Florida State University Libraries
Electronic Theses, Treatises and Dissertations
The Graduate School
2007
A Study to Determine the Effects of Mass
Media on a College Age Male and Female
Decision to Become Sexually Active as an
Adolescent
Sabrina L. Dickey
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THE FLORIDA STATE UNIVERSITY
COLLEGE OF NURSING
A STUDY TO DETERMINE THE EFFECTS OF MASS MEDIA ON A COLLEGE AGE
MALE AND FEMALE DECISION TO BECOME SEXUALLY ACTIVE AS AN
ADOLESCENT
By
SABRINA L. DICKEY
A Thesis submitted to the
College of Nursing
in partial fulfillment of the
requirements for the degree of
Master of Science in Nursing
Degree Awarded:
Fall Semester, 2007
The members of the Committee approve the Thesis of Sabrina L. Dickey defended on
October 15, 2007.
_____________________
Susan Porterfield
Co-Professor Directing Thesis
_____________________
Laurie Grubbs
Co-Professor Directing Thesis
_____________________
Dianne Speake
Committee Member
Approved:
____________________________________________________
Dianne Speake, Director, College of Nursing Graduate Program
_____________________________________________________
Lisa Plowfield, Dean, College of Nursing
The Office of Graduate Studies has verified and approved the above named committee
members.
ii
This manuscript is dedicated to my loving husband and children who have been with me through
every step of my graduate education with unconditional love. I also want to thank my parents
who have always been a constant motivating force in my life to pursue and fulfill all my dreams.
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ACKNOWLEDGEMENTS
To Dr. Porterfield I cannot thank you enough for your patience and your belief in me.
Your guidance, expertise and support throughout the entire process have kept me going and were
invaluable with helping me reach my goal.
To Dr. Grubbs thank you for your hard work, patience and support throughout this
endeavor. Your knowledge has been a wonderful asset in helping me reach my goal.
To Dr. Warren I knew it was time for me to embark on my goal of becoming a nurse
educator when I encountered you at the Health Center. Your wisdom has been irreplaceable and I
thank you for confidence and support in me.
I also say a special thank you to all those individuals who helped me with my data
collection, statistical analysis and providing me with words of encouragement.
Last but never least I am thankful and extremely blessed to have my loving and
supportive husband and two children who have endured all of my growing pains and successes.
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TABLE OF CONTENTS
List of Tables………………………………………………………………………………
Abstract…………………………………………………………………………………….
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1. INTRODUCTION……………………………………………………………………...
Statement of the Problem…………………………………………………………...
Significance of the Problem………………………………………………………...
Statement of Purpose………………………………………………………………..
Research Questions…………………………………………………………………
Operational Definitions……………………………………………………………..
Assumptions………………………………………………………………………...
Limitations………………………………………………………………………….
Summary……………………………………………………………………………
1
2
3
4
5
5
5
6
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2. REVIEW OF LITERATURE…………………………………………………………
Use of Mass Media………………………………………………………………….
Theories and Models for Sexual Behavior…………………………………………..
Social Learning Theory………………………………………………………..
Priming Theory……………………………………………………………….
Media Practice Model………………………………………………………..
Super Peer Theory…………………………………………………………….
Marketing Strategies of Mass Media………………………………………………..
Influence of Mass Media……………………………………………………………
Negative Consequences in Mass Media……………………………………………..
Health Education……………………………………………………………………
Female Physical Maturation………………………………………………………. .
Theoretical Framework……………………………………………………………...
Summary…………………………………………………………………………....
7
7
11
12
13
13
14
15
16
20
20
21
22
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3. METHODOLOGY…………………………………………………………………….
Design………………………………………………………………………………
Setting………………………………………………………………………………
Population and Sample……………………………………………………………...
Instruments………………………………………………………………………….
Procedure……………………………………………………………………………
Protection of Human Subjects………………………………………………………
Data Analysis……………………………………………………………………….
Summary……………………………………………………………………………
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28
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4. RESULTS……………………………………………………………………………...
30
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Data Obtained from the Questionnaire………………………………………………
Research Question One………………………………………………………………
Research Question
Two………………………………………………………………
Sexual Initiation and Race…………………………………………………………...
Additional Findings………………………………………………………………….
Knowledge of Protection and Onset of Sexual Activity……………………...
Knowledge of Sexual Transmitted Diseases and
Protection…………………...
Summary ……………………………………………………………………………
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35
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36
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5. DISCUSSION………………………………………………………………………….
Discussion of findings and Research Questions……………………………………
Relationship of Results to Previous Empirical Work………………………………
Relationship of the Results to the Conceptual Framework…………………………
Limitations………………………………………………………………………….
Assumptions………………………………………………………………………...
Implications for Advanced Nursing Practice……………………………………….
Recommendations for Future Research…………………………………………….
Summary……………………………………………………………………………
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APPENDICES……………………………………………………………………………..
50
REFERENCES…………………………………………………………………………….
65
BIOGRAPHICAL SKETCH……………………………………………………………...
67
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LIST OF TABLES
1 Age at first Intercourse, Groups: Age groups…………………………………………….
31
2 Average of Initiation Among Age Groups……………………………………………….
33
3 Correlation between Age at first intercourse and current Age…………………………...
33
4 The test for association between age groups and groups based on age at first
intercourse…………………………………………………………………………………..
34
5 Average Protection knowledge scores among groups based on age
at first intercourse…………………………………………………………………………...
34
6 Association between age at first intercourse and groups based on quartiles of sexual
media content………………………………………………………………………………..
35
7 ANOVA- Average age at initiation among the races……………………………………
36
8 Logistic regression of virgin on age, race and total sexual media content
logistic regression of virginq6 on ageq1 race1 race2 race3 totSmc………………………..
37
9 Linear regression of age at first intercourse on gender, race age and sexual media
content scores……………………………………………………………………………….
38
10 Linear regression of age at first intercourse on gender, sexual media content score,
protection knowledge and sexually transmitted disease…………………………………….
39
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ABSTRACT
Technology has expanded the availability of information through various routes, such as,
television, music, movies, internet and magazines. These routes avail adolescents to endless
learning venues about any issue that might be of interest to them. Television is a common media
mode and research indicates approximately 83% of programming contains sexual content.
Adolescents being impressionable believe the sexual content in the media is natural, which may
lead to an altered perception of what types of behaviors are appropriate for them.
This retrospective descriptive study explored whether mass media prompted individuals
to become sexually active as adolescents. The sample population of 180 college age students
came from a public university in the southeast United States. Factors examined in the study were
age, gender, race, and amount and mode of media consumed.
The Sexual Media Diet (SMD) Questionnaire, along with sexual history demographics,
was administered to college students (N=180) to explore how much time and type of media they
consumed as they were developing through their adolescent years. Data from the survey
established an association between age of sexual initiation and gender. Results indicated females
consume more sexual content from the media than males but males were initiating sexual
intercourse at younger ages than females. Race could not be used as a single variable to predict
the age of initiating sexual intercourse. An additional finding was the ability to predict the
college age student’s virgin status based on age, race, sexual media content score, protection
knowledge, and sexually transmitted disease knowledge
viii
CHAPTER 1
INTRODUCTION
Evaluating the influences of sexual content on television in adolescents is an area of
concern when exploring why individuals initiate sexual intercourse. Television is a heavily used
mode for disseminating information. It provides information on various issues, topics, and world
events in addition to a vast amount of entertainment for viewers. According to Brown et al.
(2006) the entertainment programs have a majority of sexual overtones. The sexual connotations
seen on television are not necessarily depictions of the act itself, but they imply a variety of
activities that lead to sex including sexual talk, intimate kissing and hugging, and heavy flirting
to solicit sex.
Adolescents are usually dealing with pre-pubertal and puberty changes, which make them
more aware of their own bodies and feelings. This is linked with a natural curiosity about sex,
which leads to many discussions with their peers. The question is whether exposing adolescents
to sexual activities on television influences their decision to become sexually active.
The prevalence of the media in adolescent’s everyday lives cannot be ignored as a possible
influence on adolescent behaviors. The glamorous lifestyles depicted by entertainers along with
the sexual overtones may seem exciting to adolescents. The excitement adolescents experience
when viewing sexual content may also be heightened due to the media’s under-representation of
negative consequences from sexual activities (Brown et al., 2006). Unfortunately, the depiction
of sexual behavior in the media is often not realistic and, to an adolescent, it may be mistakenly
perceived as being natural and what is expected (Brown et al., 2006). Adolescents seek
information from various sources, and a lack of communication between adolescents, family
members and school counselors may prompt them to see the media as a way to learn about sex
and sexual norms (Brown et al., 2006) This can create profoundly negative consequences for an
adolescent, since a majority of sex in the media is casual and it rarely shows the negative side,
which is unplanned pregnancy and sexually transmitted diseases (STD).
More research is needed to explore how influential the media is in the initiation of sexual
behavior by adolescents. Healthcare providers are also called to become aware of the influences
of media on adolescents sexual beliefs in order to educate them on the consequences of sexual
1
activity. As part of the healthy development of adolescents, the amount of sexual content they
are exposed to is a factor, which may need to be monitored. The combined efforts of health care
providers and the community in screening and/or restricting the sexual content presented to
adolescents may assist with deterring them from becoming sexually active.
Statement of the Problem
Literature indicates watching sex on television is a predictor and could accelerate an
adolescent into initiating sexual intercourse (Collins et al., 2004). Two other areas that may
contribute to the adolescent’s decision are early onset of puberty for females and the
susceptibility of the adolescent in believing what is portrayed in the media as true (Brown,
Halpern & L’Engle, 2005).
Media exposure involves unlimited access to images and the media is present in a
minor’s every day life. This is evidenced by their access to computers at home, school, libraries
or friends’ houses. Magazines with scantly dressed individuals in sexual poses are in stores, gas
stations and many homes. Billboard advertisements are also sources of media, which are viewed
daily and can feature sexual content. Radio and other electronic devices, such as ipods, that can
store, record and play hundreds of hours of music, videos and movies, are vehicles by which the
media can deliver sexual messages to the adolescent. Exploring these areas of influence may be a
means in deterring and understanding why minors choose to become sexually active.
Understanding the areas of influence may assist in obtaining insight into adolescent sexual
behaviors.
There have been considerable amounts of research into the effects of mass media on an
adolescent’s decision to become sexually active. A unique aspect of this study is that college age
males and females are asked to recall if mass media had an effect on their decision to become
sexually active as an adolescent. This retrospective study can provide an insight into influences
on adolescent sexuality, specifically mass media. The study obtains information regarding past
sexual experiences from the individual at a time when they are able to reflect on possible
influences for their sexual behavior. The college student may have increased cognitive abilities,
compared to an adolescent, to discern and identify possible influences on their sexual behavior.
The results of the study will add to the body of knowledge in determining mass media
influence on an adolescent’s decision to become sexually active. Providing solutions to the
2
problem can contribute to patient education, parental education, healthcare education, and
interventions to prevent negative consequences from the influence of mass media.
Significance of the Problem
Sexual intercourse among adolescents has become a prevalent activity, which can
produce life long consequences. Literature on intercourse among adolescents reveals the bulk of
adolescents from the United States and Canada between the ages of 15 and 19 had intercourse at
least once (Hall, Holmqvist & Sherry, 2004). There are many concepts to explore when one
examines the repercussions of adolescents engaging in intercourse. The most obvious of the
repercussions are STDs and pregnancy. Adolescence is a time when individuals are striving to
define themselves and seek independence regardless of emotional and physical maturity (Brown
& Witherspoon, 2002). It is during this time when adolescents may be especially susceptible to
depictions of sexual content in the media. It should prompt health care providers, namely the
advanced practice nurse, to examine what can be done to prevent or delay sexual behavior
among adolescents for their own benefit and their partner’s (Hall, Holmqvist & Sherry, 2004).
Research indicates the high incidence of multiple sexual partners among adolescents age
10-19 years. This high-risk behavior leads to a higher likelihood of contracting a STD (Sulak,
2004). “Of the 18.9 million new cases of STI’s in the U.S. in 2000, 48% were among fifteen-to
twenty-four year olds” (Hellerstedt & Radel, 2005, p. 31). In addition to the problem of STDs
among adolescents, there is also the financial strain due to treating adolescents with STDs. The
annual cost of STDs in the United States is $17 billion and affects one fourth of adolescents
(Rock, Ireland & Resnick, 2003).
Unplanned pregnancy is another consequence of sexual intercourse among adolescents.
It is reassuring to know the birth rates of teenagers in the United States have declined, but it does
not mean it is at an acceptable level or comparable with other countries. Recent data on
adolescent pregnancy compared with other western countries, such as Germany, France, and
Sweden indicates Canada and the Untied States still have higher adolescent pregnancy rates
despite a decrease from 40% to 35% for American women age 15 to 19 years (Hall, Holmqvist &
Sherry, 2004). Data also shows that adolescents less than 17 years of age are responsible for
more than one fourth of infants born (Sulak, 2004). It is unclear if these births occurred out of
wedlock.
3
An adolescent’s consumption of sexual content in the media seems to be a key factor when
examining media influence on an adolescent’s decision to become sexually active. The amount
of sexual content in the media consumed by the adolescent seems to be the key factor when
examining its influence. When media portrays risk-free sexual behaviors and no messages of
safe sex, an adolescent may find it appealing to initiate sexual intercourse. A study by Collins et
al. (2004) explored the influence media has on individuals, and found safe sex messages are only
displayed in 14% of television programs. If the majority of sexual content portrayed in the media
tends only to portray individuals having a good time and never showing the realities of
unplanned pregnancies or STD’s, being sexually active may seem appealing to adolescents.
When mass media does not show the consequences for sexual activities, individuals may not be
aware or may minimize the seriousness of the consequences. Adolescence is a time when the
individual is usually not fully mature and cannot differentiate in the media between acting and
real life (Escobar-Chaves et al., 2005). When sexual activity is mostly portrayed as a common
behavior that can be done with little thought for emotional or physical repercussions, adolescents
might see it as the thing to do. Collins et al. (2004) has identified the phenomena of media
cultivation, which is the initiation of sexual activity resulting from TV portraying sex as a focus
of daily life when it may not be the reality.
Statement of Purpose
The purpose of this study is to examine the effect mass media had on college age co-eds
in their initial decision to become sexually active. The study examines the areas of age, race, and
gender regarding the effects mass media had on their decision to become sexually active. The
study will incorporate all media types including television, radio, film, music, and computer.
Benefits of the study may provide:
•
knowledge on why adolescents choose to become sexually active
•
patient education on STD and unplanned pregnancies
•
education for parents and healthcare providers on talking to adolescents about sexual
behavior
•
intervention methods to prevent negative consequences caused by the influence of mass
media
4
Research Hypothesis
The following statement is the hypothesis of this study: there is an association between
mass media exposure and the initiation of sexual active as an adolescent.
Research Questions
There are two questions to be answered to fulfill the purpose of this study:
1. Does mass media play a role in the decision to become sexually active in a population
of college males and females?
2. Is there a relationship between initiation of sexual activity and age and race?
Operational Definitions
The following definitions are to assist the reader in clarifying terms and information in
provided in the study:
College age: for the purposes of this research, college is defined as college students between
the ages of 18 and 25 years old.
Mass media: is defined as newspapers, motion pictures, radio, television and magazines, all
of which have the technical capacity to deliver information to millions of people.
Sexuality: for the purpose of this research, sexuality is being concerned with or interested in
sexual activity, a condition of being characterized or distinguished by sex and sexual character or
potency.
Sexual media content: is defined by the amount of sexual content in the media.
Assumptions
The following are the assumptions related to this study:
1. The researcher will collect completed questionnaires from the participants.
2. The participants will provide truthful information on the questionnaires.
3. The participants will be able to correctly recall information and situations, which
occurred as an adolescent.
4. The participants will be able to read and comprehend English and understand and
comprehend the questions on the questionnaires.
Limitations
Limitations of the study include:
1. Inaccurate information from the participants due to the study being retrospective
2. Reluctance of individuals to participate due to sensitive information on questionnaires.
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3. The sample population, which is predominately Caucasian educated college students.
Conceptual Framework
The Theory of Planned Behavior, by Ickek Ajzen, is the conceptual framework to explain
how influences determine if individuals will commit a specific behavior. The conceptual
framework operates on the premises of behavioral, normative and control beliefs. Understanding
why individuals engage in certain behaviors requires a conceptual framework, which addresses
influences that can predict the actual behavior. The theory of planned behavior provides the
study with a theoretical framework to explain the effects of sexual content in the mass media on
the college age student’s decision to become sexually active.
Summary
Individuals involved in adolescent health care and those interested in determining why
adolescents initiate sexual behavior should be concerned with the prevalence of sexual content in
the mass media and the adolescent’s accessibility to it. This study seeks to evaluate if mass
media does play a role in an adolescents’ decisions to become sexually active. The results of the
study may assist with developing interventions to delay onset of sexual activity. In addition, the
results may also assist with implementing teaching programs aimed at promoting sexual health
and provide an understanding of how the adolescent perceives information from mass media.
6
CHAPTER 2
REVIEW OF THE LITERATURE
The review of literature explores various concepts which may influence an adolescent’s
decision to become sexually active. One area of review is the popularity of sexual content in
mass media. Exploring the popularity of sexual content in the media provides the reader with a
foundation to consider its prevalence in the lives of adolescents. The review will address various
theories and models used to explain sexual behavior and then give insights into why the behavior
may be occurring. Other concepts in the review will focus on marketing strategies of the mass
media and how they target adolescents. A large portion of the review will discuss the influence
of mass media on an adolescent’s decision to become sexually active. Finally, this review of
literature will examine the impacts of female adolescents maturing physically at an earlier age
and how these may influence their decision to become sexually active. It will investigate how
negative consequences of sexual behavior are portrayed in the media and how this affects the
adolescent’s decision to become sexually active. The literature will lend support to the basis of
this study, which is to explore a relationship between mass media and its effects on heterosexual
adolescents’ decisions to become sexually active.
Use of Mass Media
Adolescents are exposed constantly to media images. Sexual content in the media is a
reality in today’s arena of entertainment. Depictions of sexual content are displayed on television
in various programs, music videos, computers, and lyrics of songs. Teen magazines are a source
of representations of sexual attitudes and behaviors from which adolescents get skewed
perceptions of what is acceptable. A finding indicated that an average of three pages per
adolescent magazine incorporated some kind of sexual content. Those between the ages of eight
and 18 years old had a television in their bedroom according to a national survey in 1999.
Adolescents are exposed to various forms of media six to seven hours a day in the United States
(Brown & Witherspoon, 2002). Studies have provided data on just how much time adolescents
spend using some form of media, and there are differences between adolescent age groups when
comparing the amount of time spent with various forms of media. Adolescents between 8-13
years old watched TV 44%, used audio media 17%, other non-interactive screen 15%, print 10%,
7
computer 7% and video games 7% (Escobar-Chaves et al., 2005). Older adolescents between 1418 years old use TV 36%, audio media 34%, other non-interactive screen 11%, print 8%,
computer 7%, and video games 4%. The results indicate that mass media has seven different
modes to supply adolescents with sexual content whether it be visual, auditory or combinations
of visual and auditory. The numerous modes of mass media are a clear indication of how
accessible it is for adolescents to come in contact with sexual content. The data from EscobarChaves also provides data on the two age groups of adolescents regarding the amount of time
utilizing specific modes of media. Television was the mode, which had the highest utilization
rate in both adolescent age groups. The high utilization rate of television can be explained by
results in the study indicating 65% of adolescents have a television in their own bedroom
(Escobar-Chaves et al., 2005).
A study for the Kaiser Family Foundation in 2003 indicates sexual content was
“unusually high” in the television programs viewed most frequently by adolescents (EscobarChaves et al., 2005). The study revealed the following information regarding the sexual content
viewed by adolescents, “83% of programs had any sexual content (behavior or talk); 80% of
programs had sexual references (talk about sex); 49% contained sexual behavior, 59% of which
was passionate kissing; 20% contained behavior that was explicit or implicit intercourse”
(Escobar-Chaves et al., 2005, p. 311). Further analysis of indicates the amount of sexual content
in the television programs viewed by adolescents was higher than the programs on prime time
television or television programming as a whole (Escobar-Chaves et al., 2005).
The Internet disseminates a large amount of information due to its ability to transmit
virtually any type of information across the world. It provides a forum for the exchange of nearly
any type of information especially that which is of a sensitive nature, like sex. The anonymity
provided by the Internet is also another huge attraction for adolescents seeking information on
sexual intercourse and sexual activities. Kanuga and Rosenfeld’s (2004) research indicated that
75% of adolescents between 15-17 years, have used the Internet, and of those, 94% believe the
information online is helpful and accurate. Many use the Internet as a vehicle for friendship,
information on hard –to- discuss subjects, and as a substitute for real life. The Internet replaces
talking to a parent, clinician or school educator regarding sex. In addition to closing dialogue
with parents and counselors, the Internet exposes adolescents unknowingly to pornographic sites
and chat rooms which can lead to predators seeking sexual activities with adolescents. When
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exploring the effects of pornography, it is important to first note the ease with which it can be
accessed. The Kaiser Family Foundation supported a telephone survey of adolescents using the
Internet and found that more than half of adolescents between 15-17 years were unintentionally
exposed to pornography on the Internet (Kanuaga & Rosenfeld, 2004).
Various prominent organizations, such as the American Academy of Pediatrics, have
joined in researching the effect media has on influencing adolescents. The results of the research
advise that adolescent sexual activity may be due to the sexual content on television (Collins et
al., 2004). In other words, the initiation of adolescent sexual activity has to do with the amount
of sexual content viewed not the amount of media viewed overall. The reoccurring concept of a
relationship between the amounts of sexual content viewed or listened to by adolescents as
opposed to only reviewing time spent using media devices shows substantial findings. There is
evidence from Collins et al. (2004), regarding the sexual content in Nielsen rated teen programs,
but the sexual content in all TV programs needs to be investigated.
A study in 2001-2002 by Collins et al. examined the amount of sexual content in
television programming and the sexual activity of the participants. The study was conducted by a
telephone survey of 1792 adolescents between the ages of 12 and 17 years old. The survey
gathered knowledge from the adolescents on what they watched on television, their attitudes, and
their knowledge of sex and sexual behavior. A total of 23 programs were used based on Nielsen
ratings for television programs aired during peak hours. These programs were the most
frequently viewed by adolescents in groups of males, females, 12-14-year-olds and 15-17-yearolds. The programs appeared on major networks, such as, ABC, NBC, FOX and CBS to name a
few. Only sitcoms, reality shows, drama and animated programs were among those in the study.
There is concern that the amount of sexual content in television viewed by adolescents is
occurring at a high rate. A study by the Kaiser Family Foundation in 2001-2002 regarding sexual
topics in television programs frequently watched by adolescents revealed there were 6.7 scenes
per hour containing sexual issues (Brody, 2006). Another finding revealed that sexual talk
occurred in 61% of television programs and 32% of obvious sexual activity occurred in
television programs (Collins et al., 2004). A depiction of sexual intercourse whether it actually
occurred or heavily suggested was in approximately 14% of television programs (Collins et al.,
2004).
9
There are tools designed to examine the sexual content viewed by adolescents. Data
gathered by the tools may support research establishing a firm relationship between lengths of
exposure to sexual content in mass media and an adolescent’s decision to initiate sexual activity.
One such tool is the Sexual Media Diet (SMD), which measures four areas of mass media,
television shows, movies, music artists, and magazines. The SMD questionnaire was used in the
Teen Media Study Fall 2001 through Spring 2002, which was conducted in the Southeastern
United States on 3,261 seventh- and eighth grade students from three public schools. Pardun,
L’Engle, and Brown (2005) stated, “The SMD measure showed a statistically significant
association with adolescents’ sexual content in the media, based on the combination of media
consumption and content” (2005, p. 75). The study also included two other areas of the media,
Internet sites and newspapers. The demographics of the students consisted of 12-14 year olds
with the majority being female 55% and among them 50% were white and 41% were black
(Pardun, L’Engle, & Brown, 2005).
Pardun, L’Engle, and Brown, (2005) provided information on the amount of sexual
content consumed by the adolescents in general and individually in the six modes of media.
When reviewing all six modes collectively, researchers determined 11% of information from the
media contained sexual content. The amount of sexual content in the individual six modes of
media consumed by the adolescent’s was listed as: music 40%, movies 12%, television 11%,
magazines 8%, internet sites 6%, and newspapers 1%. The data reveals adolescents have
multiple choices to view a significant amount of sexual content in six different modes of mass
media. When specific sexual behaviors were reviewed overall from the six modes of mass media
it revealed a focus on viewing body parts in a sexual manner 56% and relationships 33%. Sexual
activity among consenting non-married adults overall in the six modes of mass media was at
25%. All of the data continues to reveal a large portion of information on sexual activity is
disseminated to adolescents. In contrast, there is a limited amount of information for adolescents
on safe sex messages or puberty. Messages on responsible sexual health, abstinence, body
development and condoms were in the minority at 6% of sexual information consumed by
adolescents (Pardun, L’Engle & Brown, 2005).
The results from the study by Pardun, L’Engle and Brown (2005) provided information
on a link between exposure to sexual content and the adolescent’s sexual behavior. “Analyses
showed strong positive associations between exposure to sexual content in the media and sexual
10
activity and intentions” (Pardun, L’Engle & Brown, 2005, p. 87). The study reported the amount
of sexual content consumed has a far greater impact on the individual rather than the specific
sexual behaviors observed (Pardun, L’Engle & Brown, 2005). Further analysis of the sexual
content in the media and survey results propose adolescents are “enveloped” in media which is
sexual in nature. The mode of media, identified as having the largest amount of sexual content,
was music, which was listed at 40%. An adolescent’s decision to become sexually active or
engage in sexual activity in the future may depend on the amount of sexual content viewed
(Pardun, L’Engle, & Brown, 2005). A substantial connection between the media and an
adolescent’s intent to become sexual active was established despite other significant influences
in the adolescent’s life, such as peers, family, religion and school (L’Engle, Brown & Kenneavy,
2006). The SMD indicated media influences in early adolescence as a 13% variation in their
intent to have sexual intercourse in the near future (L’Engle, Brown & Kenneavy, 2006). The
influence of media also seemed to cause an 8-10% variance in different levels of sexual behavior
once demographic controls were considered (Pardun, L’Engle, & Brown, 2005). The study
yielded some interesting findings on adolescents who are abstinent. Adolescents who are
abstinent seem to be at risk for initiating sexual intercourse when they are increasingly exposed
to sexual content and perceive an acceptance of adolescents engaging in sexual behaviors
(Pardun, L’Engle, & Brown, 2005). Another area, which may offer an explanation on the
initiation of sexual behavior is looking at various theories and models.
Theories and models have been developed which explain why individuals are influenced
to engage in various sexual behaviors. The theories and models are based on perceptions from an
individual’s encounters with peers and social situations. Part of how adolescents learn is through
socializing with peers, and from information they obtain from the media. In turn, the theories and
models offer an insight into how information is perceived and processed, and eventually cause
the adolescent to engage in sexual behavior.
Theories and Models for Sexual Behavior
Examining adolescents’ decisions to initiate sexual intercourse using models and theories
may help in explaining their behaviors. There are a number of models and theories, which deal
with behaviors and how external information influences the decisions of an individual (EscobarChaves et al., 2005). Theories and models regarding adolescent socialization practices, peer
influence and the value of media to adolescents make Albert Bandura’s social learning theory,
11
priming theory, media practice model, and super-peer theory a good choice for explaining why
they engage in sexual behaviors. Although the theories and models vary on how they explain
adolescent sexual behaviors and perceptions, they share a common premise that sexual content
consumed will initiate a change in adolescents’ perceptions of sexuality and eventually their
sexual behaviors (Escobar-Chaves et al.,2005).
Social Learning Theory
The social learning theory is based on life experiences, whether direct or indirect,
processing the information and then learning and possibly modeling a behavior from the
gathered information. It is the adolescent who is processing, learning and modeling the sexual
behaviors from the media. An adolescent is continually growing in the physical and
psychological realm. While the adolescent is growing physically and psychologically they are
receiving sexual information from the media and processing it to determine their perceptions
which may influence their decision to perform sexual behaviors. Adolescents can learn various
forms of socialization from the media, whether it is reality or not. Research has shown television
is a large part of adolescents’ lives and they often imitate what they observe. Bandura’s social
learning theory (1986) proposes that social influences determine what behaviors adolescents will
exhibit. When the behavior is perceived as being interesting and desired in addition to being
common, trouble-free, and practical, the social learning theory proposes the behavior can occur
(Brown, 2002). The social learning theory offers an explanation for the adolescent engaging in
sexual behaviors. The media is a part of the socialization process for adolescents and the sexual
behaviors in the media make up part of their socialization experiences. The adolescent develops
a perception of the sexual behaviors encountered in the media as a social encounter. Learning by
imitation of a behavior even when the behavior has not occurred is the basis of Bandura’s social
learning theory (Bandura, 1986). The theory recognizes three specific areas which occur in
learning: actually performing the behavior, watching others perform the experience without
direct contact, and the last phase using cognitive functions to accumulate and assimilate
complicated information (Escobar-Chaves et al., 2005). When adolescents actually perform a
sexual behavior after observing it in the media they are completing the area of the theory, which
states they actually perform the behavior. The last two areas of the theory, watching others
without direct contact and accumulating and assimilating information occur when the
adolescents encounter sexual behaviors in the media and then compile the information to
12
determine their perceptions of the sexual behaviors. At the time when the adolescent actually
performs the behavior, they are subjected to the possible negative consequences, such as,
pregnancy, STDS, and the psychological effects. In essence, the theory leads one to believe
social situations influence and can cause various behaviors to occur (Peterson, Moore, &
Furstenberg, 1991). Children have a tendency to learn by imitation and television is a
progressively influential mode of socialization (Peterson, Moore, & Furstenberg, 1991). While
adolescents are maturing the socialization process remains a significant part of their growth and
development. The social learning theory regards sexual behaviors as social experiences which in
turn influence adolescents to engage in sexual activities. The social learning theory offers an
explanation for sexual encounters in the media serving as a social pressure which influences
adolescents to engage in sexual behaviors.
Priming Ttheory
The priming theory operates on the premise that sexual content viewed in the media can
provide the motivation for adolescents to engage in sexual activity shortly after it is viewed
(Escobar-Chaves et al., 2005). Based on this theory, adolescents are very susceptible to initiating
sexual behaviors shortly after they have viewed or heard sexual content. The frequency of
sexual content in the media along with an adolescent’s access to various modes of media also
provides a foundation for motivating the adolescent to engage in sexual behaviors. Initially
adolescents may not have any motivation for sexual behaviors, but as the theory states, exposure
to the behaviors maybe catalyst for engaging in sexual activity. When the exposure to sexual
content is coupled with other factors in their lives, like puberty and socialization issues, the
notion of imitating sexual behaviors may seem more enticing. There is sexual content contained
in almost all forms of media, and with the amount of media consumed by adolescents, it may be
inevitable that exposure to sexual topics is only a matter of time. As the name of the theory
suggests, “priming”, is literally preparing the individual to perform a certain behavior.
Media Practice Model
The media practice model establishes that adolescents want to view the media and seek it
as a valuable source of information. The purpose of this model is to clarify how media is used in
a thorough relative structure (Steele & Brown, 2005). The main points of the model focus on a
relationship between the development of an adolescent’s personality and an adolescent’s
selection of media, the adolescent interfacing with media and how they use the media (Steele &
13
Brown, 2005). In essence the model assumes that an adolescent’s selection of media is based on
how he/she perceives him/herself or who they want to be at that time (Brown, Steele, & WalshChilders, 2002). According to the theory, if adolescents feel they are sexual beings, they will be
more interested in the sexual images and sexual content in the media. These feelings may
influence them to seek media selections containing sexual information and determine to what
level they participate in the behaviors (Brown & Witherspoon, 2002). If the adolescent chooses
to engage in the behavior it is a result of the adolescent’s intentions, past experiences, and how
they identify his/herself.
Super Peer Theory
When adolescents experience puberty, they are often filled with many questions and
substantial changes (Brown, Halpern, & L’Engle, 2005). As adolescents begin to become sexual
beings the sexual content in media may become more interesting (Pardun, L’Engle, & Brown,
2005). Generally, individuals will seek the information necessary to assist with explaining
ongoing changes, like those seen in puberty (Brown, Halpern, & L’Engle, 2005). Research has
already shown the large amount of sexual information, which can be obtained from the media.
The super-peer theory operates on the premise that adolescents choose who they want to be or
who they relate to in the media. This theory supports the notion that adolescents imitate the
behaviors of those individuals they want to be most like (Escobar-Chaves et al., 2005). When
sexual depictions are displayed in the media, an adolescent may find the actions appealing if the
adolescent favors the person in the media. In addition, adolescents may view the media as less
embarrassing and critical of questions regarding their changing bodies and development. This
non-threatening perception of information in the media may cause the adolescent to seek the
media for sexual information, which transforms the media into a kind of “super peer” (Brown,
Halpern, & L’Engle, 2005).
All of these theories establish that adolescents are influenced by mass media and that they
believe the situations in mass media are real. The mass media seeks out adolescents as potential
consumers for their products. The sheer number of adolescents and their spending power make
them an ideal audience for advertisers to target. This could lead the mass media to tailor their
marketing strategies to entice adolescents into purchasing or consuming their products.
The theories and models which were discussed, i.e. social learning theory, priming
theory, media practice model and super peer theory provide a framework for explaining how
14
mass media influences an adolescent to engage in sexual behaviors. Each theory/model explores
a unique area of an adolescent’s life. The social learning theory has a focus on social encounters
of sexual behaviors in the media being an influence for the adolescent to engage in sexual
activity. The priming theory states adolescents are motivated to engage in sexual activity shortly
after viewing sexual content in the mass media. The media practice model indicates an
adolescent values the information in media, and the information influences how they perceive the
information. The super peer theory maintains the position of the mass media influencing
adolescents to imitate the behaviors of individuals they want to be most like in the media.
Marketing Strategies of Mass Media
Mass media can be viewed from different standpoints as being a road to limitless freedom
and information or an unrealistic source of information without real life situations. Adolescents
vary in the way they perceive information, which is a fact that the producers of media have
discovered. Research on advertising to children reveals approximately 140,000 messages are
taken in by the time they are 12 years old, and the number increases to 300,000 at 19 years old
(Jo, & Berkowitz, 1994). The rise in advertised information has caused desensitization to
advertisements, which has spurred advertisers to seek innovative marketing strategies for
adolescents (Escobar-Chaves et al., 2005). How adolescents are targeted is a science for the
advertiser, and research goes into determining who will easily succumb to the effects of the
media.
Research in the area of marketing to adolescents seems to be lucrative, due to their way
of life and how receptive they are to advertisement (Brown & Witherspoon, 2002). On average,
adolescents were spending $50 per week in 1998 on various items and it was shown they have a
substantial influence on other non-media items purchased by the family, such as clothing and
food (Brown & Witherspoon, 2002). In 2002, adolescents were responsible for spending
approximately $170 billion. They are believed to be an increasing part of the consumer segment
(Escobar-Chaves, 2005). The growing adolescent population and their buying power will
continue to cause marketers to direct their attentions to convincing this population to purchase
their goods and remain consistent with their brands (Zollo, 1999). The media is seen as a
common factor among adolescents spending money and being influenced to engage in sexual
behaviors. The influence mass media has on an adolescent’s decision to become sexually active
is an area that deserves exploration when considering the amount of sexual content consumed,
15
time spent using mass media, various theories, and the possibility of mass media targeting
adolescents as potential consumers. The mass media as an influence in an adolescent’s decision
to become sexually active is an area that must be further investigated.
Influence of Mass Media
The popularity of mass media and its abundance in the lives of adolescents raises the
question of its influence on decisions to initiate sexual intercourse. The impact of mass media in
an adolescent’s life is identified in a study by L’Engle, Brown, & Kenneavy (2006) which
suggests the more they are exposed to the sexual content the greater the chances of them
engaging in the behaviors.
There is limited information available that establishes a relationship between mass media
and an adolescent’s decision to become sexually active (Rich, 2005). A report on media exposure
and sexual behavior by Rich (2005) discussed the small amount of research done on mass media
influence on an adolescent’s decision to become sexually active. This finding consistently
revealed that an increased amount of exposure to sexual content in the media may lead to more
accepting attitudes toward sexual behaviors. This finding parallels the Super Peer Theory, which
supports the notion of adolescents engaging in behaviors, which are accepted by their peers. The
Priming Theory may also be applied in that the constant exposure to the increased amount of
sexual content in media may be an initiator for engaging in behaviors.
The influence of television on adolescents continues to be a leading choice when looking
at its effects on adolescent sexuality. A national longitudinal study listed by The Brown
University Child and Adolescent Behavior Letter (2004) indicates that adolescents may increase
sexual behavior as the result of what is seen on television. The study included a baseline and a
follow-up interview one year later and included females that were white, African American,
Hispanic, Asian or another race. Those classed in another race were those who had combined
races, such as, white and African American. The participants ranged from 12-17 years old and
included a total of 1792 subjects. The primary purpose of the study was to assess the exposure
of TV sexual content and to compare sexual activity to discussions on sex, negative
consequences, and safe sex practices, and time spent watching television regardless of its
content. There were other significant factors the study examined as being indicators, such as
age, age of friends, deviant behavior, mental health, parental monitoring, and education, to name
a few. The study found a strong predictor of intercourse and advancing non-coital sexual
16
behaviors was related to exposure to TV sexual content. In addition, sexual talk and sexual
behaviors on television had similar outcomes for the initiation of sex by an adolescent.
Considering influences of mass media on an adolescent’s intent to be sexually active,
L’Engle, Brown, and Kenneavy (2006) investigated what role the concepts of family, religion,
school and peers had on their decision. The study showed that media influences had a
continuous and substantial relationship with early adolescent’s sexual intentions and behaviors.
The results indicated media accounted for 13% of the variance in relation to adolescents
initiating in sexual intercourse in the near future (L’Engle, Brown, & Kenneavy, 2006). In
regards to initiating light and “heavy” sexual behaviors the study found an 8- 10% variance
caused by the media, in comparison to other factors (L’Engle, Brown, & Kenneavy, 2006).
When other factors, such as demographics, was considered along with media there was a
variance of 54% for sexual intentions and a variance of 21-33% for sexual behaviors (L’Engle,
Brown, & Kenneavy, 2006). An additional finding indicated how attitudes regarding sex might
be influenced by mass media. This finding could also be used to help identify factors and assist
with decreasing sexual behavior in young adolescents (L’Engle, Brown, & Kenneavy, 2006).
This study took place in Southeastern United States and involved 1011 adolescents from 14
middle schools. The adolescents’ sexual activities and intent to become sexual active was
recorded thorough interviews in surveys sent in the mail and the use of audio-CASI (AudioComputer Assisted Self Interview) in their home. The average age was 13.7 and ranged from 1215 years old. There were contextual influences of parents, school and peer factors, media
influences, sexual behaviors and sexual intentions, which also were examined. When examining
mass media influence, other variables must be considered, such as age, gender, race, and
socioeconomic status. Parents, peers, school, and religion seemed to be additional factors when
accounting for adolescents decisions to initiate sexual intercourse. The results illustrated that
media made a notable impact on their sexual activities even when considering the other factors
(L’Engle, Brown, & Kenneavy, 2006).
A study by Brown et al., (2006) provides additional information on the influence of
viewing sexual content and initiation of sexual behavior. A survey was conducted in central
North Carolina in 14 middle schools among 1017 African American and white adolescents. The
Sexual Media Diet measure was used to evaluate the frequency of media content containing
sexual information. The modes of media examined for sexual content were television programs,
17
music, movies, and frequently used adolescent magazines. The data showed that a heavier sexual
media diet of white 12-14 year olds indicated a higher probability of participating in sexual
behaviors in two years compared to those with lighter sexual media diets (Brown et al., 2006).
Further analysis of the data reveals white 12-14 year olds in the higher percentile of sexual media
diet consumption had a 2.2 greater probably of engaging in sexual intercourse when compared to
14 to 16 in lower percentile of sexual media diet consumption (Brown et al., 2006). The study
provides support that sexual information from various media sources for example, magazines,
music, and movies in addition to television thrust adolescents to engage in sexual behaviors
(Brown et al. 2006).
In 1983, the Task Force on Children and Television was created by the American
Academy of Pediatrics (AAP) to examine the effects the media has on an adolescent’s sexual
behavior. An important finding from the task force recognized the powerful influence TV has on
providing adolescents with information second to the family (Rich, 2005). We often think of
parents as the primary sources for delivery of information to their children. However, with
adolescents spending large amounts of time exposed to the media (Rich, 2005), mass media may
be the most influential delivery method of information.
A study by Collins et al., (2004) focused on the concept of television influencing an
adolescent to initiate sexual intercourse and sexual behaviors. This longitudinal study was
conducted nationwide via telephone on adolescents between the ages of 12 and 17. Once the
initial survey was done a 1-year follow-up interview was conducted. The sample size was 1792
and was compromised of male, female, white, African American, Hispanic, Asian and other race.
The study was able to examine sexual activity, whether coital or not, after one year of examining
the sexual programming viewed by the minor. The study reviewed three main areas of sexual
content on television. They pertained to the amount of sexual content viewed, negative
consequences of sexual behaviors, and utilization of safe sexual practices. Viewing habits, race,
culture and sexual knowledge were included in the survey. There were covariates, which also
provided a substantial amount of information: parental education, parental monitoring, age of the
participants, friends whether older or younger, mother’s work status, and perceived parental
response if the participant had sex the following year. Personal characteristics of the respondents
were also taken into account. The study found there was no correlation among the amount of
time spent viewing sexual content and sexual activity, which was not found in other studies;
18
however, there was a profound relationship among adolescents viewing sexual content and the
initiation of sexual activity in the following year (Collins et al., 2004).
Another finding indicates an adolescent’s onset of sexual activity can be delayed by
reducing sexual content heard through conversations and viewed on television. The study
indicates adolescents had sexual behaviors similar to those 9 to 17 months, 32/.42 = 0.76 years
and .31/.22 = 1.40 years, older than they were when they watched 1 more standard deviation of
sexual information than the average adolescent (Collins et al., 2004). This study showed an
increased probability that adolescents who watched the largest amounts of sexual topics had an
increased chance of engaging in sexual intercourse two-fold. The probability of adolescents
engaging in intercourse was two times higher for those in the 90th percentile of watching TV
when compared to those in the 10th percentile (Collins et al., 2004).
As research indicates, there are very few portrayals of the negative consequences for engaging in
sexual behaviors. The limited portrayal of negative consequences works to the disadvantage of
an adolescent when he/she decides to become sexually active. When adolescents are provided
with sexual content that lacks negative consequences, and is depicted as pleasurable they may be
more likely to engage in sexual activity. The next section will explore negative consequences in
the media and how they affect adolescents.
Negative Consequences in Mass Media
Negative consequences in the media influence adolescents differently when comparing
them by race. African American youth can benefit from increasing portrayals of safe sex and the
consequences of high risk sexual behaviors by possibly delaying sexual activity. An important
discussion from the study concluded that the initiation of sexual activity can result from viewing
large amounts of sexual content. There was an interesting finding in the study regarding African
Americans and initiating intercourse and non-coital activity. Apparently, African Americans had
a lower incidence of initiating intercourse and advancing non-coital activity when exposed to the
consequences of sexual behaviors, such as STD’s and pregnancy, and safe portrayals of
behaviors (Collins et al., 2004). Data revealed African Americans had a decreased incidence of
engaging in sexual intercourse, compared to any other racial group, with a regression coefficient
of -.67 and a regression coefficient of .00 for the other races. The study could not provide an
explanation for the finding, but it is an area that deserves further investigation. However, the
19
finding lends credit to the notion that sexual activity may be delayed when adolescents are
exposed to the negative consequences of sexual activity.
Dispelling myths regarding sexual behavior in the media can protect adolescents from
negative physical and emotional consequences in the future. Clinicians are also called to become
aware of the influences of media on adolescents’ sexual beliefs in order to educate them on the
effects of sexual activity. The unrealistic nature of sexual depictions in the media is the greatest
cause for concern. When any behavior is depicted as being risk free, fun and pleasurable, it is
difficult for anyone not to perform the behavior if given the opportunity to do so. The notion of
performing a sexual activity when it is depicted as being practical and having no negative
consequences coincides with the social learning theory. Adolescents are immersed in the media,
for it provides ways to receive information from the world at large.
Unfortunately parental advice may fall behind that information obtained from the media.
The ease at which adolescents are influenced by the media may correspond to the many media
devices that are available. Rich (2005) describes how adolescents often use multiple forms of
mass media at one time, consisting of the Internet, email, listening to music and viewing
television. The abundance of media devices and ease of use calls for increased communication
with adolescents from a reliable reputable source, which will have the adolescents’ best interest
as the main focus. Key reliable sources are often the parents or other sources the adolescents
trust, such as teachers, religious leaders and counselors.
When examining sexuality in the media, there seems to be an abundant portrayal of
sexual behavior without any regard to STD’s or pregnancy. Some of the consequences from
sexual activities, such as STD’s and pregnancy, are rarely portrayed in the media. Sexual content
on teen television programs per Nielson-rated television shows found 83% of shows had only
12% addressing consequences of sex (L’Engle, Brown, & Kenneavy, 2006). These depictions
may give rise to unsafe and high risk sexual behaviors among adolescents. An adolescent needs
to be informed of the consequences of any behavior in addition to being assisted in
differentiating reality from media “hype.”
Health Education
Some of the responsibilities of being a health care provider are providing patient
education and teaching. Unfortunately, many of the health care providers may feel they do not
have the time to provide counseling and education regarding the sexual content adolescents
20
encounter. Health care providers should provide a thorough exam of the adolescents’ sexual
ideations or beliefs while examining their overall health. The extra time it takes to answer
questions on sexual issues or the opportunity to address sexual issues with adolescents may assist
in keeping them from engaging sexual behaviors before they are physically or mentally ready.
There are two opposing views from influential organizations that shape how health care
for adolescents should be provided. The American Academy of Pediatrics, AAP, created a task
force in 1983 called the Task Force on Children and Television. The purpose of the task force
was to examine the effects media has on an adolescent’s sexual behavior. The task force revealed
television’s depiction of sex as often not realistic and not showing the negative consequences,
such as, pregnancy and STD’s (Rich, 2005). The AAP has been committed in trying to change
how sexuality is portrayed on TV. Various studies Collins et al., (2004) and Rich (2005) help to
support the idea that providing more realistic consequences of sexual activity and decreasing the
amount of sexual material in the media can prolong an adolescent’s initiation of sexual activity.
There seem to be two different views from the AAP and the American Medical Association
regarding adolescents. It appears the medical community is not resigned to the media being a
health threat to adolescents. Both the AAP and the AMA agree on the need for more research in
the area of media influences on sexual behavior of adolescents (Rich, 2005).
Female Physical Maturation
Another area of exploration into an adolescent’s decision to initiate sexual intercourse is
focused on adolescent females who mature at an early age. In a study by Brown, Halpern, and
L’Engle, (2005) the average age of menarche, or the onset of menses, in the United States was
younger for black adolescents (11.6 years) when compared to white adolescents (12.2 years).
Combine this with the frequency of sexual content in the media and it may be a factor to consider
for the early sexual activity.
The study by Brown, Halpern, and L’Engle (2005) investigates how mass media is a
highly influential peer for those who encounter puberty at a younger age than their counter parts.
Four hundred seventy one African American and white female adolescents with an average age
of 13.7 years old participated in the study. They were from central North Carolina and selected
from middle schools to receive two self-administered surveys in their homes. The studies
focused on their perceptions of sexual content in the media, pubertal status and desire, and
exposure to various media. After consent was obtained from parents for participation in the
21
study, a 45 minute survey was administered. Using the Audio-CASI allowed the participants to
hear the questions through earphones and respond by way of a laptop. This helped to ensure
confidentiality for the questions and answers solicited from the adolescent. Some of the
independent variables were age, race and pubertal timing, while dependent variables were
interest in sexual media content and exposure to it, perceived sexual permission from the media,
and frequency in watching R-rated movies. The results of the study concluded that adolescent
girls who enter puberty earlier than their peers have an increased interest in viewing, hearing
about sex, and sexual activities (Brown, Halpern, & L’Engle, 2005). The results of the study
reported a statistical significance of (F[3], 426 = 13.5, p, < .000 with a variance of (R2 = .086)
which accounted for earlier maturing girls having an increased interest in sexual content in the
media (Brown, Halpern, & L’Engle, 2005).
Theories may also be used to explain a connection between sexual activity and the
onset of puberty. The Priming Theory posits that viewing sexual content may stimulate an
individual to consider performing the activity. If the adolescent has an increased interest in
sexual context due to puberty he/she may seek the information, which would not be difficult to
obtain due to the prevalence of sexual content in the media. Viewing the sexual context may
serve as a stimulant/primer for the adolescent to engage in sexual activity. Adolescents may also
think that the body changes mandate they behave more like adults even though their minds are
not fully mature. Increased exposure to various forms of sexual content in the media may be
seen as acceptable adult behavior to the maturing adolescent. When the behavior is considered
the norm and supposed to occur when the body is matured, the Super-Peer Theory may provide a
framework as to why the behavior is occurring.
Theoretical Framework
The theoretical basis being used in this study is Ickek Ajzen’s Theory of Planned
Behavior. This theory looks at the attitudes toward behaviors and the factors influencing
behavior. It also provides an understanding of how a person’s perceptions of a behavior can be a
good indicator of whether the behavior will occur. This study’s exploration of mass media is in
alignment with the theory’s basis of studying influencing factors on behavior. The ability to
comprehend certain behaviors and learn how they can be changed is a major premise of the
Theory of Planned Behavior, (Theory of Planned Behavior, 2006). There are three purposes for
this theory, which are identified as: 1) predicting and understanding influences which motivate
22
an individual to perform a certain behavior when it is thought to be beyond the person’s control,
2) learning to recognize various strategies to change behavior, and 3) explain all the decisions an
individual makes regardless of its importance. If there are negative behaviors on the part of the
patient, it is essential that health care providers are aware and assist with interventions to change
the behavior
This theory can guide understanding as to why individuals exhibit certain behaviors.
This theory is divided into three main areas; 1) behavioral beliefs- attitude about the behavior; 2)
normative beliefs- subjective norms, knowledge and perceived social pressure of performing the
behavior; and 3) control beliefs – perceived behavioral control, a person’s initiative to perform
the behavior is based on how easy or difficult it will be to perform the behavior and the
difficultly in performing the behavior (Ajzen, 2006). These areas in turn are combined to
influence behavioral intention and ultimately the behavior being studied. Based on the theory,
perceived behavioral control also has a direct link to the actual behavior.
The concept of behavioral beliefs when examined is analogous to a bridge between a
certain behavior and anticipated outcomes (Ajzen, 2006). An individual’s decision to perform the
behavior is influenced by their perception of the behavior producing a positive or negative
outcome. For example, if the individual predicts the behavior will produce a positive outcome, it
increases the probability that the behavior will occur. In contrast, if the behavior is perceived as
having a negative outcome it will diminish the likelihood that the behavior will occur. If
television decreased the amount of sexual content shown and increased the messages regarding
negative consequences, the behavioral belief regarding the perception of sex without
repercussions may prevent or delay sexual activity in adolescents (Collins et al., 2004).
If adolescents perceive a certain behavior as being the norm, it can influence the
individual to perform a behavior. The prevalence of sexual content in the media encountered by
the adolescent may appear to be normal acceptable behavior. According to the theory, the
perceived behavioral expectations from significant sources, such as peers or other groups
encountered by the adolescent, makes up an individual’s normative beliefs. The normative
beliefs which appear attainable and are perceived as a high expectation by the individual’s
significant groups comprise the subjective norms. Subjective norms are an individual’s
perception of social pressure to take part or not take part in a behavior. When the adolescent is
receiving a continuous stream of sexual information, whether it is from mass media or peers, the
23
individual may believe it is a behavior that is expected to occur. Research supports the influence
of peers on each other in a study of psychosocial factors influencing middle school adolescents
to initiate sexual intercourse. The conclusion of the study indicates that an individual’s
acquaintances and peers can have a substantial influence over the decision to become sexually
active (Santelli et al., 2004).
Control beliefs relate to the adolescent’s idea of the accessibility of becoming sexually
active. If the adolescent believes the behavior could occur, the individual will seek and set up
situations for it to happen. When the adolescent feels empowered and a sense of control over the
situation, it is more likely the behavior will occur. As nurses we want to empower the adolescent
to make responsible decisions, in addition to informing them of situations they cannot control.
Adolescents have an opportunity to make responsible decisions when they are informed of
potential outcomes from situations within their control and out of their control. Contracting a
STD or becoming pregnant are potential outcomes for situations out of their control if a condom
is not worn or if it breaks during sexual activity. When adolescents choose to abstain from sexual
activity despite multiple exposures to sexual content in the media, it demonstrates something
within their control.
Summary
Mass media seems to influence an adolescent’s decision to initiate sexual intercourse.
According to Rich (2005) there is limited research on adolescent sexuality and the media due to
its sensitive nature and the ethical concerns raised by purposely exposing adolescents to sexual
material. However, the media does have an effect on permissive attitudes toward sexual activity.
Rich (2005) indicates limited research on this topic and the various studies had different
outcomes. The consistent facts cited in the literature reveal that an increased exposure to sexual
content may produce a more tolerant attitude toward sexual activity. The literature also found
adolescents were initiating sexual intercourse at a younger age and higher approximations of
sexual activity among peers (Rich, 2005). The literature indicates the amount of sexual content
viewed is more significant than the actual time spent viewing the media. In addition there is
some indication in the literature that puberty in females, as well as the mental maturity of the
adolescent, determines how they input, process, and react to sexual content in the media. The
literature did not cite substantial differences among socioeconomic levels. Another area of
research to explore is how African Americans are more susceptible to negative consequences
24
from sexual behaviors, which may delay onset of sexual activity (Collins et al. 2004). In
reviewing the literature, the researcher believes it aligns with the notion that mass media has an
influence in a heterosexual female or male adolescent’s decision to initiate sexual intercourse.
25
CHAPTER 3
METHODOLOGY
This chapter will provide the reader with information on the study’s design, setting,
population, instruments, procedures, and data analysis. Ethical considerations for the study’s
participants will also be discussed.
Design
A non-experimental, descriptive, and exploratory study was conducted. In addition, a
retrospective design was used on college age males and females to explore influences and
contributing factors, which led them to become sexually active as adolescents. Data was
collected at one point in time, thus a cross-sectional approach was used.
Setting
A student health center on the campus of a public university in the southeast U.S. was the
setting for the study. The health center is compromised of two family practice clinics and one
gynecology clinic. The total number of patients seen throughout the health center is
approximately 200-300 per day. The family practice clinic, which accommodates 100-120
patients a day, was the site for solicitation of participants.
Population and Sample
Participants in the study were males and females between the ages of 18-25 years old.
The participants were English speaking and came from a variety of races, ethnicities, cultural and
socio-economic backgrounds. A sample size of 180 participants was used for data collection.
Instruments
The Sexual Media Diet (SMD) Questionnaire with sexual history demographics was used to
gather information about mass media influences on adolescents. The sexual media diet is an
instrument which explores how much time and how much sexual content is consumed by the
individual. See Appendix A for the questionnaire.. Permission to use the questions and make
revisions to the SMD was obtained from Kelly L’Engle; see Appendix B for permission.
Reliability of the sexual media diet was established by using Scott’s pi, which determined
intercoder reliability; the larger the number the better the reliability of the instrument. There
26
were six modes of media used in the SMD, television, movies, music, magazines, internet
newspapers and overall. The Interrater reliability for the following media are listed as follows:
.85 television, .82 movies, .76 music, .73 magazines, .69 internet, .89 newspapers, .79 overall
(Pardun, L’Engle & Brown, 2005).
Descriptive statistics were used to analyze the data. Adjustments were made to
accommodate for the independent variables and to obtain valid and reliable results. The sexual
history questions contain the demographic data for the participant in questions 1 through 4.
Questions 5 through 11 provide background information on the participant’s sexual orientation,
virgin status, age at first intercourse, number of partners, relationship status, and date of last
intercourse. Information regarding the participant’s access to modes of media was obtained from
questions 12 and 13. Influence from the modes of media, TV, newspapers, magazines, music and
the Internet came from questions 14 through 35. Consequences of sexual activity were received
from questions 36 through 38.
The purpose of utilizing these instruments is to:
•
provide information on sexual behavior
•
assist with establishing a connection between mass media and an adolescent’s sexual
behavior.
•
determine types of mass media utilized
•
determine amount of time spent viewing
•
establish time spent using mass media devices
•
provide demographic information
•
review quantity of mass media containing sexual content consumed by the participant
The variables to be examined in the study are:
Dependent:
•
heterosexual adolescents’ decision to become sexually active
Independent
•
Mass media influence
•
Time spent using mass media
•
Type of mass media
Demographics
•
Age
27
•
Gender
•
Race/Ethnicity
•
Socioeconomic background
•
Parental Involvement/Supervision
•
Knowledge/perceptions of sex, STD’s, pregnancy
Procedure
Prior to data collection, the Institutional Review Board (IRB) at Florida State University
granted approval for the researcher to conduct the study; see Appendix C for the approval letter.
The Health Center granted the researcher permission to use the facility and display flyers for the
study; see Appendix D for an example of the Flyer. The researcher trained representatives
regarding the completion of the questionnaires. After the approvals were obtained and
representatives were trained, participants were given the opportunity to participate in the study.
The data was collected when students came to the clinic for any type of visit, whether it was for
preventative care or a sick visit. Participants were asked to participate when they are being
triaged by the Health Center staff for an appointment. Individuals who arrived at the clinic
without an appointment were also asked to participate by a trained representative during the
patient triage process. Information packets regarding the study were distributed to the
participants. The packets contained an information flyer, description of the study, a consent letter
to participate in the study, and researcher contact information; see Appendix E for the consent
letter.. Participants who volunteered to participate were told about the study by the researcher or
assigned representatives, the informed consent was signed, and a questionnaire was completed.
Each participant was given a copy of the informed consent letter and the researcher contact
information. The participants were asked to complete the surveys in the clinician’s exam room or
the office of a Health Center staff member. Once the participants had completed the
questionnaire they placed the forms into a locked box. Each completed questionnaire was placed
in a locked box in the researcher’s office at the clinic. The anticipated length of time to complete
the data collection was two to four months and the actual time it took to complete the study was
one and a half months.
Protection of Human Subjects
The IRB’s approval for the study was the first ethical consideration to be met.
Confidentiality was first and foremost in addition to abiding by the laws of HIPPA. A signed
28
consent form was required from all participants. The information obtained was only for the
purpose of research and will remain confidential. Data was securely kept in the researcher’s
office throughout the duration of this research and as required by the institution. Data was
collected in a private place. Questionnaires had assigned numbers and no names were used.
Completed surveys are secured in a lock drawer in the researcher’s office at the university. Strict
confidentiality was maintained at all times.
Data Analysis
The Pearson's product moment correlation was used to establish whether a relationship exists
between mass media and initiation of adolescent sexuality. One-way ANOVA statistics was
used to determine differences when comparing the amount of sexual content in the media and
demographics. Tests for associations, such as, linear and logistic regression sought to establish
relationships between sexual content in the media, demographics, age, gender and race.
Summary
The study is aimed at exploring the effects mass media has on an adolescent’s decision to
become sexually active. A quantitative retrospective design was used to survey college students.
The Sexual History Questionnaire in addition to the Sexual Media Diet were the instruments
used to answer the research questions. The study began after approval from the University’s IRB
and the Health Center. The researcher conducted the study along with trained representatives in
the clinic. The participants’ confidentiality was maintained throughout the study in accordance
with HIPPA and the university’s IRB. Descriptive statistics were used to answer the research
questions.
29
CHAPTER 4
RESULTS
The purpose of the study is to explore two possible relationships that may result from the
influence of mass media. The first possible relationship is between mass media’s affect on a
college-age male’s and female’s decision to become sexually active, and the other is the
relationship between initiation of sexual activity and age and race. The study also examined if
the average amount of sexual media content consumed and knowledge of sexually transmitted
disease vary among sub-groups based on age, race, gender, and virgin/status by using one-way
ANOVA. A test for association was conducted between the variables accounting for factors such
as, the amount of exposure to sexual content in the media, types of media exposure, age of first
intercourse, participant’s age, race, gender and virginal status.. An indication of a causal
relationship was conducted by utilizing a linear regression of the response (age at initiation/age
at first intercourse on the covariates of gender, race, sexual media content and knowledge of
sexually transmitted disease scores. A logistic regression was also done on virgin status in
anticipation of establishing a relationship among age of first intercourse. The results indicated
that a relationship exists among age of first intercourse, gender and sexual media content scores.
There were no significant findings between age of initiation and race. The findings of the study
are further discussed in this chapter.
Data Obtained from the Questionnaires
There were 230 questionnaires distributed to participants at a large university student
health center, which resulted in 180 questionnaires returned to the researcher (N = 180). The
collection of data began on April 9, 2007 and concluded on May 15, 2007. The age of
participants was divided into the following four groups, Group 1) <= 20 years old, Group 2)
>20 and <=25 years old, Group 3) >25 and <=30 years old and Group 4) >30 years old. The
participants were further categorized into gender, 56% male and 44% female. An average of the
participant’s age at first intercourse was also obtained in data and reflected in Table 1. The
descriptive statistics in table one tests for homogeneity of variances among the age groups.
30
Research Question #1: Does mass media play a role in the decision to become sexually active in
a population of college males and females?
A primary objective of the study is the amount of sexual media content consumed by the
participants and its effect on sexual initiation. The questionnaires contained information
regarding sexual media content, which revealed different forms of media, the frequency and
amount of time spent consuming the media and messages regarding sexually-transmitted disease
and prevention. In order to calculate sexual media content scores it was necessary to obtain the
relative frequency of each type of media use for every participant. The questionnaire provided
data on the frequency of usage for the following types of media, television, movies, news,
magazines, music, and the Internet. A five point likert scale was used to obtain the frequency and
amount of sexual content consumed by the subjects. The next step was to obtain the sexual
media content exposure from each type of media for every person by multiplying the sexual
media content score with the relative frequency. Last the total sexual media content score (Smc)
was obtained for every person using the following formula:
TotSmc= MovieSmc+TVSmc+NewsSmc+MagSmc+MusicSmc+InternetSmc.
Tests of association were conducted in hopes of revealing an association between sexual
media content scores and age at first intercourse. The first step to determine an association was
to establish age groups, groups based on age at first intercourse, and categories were established
for sexual media content scores based on their quartiles. The result of data in Table 1 does not
support the notion that sexual media content influences age at first intercourse.
Table 1. Chi-square tests for association: Association between age at first intercourse and
groups based on quartiles of sexual media content
Value
Pearson Chi-Square
Likelihood Ratio
Linear-by-Linear
Association
N of Valid Cases
df
Asymp. Sig. (2-sided)
11.428(a)
12
.493
12.520
12
.405
.847
1
.357
180
31
The p value in Table 1 is 0.493, which supports the notion that there is no statistically significant
association between the groups based on age at first intercourse and groups based on the
quartiles of sexual media content scores. However, in reviewing the amount of sexual media
content consumed among males and females, there are notable differences.
Sexual Media Content Scores and Gender
The participants consisted of 56% males and 44% females, which were categorized into
age at first intercourse. Data reveals a significant difference between the mean sexual media
content score for males and the mean sexual media content score for females
(p value = 0.04). This p value supports the notion that females have a higher sexual media
content score on average than males. After the categorization of the age at first intercourse was
done a significant association between groups based on age at first intercourse and gender was
observed. The results yielded a p value of 0.052 and 0.035, which supports a correlation
between age at first intercourse and gender. Males were referenced as “1” and females were “0”.
Age at first intercourse groups were divided as such: Group 0-virgin, Group 1- ages 0-10 years
old, Group 2- ages 10-15 years olds, Group 3- ages 15-20 years old, and Group 4- ages 20-25
years old. According to the data obtained in this study, the age range with the highest number of
individuals engaging in intercourse for the first time are those between 15 and 20 years of age.
However, males were shown to initiate sexual intercourse at a younger age when compared to
females. In the age group of initiating sexual intercourse between 0-10 years old, males had a
100% rate while females rated 0%. The next age group of initiating sexual intercourse between
the ages of 10-15 years yields males with 57% rate and females at a rate of 43%. Even though
females seemed to consume more sexual content in the media males seemed to initiate sexual
intercourse at an earlier age than females.
Research Question #2: Is there a relationship between initiation of sexual activity and age and
race?
Research question two explores the effects of age and race on the initiation of sexual
activity of the college age male and female when they were adolescents. After demographic and
sexual history data was obtained from the population sample, the researcher sought to determine
if a relationship existed between initiation of sexual activity and age and race. The data in Table
2 assess the mean value of age of intercourse among the four age groups in the sample
population.
32
Table 2. Summary of Statistics: Age at first intercourse, groups: Age groups
Age
Groups
1 (<=20
years old)
N
Mean
Std.
Std.
95% Confidence
Deviation
Error
Interval for Mean
Lower
Upper
Bound
Bound
Minimum
Maximum
75
15.27
4.897
.565
14.14
16.39
-1
20
69
15.52
5.063
.610
14.31
16.74
-1
23
13
16.31
3.903
1.082
13.95
18.67
6
23
6
15.00
2.098
.856
12.80
17.20
12
18
163
15.45
4.802
.376
14.71
16.19
-1
23
2 (> 20
and <=
25years
old)
3 (>25
and <30
years old)
4 (>30
years old)
Total
Table 2 depicts a relatively equal mean score and the p value is >0.050, which indicates the
variation in age at initiation among the age groups is not statistically significant. Levene
statistics for age at first intercourse among groups were 0.275 (3, 159) and a p value of 0.843.
Using the ANOVA method, Table 3 indicates the average age at initiation among the age groups
is not statistically significant, with a p value of 0.900.
Table 3. ANOVA: Average of initiation among age groups
Sum of
Squares
Between
Mean
df
Square
13.653
3
4.551
Within Groups
3722.653
159
23.413
Total
3736.307
162
Groups
33
F
.194
Sig.
.900
Tests for association using pearson correlations and chi-square tests were performed
between age groups and age at first intercourse revealed the data in Table 4 and 5. In this case
the pearson correlations in table 4 is 0.048 and the p value is 0.541. The chi-square tests in table
5 have a p value of 0.177, which means there is no association between the two variables of age
at first intercourse and current age.
Table 4. Pearson correlations: Correlation between age at first intercourse and current age
ageatinter
ageatinter
Pearson
1
.048
.
.541
163
162
.048
1
.541
.
162
179
Correlation
Sig. (2-tailed)
N
age
Pearson
Correlation
Sig. (2-tailed)
N
age
Table 5. Chi-square tests: The test for association between age groups and groups based on age
at first intercourse
Asymp. Sig.
Value
Pearson Chi-Square
Likelihood Ratio
Linear-by-Linear
Association
N of Valid Cases
df
(2-sided)
16.324(a)
12
.177
15.374
12
.222
.982
1
.322
180
Sexual Initiation and Race
The next objective of the study is exploring if there is a relationship between initiation of
sexual intercourse and race. A total of four categories were established based on race, which
consisted of 1- whites, 2-blacks, 3- Hispanics and 4- Other. A breakdown of races participating
in the study was 59% white, 30% black, 7% Hispanic and 4% Other. In order to explore the
34
relationship between initiation of sexual intercourse and race, the study obtained age of initiation
among the races. The mean age for initiating sexual intercourse ranged from 14.17 and 15.78
years old. The close proximity of mean scores indicates no significant difference in age at first
initiation of sexual intercourse among the races. This finding is further validated by ANOVA
producing a p value of 0.677 which supports the average age by races age at initiation is not
statistical significant (Table 6).
Table 6 – ANOVA: Average age at initiation among the races
Sum of
Squares
Between Groups
df
Mean Square
35.956
3
11.985
Within Groups
3695.845
157
23.540
Total
3731.801
160
F
.509
Sig.
.677
Tests for association between age at first intercourse and race also indicate there are no
significant differences. Pearson correlation examined the variables of race and age and yielded a
p value of 0.996, which clarifies the lack of association between the variables. A lack of
association between the variables is further supported by the Chi-Square Tests for Association’s
p value score of 0.211 for the variables.
Another finding in the data regarding the races is the lack of difference in sexual media
content scores among the races. The ANOVA calculation yields a p value of 0.923, which
indicates no significant difference between the average sexual media content scores in the four
races. This finding is additionally supported by a mean sexual media content score of 1.54 to
1.75.
Additional Findings
Knowledge of Protection and Onset of Sexual Activity
Differences in the age of onset of sexual activity occurred between those who had
knowledge of sexually-transmitted diseases and protection and those who did not. On the
questionnaire, the participant was asked about their awareness of protection from sexually
transmitted diseases. The information was then compared to four groups defined by the age of
first intercourse among the participants. Group 3, those who experienced first intercourse at 1520 years old, had the highest protection score. In essence those who engaged in intercourse
between the ages of 15-20 years old were the most knowledgeable regarding protection from
35
sexual-transmitted diseases. Group 3 also had the largest number of participants engaging in
intercourse for the first time. The results of the data in Table 7 show the average protection
knowledge scores among groups based on age at first intercourse are significantly different with
a p value of 0.028.
Table 7. ANOVA: Average protection knowledge scores among groups based on age at first
intercourse
Sum of
Squares
Between
Mean
df
Square
.515
4
.129
Within Groups
7.538
164
.046
Total
8.053
168
Groups
F
2.802
Sig.
.028
Knowledge of Sexual Transmitted Diseases and Protection
Knowledge of sexually transmitted diseases is another finding, which shows there is
equality among the races. The scores regarding knowledge of protection against sexuallytransmitted diseases were obtained in a similar method as the sexual media content score. The
following equations were used to obtain the scores:
Protection Scores= Relative Freq* protection information obtained from a media type yes/no)
and STD Scores= Relative Freq* protection information obtained from a media type (yes/no).
The average protection knowledge scores among groups based on age at first intercourse are
significantly different with a p value of 0.028.
Regression models provided data on the ability to predict virgin status and age at first
intercourse when factoring in variables of race, age, sexual media content scores and gender.
36
Table 8 Logistic regression of virgin on age, race and total sexual media content
logistic regression of virginq6 on ageq1 race1 race2 race3 totSmc
Logistic regression
Log likelihood = -59.177003
virginq6 | Odds Ratio
ageq1 |
.7235917
Std. Err.
z
Number of obs
=
161
LR chi2(5)
=
13.70
Prob > chi2
=
0.0176
Pseudo R2
=
0.1038
P>|z|
[95% Conf. Interval]
.0988667
-2.37
0.018
.5535936
2.60e+07
3.01e+07
14.77
0.000
2699149
3.12e+07
3.48e+07
15.46
0.000
3499484
.9457929
race1 |
2.51e+08
race2 |
2.78e+08
race3 |
1.62e+07
.
.
.
.
.
TotSmc |
.6249096
.1733803
-1.69
0.090
.3627876
1.07642
Gender was not used in this model due to it not being significant at 0.10. When the covariates in
the model are significant at 0.10, as indicated in Table 8, age, race and sexual media content
scores predict virgin status. One consideration is sexual media content scores are not considered
significant at a 0.50 level.
37
Table 9 Linear regression: Age at first intercourse on gender, race age and sexual media
content scores
Source
SS
df
MS
Number of obs =
F(
Model
Residual
Total
ageatinterq7
80.0832272
727.90942
807.992647
Coef.
2
133
40.0416136
5.47300316
135
Std. Err.
5.98513072
t
P>|t|
2,
136
133) =
7.32
Prob > F
=
0.0010
R-squared
=
0.0991
Adj R-squared =
0.0856
Root MSE
2.3394
=
[95% Conf. Interval]
maleq2
-1.408368 .4127932
-3.41
0.001
-2.224857
-.5918788
TotSmc
-.600579
.24512
-2.45
0.016
-1.085417
-.1157411
cons
18.19636
.5404182
33.67
0.000
17.12743
19.26529
In Table 9, the intercept, gender and sexual media content scores have significant coefficients
and can predict age at first intercourse. The model R square, however is not very high and the
variables in the model do not explain much of the variation in the response. The linear model is
appropriate however, based on the residual test.
The study also combined data regarding age at first intercourse, gender, sexual media
content, protection knowledge and sexually transmitted disease to determine age at first
intercourse. An unexpected finding of the study indicated virgins were less knowledgeable
regarding sexually transmitted diseases. It was also revealed that those who were sexually active
had higher scores regarding knowledge of sexually transmitted diseases. The data can assist
health care providers with patient education on sexually transmitted diseases for adolescents and
college age individuals.
38
Table 10 Linear regression: Age at first intercourse on gender, sexual media content score,
protection knowledge and sexually transmitted disease.
Source
SS
df
MS
Number of obs =
F(
4,
133
128) =
3.85
Model
81.5182778
4
20.3795694
Prob > F
=
0.0055
Residual
677.504279
128
5.29300218
R-squared
=
0.1074
Adj R-squared =
0.0795
Root MSE
2.3007
Total
ageatinterq7
759.022556
Coef.
132
5.75017088
Std. Err.
t
P>|t|
=
[95% Conf. Interval]
maleq2
-1.508546 .4141866
-3.64
0.000
-2.328085
-.6890075
TotSmc
-.4926722 .2449215
-2.01
0.046
-.9772912
-.0080532
-1.403576
-1.00
0.320
-4.18362
1.376468
0.96
0.338
-1.431228
4.13852
24.75
0.000
16.5729
19.4536
TotProtect
TotSTD
1.353646
cons
18.01325
1.405006
1.407447
.7279369
The linear regression data in Table 10 indicates a p value of 0.046 for the sexual media content
score and a p value of 0.000 for gender. These values offer variables which may predict age at
first intercourse. The protection knowledge and sexually-transmitted disease knowledge scores
do not have significant coefficients and do not seem to be able to predict age at first intercourse.
Summary
Significant differences were found between the average sexual media content scores for
males and females. There is an indication that females have a higher consumption of sexual
content in the media than males. However, males were more likely to initiate sexual intercourse
at a younger age than females. Gender and sexual media content scores seemed able to predict
age at first intercourse. As the sexual media content score increases by one unit, the age at
initiation decreases by 0.59 years. The age at initiation is higher by 1.5 years for males than it is
for females. The findings establish an association between age at initiation and gender.
The data collected reveals no significant differences in age of initiating sexual intercourse
among the age groups or races. There were also no significant differences in the amount of
sexual content consumed among the races or age groups. Additional findings obtained from the
study provided data regarding knowledge of protection, sexually transmitted diseases and being
able to predict virgin status. Knowledge of protection or sexually-transmitted diseases indicated
no significant differences among the age groups, genders or races. A regression model of virgin
39
status on age, race, sexual media content score, protection and sexually transmitted disease
knowledge scores indicates that all these variables can explain virgin status.
40
CHAPTER 5
DISCUSSION
This chapter will discuss the findings of the research study and relate it to the review of
literature. The results will also explore a relationship between the findings and the conceptual
framework. This final section will address the relevance of trends and significant implications for
future nursing practices. Limitations of the study are identified, which should ultimately assist
with recommendations for future research.
Discussion of Findings
The purpose of this study was focused on the influence mass media has on college- age
males’ and females’ decisions to initiate sexual intercourse. A retrospective approach was used
to determine mass media’s influence on decisions to become sexually active as adolescents.
Utilizing a retrospective approach allows participants to use their higher level of maturity, in
comparison to that of adolescents, to explore how mass media influences their decisions to
engage in sexual intercourse. There are two research questions that form the basis of the study.
Question one of the research study is: Does mass media play a role in the decision to become
sexually active in a population of college males and females? The second question of the
research study asks: Is there a relationship between initiation of sexual activity and age and race?
A large university student health center was selected for data collection. After the
Institutional Review Board at Florida State University granted approval for the study the
researcher commenced gathering data. The target sample size was established at 150 and the
actual sample population of the study was 180 participants (N = 180).
A questionnaire consisting of 38 questions was available for the participants to complete
while they were in the health center. The questionnaire was divided into five sections comprised
of: 1) demographics, 2) sexual history, 3) access to modes of media, 4) influence from TV,
movies, newspapers, magazines, music and internet, and 5) consequences of sexual activity. Due
to the sensitive nature of the content, the questionnaires were anonymous. The questionnaires
provided key data for the study, such as the virgin status of the participants, age of first sexual
intercourse, frequency/access and modes of mass media, influence of mass media, and awareness
41
of sexually transmitted diseases. This data forms the basis to answer the questions proposed by
the research study.
One might think that possessing knowledge of sexually-transmitted diseases and
protection from them would deter initiating sexual intercourse. These variables do not have
statistically significant coefficients in the regression model to predict age at first initiation of
intercourse. The study did find that virgins had lower scores on knowledge of protection than
non-virgins. Logistic regression of virgin status on age, race, sexual media content score,
protection knowledge, and sexual transmitted disease knowledge scores indicates that all these
variables can explain virgin status.
The age for initiation of first sexual intercourse provided the basis for formulas used to
calculate the amount of sexual content participants consumed and their knowledge of protection
and sexually transmitted diseases. Other data, which assisted with producing information
regarding the media's influence, was the age groups of participants, age groups for initiation of
sexual intercourse, gender, and race. The amount of sexual media content formed the foundation
by which to answer the research questions. Taking the information obtained from the data, a
conclusion for the research questions was obtained which was comprised of multiple variables.
The overall research question of mass media influencing a college- age male’s and female’s
decision to become sexually active seems to be determined by the variables of gender and sexual
media content scores. This study reveals that one can predict the age of initiation of sexual
intercourse by using a subject’s gender and sexual media content score. This finding is further
validated by the data showing that as sexual media content scores increase by one unit, the age at
initiation decreases by 0.59 years. Females had higher scores than males, and the age of initiation
for males was 1.5 years higher than females. This was a remarkable finding, which persisted
even though there were instances when males and females had the same sexual content scores.
The single variable of exposure to sexual media content was unable to predict the age of first
sexual intercourse. Race could not be used as a single variable to predict the age of initiating
sexual intercourse. The data shows that a combination of variables led to the prediction of
engagement in sexual intercourse. Linear regression indicates that an individual’s amount of
sexual media content coupled with gender seem to predict the age at first initiation of sexual
intercourse. Ultimately, the findings suggest that sexual content in the media plays a role in the
initiation of sexual intercourse.
42
Relationship of Results to Previous Empirical Work
The basis of the research study abides by the notion that substantial exposure to sexual
content in the media has an influence on an individual’s decision to initiate intercourse for the
first time as an adolescent. Leading researchers in the field of mass media’s influence on the
initiation of intercourse, Pardun, L’Engle, and Brown (2005), have conducted studies, which
show strong associations between consumption of sexual content in the media and sexual activity
and intentions. The sexual media content scores in this current study were obtained to measure
the amount of sexual content consumed by the participants. Various organizations cited in the
review of literature have recognized the importance of establishing a type of measurement to
evaluate the amount of sexual media content consumed by individuals. Pardun, L’Engle, and
Brown (2005) created the sexual media diet to measure the amount of sexual exposure in their
study of mass media’s influence on adolescents initiating sexual intercourse. A sexual media
content score was developed for this research study and it provides a measurement of exposure
to sexual content in the media similar to that of the sexual media diet.
Escobar-Chaves et al. (2005) identify seven modes of media, which supply sexual content
to adolescents. The modes consisted of television, audio media, other non-interactive screen,
print, computer and video games. The seven modes of media are listed in the section of the
questionnaire, which measures access to media. Based on the responses from the participants
regarding access to media, most participants in the current study were exposed to a minimum of
three modes of media. As indicated in the review of literature, the increased accessibility to
media points to the ease in which sexual content is available to individuals. Escobar-Chaves et
al. (2005) cite television as the predominate choice of media mode, at 36% for adolescents ages
14 to 18 years old. These results are in contrast to those obtained in this research, which has
computers as the dominant mode of media at 94% for those 18 years and older. The difference in
predominate modes maybe due to the difference in age groups of adolescents up to 18 years and
college students 18 years or older. With the notion of increased exposure of sexual content in the
media leading to the initiation of sexual intercourse, the sexual media score corresponds with a
measurement system to evaluate the exposure to sexual content. The results, in turn, provide a
43
foundation for the research study to build a case which supports mass media as an influence on
an individual’s decision to initiate sexual intercourse for the first time.
The results of the study share a similarity with previous empirical work in that an
association exists between exposure to sexual content in the media and an individual’s sexual
behavior and intentions. In this research study, an association was determined to exist between
an individual’s sexual media content score and gender. The findings of previous empirical work
did not identify an association between exposure to sexual content, gender, and age of first
initiation of sexual intercourse. However, the one variable which is consistent in all the previous
empirical work and this current study is that exposure to sexual content in the media has a link
with sexual activity and behaviors. The study by L’Engle, Brown & Kenneavy (2006) noted a
substantial connection between the media and an adolescent’s intent to become sexually active.
Like the previous empirical work, this study identifies the significant role exposure to sexual
media content has on an individual’s decision to initiate sexual intercourse.
In the study by Collins et al. (2004), adolescents who displayed sexual behaviors of those
9 to 17 months older than themselves consumed one more standard deviation of sexual
information than the average adolescent. One of the findings in the current study indicates that as
the sexual media content score increases by one unit the age at initiation of sexual intercourse
decreases by 0.59 years. The findings in both studies show a common variable of sexual content
and how it affects sexual behavior.
Race was also a variable which was explored. The results of this study regarding race
alone causing a significant difference revealed no association to initiation of sexual intercourse.
In previous studies, Collins et al. (2004) cite the fact that African Americans had lower rates of
initiating intercourse and advancing non-coital activity when exposed to the consequences of
sexual behaviors, such as STD’s, pregnancy, and safe portrayals of behaviors. There was one
association found in the current study which establishes that virgin status can be explained by a
regression of virgin with age, race, sexual media content score, protection knowledge and STD
knowledge scores. There were no other associations or similarities to previous empirical work
regarding race as an influence for initiating sexual intercourse or behaviors. The sexual media
content scores and protection and sexually transmitted disease scores proved to have equal
means, in addition to p values, which found no significant differences among the groups.
44
Relationship of the Results to the Conceptual Framework
The Social Learning Theory by Bandura (1986) was discussed in the review of literature
and it seems to have a significant association between exposure of sexual content and initiation
of sexual intercourse. The Social Learning Theory establishes that social influences determine
what behaviors individuals will exhibit. Media is easily accessible and part of the socialization
process. Bandura (1986) implies that social influences determine what behaviors people will
exhibit. Sexual behaviors are part of socialization and the Social Learning Theory provides an
explanation for the individuals engaging in sexual intercourse. The theory also upholds the
notion that we learn behaviors by imitating the behavior, even if we have not performed the
behavior.
Data from the current study identifies the amount of sexual content consumed in the
media as a variable which can predict the age of first initiation of sexual intercourse. These
findings coincide with the Social Learning Theory in that an increase in exposure to socialization
forces leads to the imitation of those behaviors by the individuals who consume significant
amounts of sexual content in the media. The sexual media content score is seen as a significant
variable in predicating age of initiation and virgin status. Again, this finding lends support to the
Social Learning Theory in that individuals may eventually imitate observed behaviors.
The priming theory discussed in this study also provides a foundation for the explanation
of why the individuals engage in sexual intercourse. In the priming theory, the consumption of
sexual content in the media is seen as a motivation to engage in sexual activity shortly after it is
observed. The current study does not reflect the time span that participants engage in sexual
behaviors after consuming sexual content in the media. However, it does recognize that the
consumption of sexual media content is a variable associated with age at initiation of first sexual
intercourse and virgin status. The accessibility of sexual content in the media was considered in
the current study, and it was determined that individuals had a significant amount of access to
multiple modes of media. A steady exposure of sexual content from various forms of media
seems to serve as a catalyst or priming for the initiation of sexual behaviors.
There are two other theories reviewed in this study, which provide a conceptual
framework for understanding the results of the data. The last two theories are the media practice
model and the super peer theory. Based on the findings of this current study the individuals have
a large variety of different modes of media and they frequently utilize those modes of media.
45
Under the media practice model, individuals seek to consume the media and regard it as a
significant source of information. The theory centers on the relationship between how
adolescents develop their personality based on interfacing with the media and how they use the
media (Escobar-Chaves et al., 2005). A previous empirical study done by Brown & Witherspoon
(2002) argues that the feelings of being a sexual being may influence individuals to seek sexual
content in the media, which will in turn determine the level of sexual behaviors displayed by the
individual. In the current study, the findings identify higher sexual media content scores for
females than males and show that the age of first initiation of sexual intercourse was higher in
males than females. In turn, this data could be used to predict first age of initiation and virgin
status of the individual.
The super peer theory is based on an individual choosing who they want to be or who
they relate to as a result of what they relate to in the media. The various modes of media which
can be accessed (i.e., a personal computer) establish the relative ease and privacy of accessing
sexual content in the media. This indicates that media access can serve as a type of super peer for
the individuals. Results of access to media show that participants have access to at least three
forms of media. In essence, individuals choose who they want to be or who they want to be like
in the media. This premise relates to the data in the current study regarding higher sexual media
content scores being associated with age of first initiation of sexual intercourse.
Limitations
Possible limitations of the study maybe associated with only one setting, the number of
participants, reluctance of participants to honestly answer the questions. In addition, more focus
could have been applied to determining the effects of information of sexually- transmitted
diseases and protection from pregnancy. The sample population, which consisted of college age
individuals was a limitation of the study. A rural population sample may have produced
different results regarding age of intercourse, race, gender and knowledge of sexually transmitted
diseases and pregnancy.
Increasing the locations for distribution of the questionnaires, such as additional post
secondary institutions in the southeast region would have provided a larger sample size along
with greater diversity among participants. The current sample size resulted in a small
convenience sample, which decreased the ability to generalize the results to the larger
population. The participants were college age individuals, who have a higher educational
46
background, which can have an affect on their access to mass media and knowledge to prevent
pregnancy and sexually transmitted diseases. Race can also be viewed as a limitation due to the
public university being predominately Caucasian. The racial demographics of the participants
revealed 59% Caucasian, 30% African American, 7% Hispanic and 4% other. A more diverse
population may have produced results, which were not found in this study.
Also, due to the sensitive nature of the material on the questionnaire, some participants
may have falsely answered some of the questions. In an attempt to overcome uncomfortable
feelings with the sensitive information, the questionnaire was anonymous. Even by creating the
questionnaire as anonymous and asking that participants place it into a locked box, the present
study could not escape the possibility of individuals providing false information.
Assumptions
The primary assumption, which affects the entire outcome of the study, is assuming the
participants answered the questions honestly. Due to the study being retrospective, having a
correct recollection of memory was essential. There was also the assumption that every
participant would complete the questionnaire in its entirety. The assumption of completing the
questionnaire in its entirety was an assumption because some participants skipped questions or
they only completed the first page. The other assumptions of the study, which were the
collection of completed questionnaires and the participants’ understanding and reading English,
seemed to be met.
Implications for Advanced Nursing Practice
The results of this study support the idea that media is a prominent aspect in an
individual’s life. The relative ease of accessing media and the amount of sexual content
consumed should lead those in the field of nursing to be aware of how it can influence
individuals to engage in sexual behaviors at young ages. No matter what age the individual
engages in intercourse, there is always the risk of an unplanned pregnancy or acquiring a
sexually-transmitted disease. When faced with the prospect of how costly it is to treat someone
with HIV/AIDS, other sexually-transmitted diseases and unplanned pregnancies, it is to the
advantage of nurses to adequately assess an individual’s protection and sexually-transmitted
disease knowledge. By doing so, any incorrect information that the individual possesses can be
corrected by the advanced practice nurse, who can provide accurate information about the risks
and consequences of initiating and/or continuing to engage in sexual behaviors. In addition to the
47
physical consequences of sexual intercourse, there are also emotional consequences if an
individual is immature. Rejection by a partner after intercourse could cause the individual to
suffer from depression and anxiety in future relationships.
As health care professionals, we provide a direct route for individuals to speak freely and
confidently without being judged. We can use our roles to assist an individual in becoming a
well-informed health consumer. Health care providers can use opportunities to interact with
adolescents and college age individuals during a routine office visit or a sick visit.
Communication is an essential element for nurses to master when talking to adolescents about
the sensitive topic of sexuality. Building a rapport which establishes trust between the nurse and
the adolescent or college age individual when trying to obtain information is another important
part of nursing care when providing patient education. Once the adolescent or college age
individual feels as though he/she can freely communicate and trust the nurse, discussions on the
topic of initiating sexually activity can begin.
Recommendations for Future Research
A common factor in all the previous empirical work is the consensus that more research
is needed. Sexual behaviors and initiation of sexual intercourse is such a sensitive subject that it
is difficult to acquire open and honest information regarding sexual history and sexual behaviors.
More research focused on adolescents’ decisions to initiate and continue to engage in sexual
intercourse is needed. The data should be collected in an environment in which the individual’s
parents, peers or significant others cannot obtain the information.
Another common variable is the amount of sexual content consumed and its association
to sexual intercourse. Exposure to sexual content in the media seems to be a key variable and
additional research should be focused on that variable.
Summary
This chapter provided further discussion regarding the study findings as they related to
the research questions, previous empirical work and the conceptual framework. There is a large
segment of adolescents who are engaging in sexual intercourse at a young age and who have
access to multiple modes of mass media. The initiation of sexual intercourse by adolescents
necessitated that previous empirical work be reviewed regarding the effects mass media had on
their decision to initiate sexual activity. Following data analysis, it was determined that sexual
media content scores and gender can predict age at first initiation of sexual intercourse. An
48
additional finding, which is of significance, is being able to predict virgin status based on age,
race, sexual media content score, and protection knowledge and sexually-transmitted disease
knowledge scores. The correlations discovered in the study indicate that exposure to sexual
content in the media should be understood as an influence on a college age male’s and female’s
decision to initiate sexual intercourse as an adolescent.
49
APPENDIX A
SEXUAL MEDIA HISTORY QUESTIONNAIRE
50
MEDIA INFLUENCE ON SEXUAL BEHAVIOR QUESTIONNAIRE
DO NOT PUT YOUR NAME OR ANY IDENTIFICATION ON THIS
QUESTIONNAIRE
Section I
DEMOGRAPHICS
1.
What is your current Age? __________
2.
What is your sex?
Male
Female
3.
What is your race
African-American White Asian Hispanic
_______________
4.
Are you married?
Yes
No
Pacific/ Islander Other
Section II
Sexual History
5.
Do you consider yourself to be: Heterosexual / Lesbian / Bisexual
6.
Have you ever had intercourse? Yes or No
7.
At what age did you start having sex/intercourse? ______________
8.
How many partners have you had?______________
9.
Are you currently in a relationship? Yes or No
10.
How long?_____________
11.
When did you last have intercourse?____________
Section III
ACCESS TO MODES OF MEDIA
12. Think of about where you live. How many of these are in your house/apartment/dorm? Place a “check” in
the space next to the ones you own.
___TV with cable
___ TV with satellite
___TV without cable or satellite
___ VCR
___ Radios
___ Stereos (including CD players)
___ Computer with internet
___ Computer without internet
___ Portable CD player
___DVD player
___ MP3 (or similar) player
___ Video game player
13. Think of the things you have in your own bedroom (or area that you consider your very own). Look at the
list below and place a “check” in the space next to the ones you have in your very own area.
___TV with cable
___ TV with satellite
___TV without cable or satellite
___ VCR
___ Radios
___ Stereos (including CD players)
___ Computer with internet
___ Computer without internet
___ Portable CD player
___DVD player
___ MP3 (or similar) player
___ Video game player
51
SECTION IV
INFLUENCE FROM TV, MOVIES, NEWSPAPERS, MAGAZINES, MUSIC AND THE INTERNET
TV
Choose the number that best represents what you think about the following statements.
1= Strongly disagree 2= Disagree 3= No opinion 4= Agree 5= Strongly agree
14. I see individuals on TV who are a lot like me and my
friends
1
2
3
4
5
15. I like to use the TV …..
so I can forget about school or other things
so I have something to
because it’s exciting
so I can see what other people my age are doing
1
1
1
1
1
2
2
2
2
2
3
3
3
3
3
4
4
4
4
4
5
5
5
5
5
1
1
2
2
3
3
4
4
5
5
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
1
2
3
4
5
1
2
3
4
5
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
1
2
3
4
5
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
1
1
1
1
1
2
2
2
2
2
3
3
3
3
3
4
4
4
4
4
5
5
5
5
5
16. Movies
I see individuals in movies who are a lot like me and my friends
Movies show the real life and concerns of individuals like me
and my friends
I would like to be more like the individuals I see in movies
Movies show what people my age are doing
Movies are exciting to me
17. Magazines
I see individuals in magazines who are a lot like me and my
friends
Magazines show the real life and concerns of individuals like
me and my friends
I would like to be more like the individuals I see in magazines
Magazines show what people my age are doing
Magazines are exciting to me
18. Music
I look forward to hearing new songs from music artists or
groups
I would like to be more like the musicians I listen to
Musicians sing about what people my age are doing
Music is exciting to me
Musicians sing about real life and concerns of individuals like
me and my friends
19. Internet
I look forward to going on line
I would like to do the things I see on line
The internet shows what people my age are doing
The internet is exciting to me
The internet sites I visit show real life concerns for people like
me and my friend
52
20.
TV
When I see something about dating, sex and relationships on TV, how interested are you in
watching it? (circle one)
I’m not at all interested
I’m a little bit interested
I’m quite interested
21.
Two or three times a week
About every other month or less
A few times a month
About once a month
About once a week or more
When I see something about dating, sex and relationships in movies, how interested are you in
watching it? (circle one)
I’m not at all interested
I’m a little bit interested
I’m quite interested
I’m somewhat interested
I’m extremely interested
Newspapers
Do you or anyone in your home/apartment/dorm subscribe to a newspaper? (circle one)
Yes
26.
About once a week or more
About every other month or less
A few times a month
25.
About once a month
How often do you watch movies on VCR, DVD, or Pay Per View? (circle one)
I never go to the movies
24.
Almost everyday
Movies
How often do you see movies in the movie theater? (circle one)
I never go to the movies
23.
I’m extremely interested
How often do you watch TV Monday through Sunday? (circle one)
Never
22.
I’m somewhat interested
No
I don’t know
How often do you read a newspaper? (circle one)
Never
A few times a year
A few times a week
53
About once a week
Everyday
27.
What parts of the newspaper do you typically read or look at? (circle all that apply)
I never read the newspaper International news News that happens in the U. S.
News that happens where I live
28.
Horoscopes
Lifestyles
Entertainment
Advertisements
Sports
Comics
Magazines
Do you or anyone in your home/apartment/dorm subscribe to a magazine? (circle one)
Yes
29.
Dear Abby/Dear Ann Landers/ Heloise
No
How often do you read a magazine? (circle one)
Never
A few times a year
A few times a week
30.
I’m somewhat interested
I’m extremely interested
Music
How often do you listen to music Monday through Sunday? (circle one)
Almost never
Once in a while
Frequently
Sometimes
Almost all the time while not in classes
How often do you get pre-recorded music? These might be CD’s you buy, get as a gift, download from
the internet, or create with your MP3 player? (circle one)
Once about every month or less
One or two every month
33.
Everyday
I’m a little bit interested
I’m quite interested
32.
About once a week
When I see something about dating, sex and relationships in magazines, how interested are you in
watching it? (circle one)
I’m not at all interested
31.
I don’t know
One about every other month or so
One every week or so
More than once a week
When I hear songs about dating, sex and relationships in magazines, how interested are you in watching
it? (circle one)
I’m not at all interested
I’m a little bit interested
I’m quite interested
54
I’m somewhat interested
I’m extremely interested
34.
Internet
How often do you use the internet Monday through Sunday? (circle one)
Almost never
Once in a while
Frequently
35.
Sometimes
Almost all the time while not in classes
When I see on the internet about dating, sex and relationships in magazines, how interested are you in
watching it? (circle one)
I’m not at all interested
I’m a little bit interested
I’m quite interested
I’m somewhat interested
I’m extremely interested
Section V
Consequences of Sexual Activity
36.
37.
38.
Have you ever seen or heard about the consequences of not using a birth control method, like condoms,
from any of following sources? Circle each source.
TV shows
Magazines
Movies
The Internet
Newspapers
Music artists
I've never learned about this from any of these sources.
Have you ever seen or heard about AIDS or another STD from any of the
following sources? Circle each source from which you've learned this.
TV shows
Magazines
Movies
The Internet
Newspapers
Music artists
I've never learned about this from any of these sources.
The messages I get from the media are that it's OK for people to have
sex. Circle one for each age range.
11-15 years old
16-20 years old
Strongly disagree
Disagree
Agree
Strongly agree
Strongly disagree
Disagree
Agree
Strongly agree
21 years old and older Strongly disagree
No opinion
No opinion
Disagree
Agree
Strongly agree
55
No opinion
APPENDIX B
AUTHORIZATION TO USE SEXUAL MEDIA DIET QUESTIONNAIRE ON
INITIATING SEXUAL INTERCOURSE
56
From: Kelly Ladin L'Engle [mailto:[email protected]]
Sent: Wed 8/2/2006 1:46 PM
To: Dickey, Sabrina L
Subject: RE: Use of questionnaire
Sabrina,
I will send you a media survey. The SMD (sexual media diet measure) was
calculated based on specific content analyses of the vehicles used regularly
by teens as indicated in the media survey. We also included the following
questions on the health survey. As we state in our publications, there
really is no easy and accurate way to assess an individual's exposure to
sexual content in the media, and that is why our SMD measure was so complex.
You could also ask about use of pornographic media on the Internet, in
movies, and in magazines. These measures tend to be very predictive of
sexual behavior, too.
Hope this is helpful.
Kelly
**********************************************
Kelly Ladin L'Engle, PhD, MPH
University of North Carolina--Chapel Hill
Project Director, Teen Media
[email protected] (919) 843-585
Have you ever seen or heard about how you should act on a date from any of
the following sources? Check each source from which you've learned this.
1= TV shows
2= Magazines
3= Movies
4= The Internet
5= Newspapers
6= Music artists
7= I've never learned about this from any of these sources.
57
Have you ever seen or heard about the consequences of not using birth control, like condoms from any of the
following sources? Check each source from which you've learned this.
1= TV shows
2= Magazines
3= Movies
4= The Internet
5= Newspapers
6= Music artists
7= I've never learned about this from any of these sources.
Have you ever seen or heard about AIDS or another STD from any of the
following sources? Check each source from which you've learned this.
1= TV shows
2= Magazines
3= Movies
4= The Internet
5= Newspapers
6= Music artists
7= I've never learned about this from any of these sources.
The messages I get from the media are that it's OK for people my age to have
sex
1= Strongly disagree
2= Disagree
3= No opinion
4= Agree
5= Strongly agree
58
APPENDIX C
FLORIDA STATE UNIVERSITY’S INSTITUTIONAL REVIEW BOARD APPROVAL
LETTER
59
Office of the Vice President For Research
Human Subjects Committee
Tallahassee, Florida 32306-2742
(850) 644-8673 . FAX (850) 644-4392
APPROVAL MEMORANDUM
Date: 4/5/2007
To: Sabrina Dickey
Address: 2140
Dept.: THARGARD
From: Thomas L. Jacobson, Chair
Re: Use of Human Subjects in Research
Did mass media influence a college age male and female decision to become sexually active as an adolescent
The application that you submitted to this office in regard to the use of human subjects in the proposal referenced
above have been reviewed by the Secretary, the Chair, and two members of the Human Subjects Committee. Your
project is determined to be Expedited per 45 CFR § 46.110(7) and has been approved by an expedited review
process.
The Human Subjects Committee has not evaluated your proposal for scientific merit, except to weigh the risk to the
human participants and the aspects of the proposal related to potential risk and benefit. This approval does not
replace any departmental or other approvals, which may be required.
If you submitted a proposed consent form with your application, the approved stamped consent form is attached to
this approval notice. Only the stamped version of the consent form may be used in recruiting research subjects.
If the project has not been completed by 3/31/2008 you must request a renewal of approval for continuation of the
project. As a courtesy, a renewal notice will be sent to you prior to your expiration date; however, it is your
responsibility as the Principal Investigator to timely request renewal of your approval from the Committee.
You are advised that any change in protocol for this project must be reviewed and approved by the Committee prior
to implementation of the proposed change in the protocol. A protocol change/amendment form is required to be
submitted for approval by the Committee. In addition, federal regulations require that the Principal Investigator
promptly report, in writing any unanticipated problems or adverse events involving risks to research subjects or
others.
By copy of this memorandum, the Chair of your department and/or your major professor is reminded that he/she is
responsible for being informed concerning research projects involving human subjects in the department, and should
review protocols as often as needed to insure that the project is being conducted in compliance with our institution
and with DHHS regulations.
This institution has an Assurance on file with the Office for Human Research Protection. The Assurance Number is
IRB00000446.
Cc: Susan Porterfield, Chair
HSC No. 2007.361
60
APPENDIX D
FLYERS FOR THE RESEARCH STUDY
61
A research study is being conducted by Graduate student
Sabrina L. Dickey RN, BSN from the College of Nursing to examine
the influence of mass media on sexual behavior
How do these forms of mass media influence an individual to
become sexually active?
Your participation in the study is voluntary and anonymous.
Complete a questionnaire which should take approximately 10-15
minutes and drop it in the locked box beside the questionnaire.
Your participation will provide data on how mass media could
influence young adults to become sexually active. This will provide a
framework to develop programs to curb unhealthy behaviors among
adolescent
62
APPENDIX E
CONSENT LETTER FOR THE STUDY AND INSTRUMENT
63
College of Nursing
Vivian M. Duxbury Hall
Tallahassee, Fl. 32306- 4310
( 850) 644- 3299
Dear Part icipant .
I am a graduat e st udent under t he direct ion of Professor Susan Port erfield in t he College of
Nursing at Florida St at e Universit y. I am conduct ing a research st udy t o exam ine t he
influence m ass m edia has on college age co- eds in t heir init ial decision t o becom e sexually
act ive.
I am request ing your part icipat ion, which will involve t he com plet ion of an anonym ous
quest ionnaire, which should t ake approxim at ely 10 t o 15 m inut es. Your honest feedback is
needed when com plet ing t he quest ionnaire. The quest ionnaire is t o be com plet ed by t he
part icipant at t he Healt h Cent er and not t o be t aken from t he sit e t o be com pet ed. Once t he
quest ionnaire is com plet ed you will place it in t he locked box next t o t he blank
quest ionnaires. The researcher will collect t he quest ionnaires and t hey will be kept locked in
t he researcher’s office.
Your part icipat ion in t his st udy is volunt ary. I f you choose not t o part icipat e or t o wit hdraw
from t he st udy at any t im e, t here will be no penalt y; it will not affect your grade, t reat m ent
or care at t he Healt h Cent er. The result s of t he research st udy m ay be published, but your
nam e will not be used.
I f you have any quest ions concerning t he research st udy, please call m e Sabrina L. Dickey
at ( 850) 644- 3600 and e- m ail address, sldickey@adm in.fsu.edu You m ay also cont act m y
t hesis com m it t ee chair, Dr. Susan Port erfield in t he College of Nursing at ( 850) 644- 5621.
Ret urn of t he quest ionnaire will be considered your consent t o part icipat e. Thank you.
I f you have any quest ions about your right s as a subj ect / part icipant in t his research, or if you feel you
have been placed at risk, you can cont act t he Chair of t he Hum an Subj ect s Com m it t ee, I nst it ut ional
Review Board, t hrough t he Vice President for t he Office of Research at ( 850) 644- 8633.
Sincerely,
Sabrina L. Dickey, RN BSN
64
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BIOGRAPHICAL SKETCH
Sabrina L. Dickey is the daughter of Ned and Sarah Lane and she has one older sibling a
brother, Byron Lane. She currently resides in Tallahassee, Florida with her husband, Clay and
their two children, Alanna and Ashley. Sabrina has been a registered nurse supervisor for the
Gold clinic in Thagard Student Health Center on the campus of Florida State University since
1999.
Sabrina graduated from Florida State University with a Bachelor of Science in Nursing in
December, 1993. In the summer of 2007 she was awarded an educational leave grant from the
University to complete her Master’s of Science Degree which she anticipates on receiving in
December, 2007.
Sabrina’s academic interests are in promoting health in adolescents as well as
underserved and vulnerable populations. After graduation she plans to pursue a career in nursing
education where she will have a positive impact on the lives of the students and in the
community at large.
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