclusively adolescent-based studies (sample age ≤ 18). Most studies reported reliability (n = 25) or at least one form of validity (n = 21). Future studies should develop or refine HIV knowledge scales so that they reflect recent scientific developments, use rigorous psychometric testing, and target samples that include those persons at highest risk for HIV.

Is Regulatory Focus Related to Condom Use, STI/HIV Testing, and Sexual Satisfaction?

Regulatory focus theory contends that when making decisions people are either more inclined to focus on avoiding negative consequences (more prevention-focused) or achieving pleasurable outcomes (more promotion-focused). Some research suggests that regulatory focus is related to health behaviors, although this has not been thoroughly investigated in the sexual health domain. The purpose of this study was to examine the relationship between regulatory focus (prevention, promotion) and sexual health. In an online survey of 409 youth from the U.S. (ages = 18-25; Mage = 23.5; 57.2% women; 74.1% White, 13.4% Asian, 10.5% Black, 9.8% Hispanic), we examined the relationship between regulatory focus and three sexual health outcomes: condom use, STI/HIV testing, and sexual satisfaction. Of youth in our sample, 31.8% had a dominant prevention-focus, while 54.8% had a dominant promotion-focus. Compared to youth who were more promotion-focused, more prevention-focused youth used condoms more frequently but reported less sexual satisfaction. No differences were found in rates of STI/HIV testing. This study lays the groundwork to investigate the dynamic role that regulatory focus may play in contributing to youths' sexual health. More experimental and longitudinal studies are needed to confirm the causal nature of the association between regulatory focus and sexual health.

Parent-child communication and adolescent sexual decision making: An application of family communication patterns theory.

Family communication patterns theory proposes two dimensions of family communication-conversation orientation and conformity orientation-that can impact adolescent decision making. The purpose of this study is to examine how family communication patterns, above and beyond the frequency of parent-child sexual communication, are associated with adolescents' (a) sexual self-efficacy, (b) intentions to communicate about sex with partners, and (c) intentions to use condoms. Participants were 452 U.S. adolescents (Mage = 15.06; 59% girls; 35% White, 33% Latinx, 25% Black). Controlling for the frequency of parent-child sexual communication and gender, we found the interaction between conversation and conformity orientation was associated with adolescent sexual self-efficacy and intentions to communicate about sex with partners. When families were high on conversation and low on conformity, adolescents had statistically significantly higher sexual self-efficacy than any other family communication patterns. When families were low on conversation and low on conformity, adolescents had statistically significantly lower intentions to communicate with future sex partners than any other family communication pattern. Findings highlight the importance of understanding general communication processes beyond the frequency of parent-child sexual communication. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Parental influence on sexual intentions of Black adolescent girls: Examining the role of gendered-racial socialization.

Parents can promote the sexual health of adolescents in a number of well-established ways, such as through sexual communication and parental monitoring. Another unexplored avenue through which parents might influence sexual decision-making among Black girls is gendered-racial socialization-the process through which parents send messages to their Black daughters about what it means to be a Black girl, in part, to improve their self-esteem. In a national, U.S.-based sample of 287 Black girls (Mage = 15.4) and their parents (87.8% female), we examine how two dimensions of gendered-racial socialization (gendered-racial pride socialization; gendered-racial oppression socialization): (a) are related to adolescents' intentions to have early sex and (b) moderate the association of parental communication and monitoring with adolescents' intentions to have early sex. We found Black girls who are exposed to more empowering messages about Black girls and women are less likely to intend to have early sex. Additionally, gendered-racial pride socialization moderated the relationship between parental monitoring and intentions to have sex, such that more monitoring was associated with lower intentions to have early sex among girls low in gendered-racial pride socialization. For girls high in gendered-racial pride socialization, there was no relationship between parental monitoring and sexual intentions. Gendered-racial pride socialization is an important asset in Black families, which can be leveraged to improve the sexual health of Black girls. Future studies are needed to examine the causal, temporal pathways between gendered-racial socialization and sexual health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).