HEALTH EDUCATION RESEARCH
Theory & Practice
Vol.18 no.4 2003
Pages 461±476
Development of a youth survey to measure risk
behaviors, attitudes and assets: examining multiple
in¯uences1
1
1
1
Abstract
developing, but promising, state. Additional
psychometric work will provide program practitioners and evaluators with a psychometrically sound tool to measure behaviors, attitudes
and assets.
Currently, most surveys assessing adolescent
health concerns focus primarily on risk behaviors and negative in¯uences rather than positive in¯uences such as assets. The purpose of
this paper is to describe the development and
validation of the Adolescent Health Attitude
and Behavior Survey (AHABS). This instrument was developed to measure the prevalence
of youth health risk behaviors, attitudes
towards adolescent sexual behavior and youth
assets in a statewide evaluation effort. The
questionnaire was completed by 4368 public
high school students in Grades 9±12. Content
validity was established through an extensive
review of literature, a group process and factor
analyses. Reliability was established through
Cronbach's a coef®cients. Factor loadings ranged from 0.48 to 0.84 for scales measuring attitudes towards adolescent sexual behavior and
a coef®cients ranged from 0.61 to 0.81. Factor
loadings ranged from 0.34 to 0.90 for scales
measuring youth assets and a coef®cients ranged from 0.69 to 0.85. Because of several limitations (e.g. construct validity was not
measured), additional development work is
needed. Therefore, the AHABS is still in a
Introduction
Adolescence is the period in life characterized by
signi®cant change. Biological, psychological
changes and social learning changes occur at an
astonishing rate (Lerner, 1980). Adolescents are
more capable of making decisions (Hoffman et al.,
1994) and are often given more freedom to do so. It
is also a time when youth are particularly impressionable and vulnerable to many environmental
factors (Fullerton, 1994) that positively or negatively in¯uence their future health behaviors.
Traditionally, researchers have conducted studies that supported society's wish to recognize the
signs and symptoms of predisposing or developing
risk traits and behaviors in children, so that
problem behaviors could be lessened or avoided.
Adolescent risk behaviors and choices tend to
occur in a social context and may be synergistic.
For example, evidence suggests that teenage
substance abuse is correlated with numerous risk
behaviors including delinquency, conduct disorders at school, school dropout, violent and
aggressive behaviors, and unplanned and unprotected sexual intercourse (Jessor and Jessor, 1977;
Zabin et al., 1986; Elliott et al., 1989; Richter et al.,
1993; Coker et al., 1994; Baker et al., 1995; Valois
et al., 1995). According to Hawkins et al.
(Hawkins et al., 1992), the more risk factors a
child has in his/her life, the more likely he/she is to
School of Public Health, Regional Campus at Brownsville,
Brownsville, University of Texas±Houston, TX 78520, and
1Department of Health Promotion, Education and
Behavior, Norman J. Arnold School of Public Health,
University of South Carolina, Columbia, SC 29208, USA
*To whom correspondence should be addressed
E-mail: [email protected]
ã Oxford University Press 2003. All rights reserved
461
doi: 10.1093/her/cyf046
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1,
B. Reininger, A. E. Evans *, S. F. Grif®n , R. F. Valois , M. L. Vincent ,
1
1
1
D. Parra-Medina , D. J. Taylor and K. J. Zullig
B. Reininger et al.
462
common underpinnings of multiple problem behaviors such as teen pregnancy, substance abuse,
delinquency and school dropout. By simultaneously addressing multiple risk behaviors and
building resiliency, youth development interventions are comprehensive and possibly more effective (Barton et al., 1997). Furthermore, while youth
development programs tend to focus on building
competencies and empowering responsible behavior, they naturally address personal de®cits.
Programs that enhance protective factors and take
into account risk factors (i.e. de®cits) appear to be
promising, particularly for substance abuse prevention (Hawkins et al., 1992).
A core framework for the youth development
approach to prevention programming is the
Developmental Assets Framework suggested by
the Minneapolis-based Search Institute (Leffert
et al., 1998; Scales and Leffert, 1999). Benson et al.
(Benson et al., 1998) noted that the Framework
blends risk factors, resiliency and protective factors that precede health outcomes. The
Developmental Assets Framework suggests 40
assets that can be enhanced (when present) or
established (when initially absent) in youth. Half of
these assets are suggested as internal and are
labeled as the following domains: educational,
community, values, social competency and positive identity. The other 20 assets are external,
suggesting that they support resources available to
adolescents and are labeled as the following
domains: support, empowerment, boundaries and
expectations, and time. As with protective factors,
the more assets a youth has, the more likely he/she
is to avoid problems such as substance abuse, teen
pregnancy or delinquency (Scales and Leffert,
1999).
Based on the current varied emphases in
adolescent health research, there is a need for
psychometrically sound instruments to measure the
multiple in¯uences in adolescents' life including
risk behaviors, attitudes and assets or protective
factors. A better understanding of the various
psychosocial and behavioral in¯uences on adolescents could assist efforts in school and community
settings to promote life-long health. Currently, few
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become involved in `problem' behaviors. As a
result of this focus on risk factors, the majority of
current surveillance efforts assessing adolescent
health issues focus primarily on negative behaviors
and in¯uences (Kolbe, 1990; Garrison et al., 1993;
Kolbe et al., 1993; Valois et al., 1995, 1999).
However, an increasingly popular approach to
youth prevention involves investigation beyond
risk factors to include identifying and establishing
the prevalence of protective factors among adolescents. Protective factors are positive characteristics, predispositions and in¯uences in adolescents'
lives that can buffer them from negative in¯uences
(Benard, 1991). Over time, protective factors can
help an adolescent become more resilient and more
able to resist negative in¯uences (Benard, 1991;
Rak and Patterson, 1996; Benson, 1998). Jessor
et al. (Jessor et al., 1995) determined that there is
an inverse relation between protective and risk
factors in the prediction of problem behavior. They
found that the greater number of protective factors
present in the lives of adolescents, the lower
engagement in problem behaviors.
Researchers who have studied resiliency have
identi®ed certain characteristics that make adolescents more resilient. Examples of resiliency factors
include involvement in structured activities, parental boundary setting, religious commitment and
adult mentors (Jessor et al., 1995; Greene, 1998).
This relatively new focus on resiliency and protective factors has offered researchers an alternative from a pathology model that tends to be overly
problem-focused (Pittman and Wright, 1991).
Building on the research of resiliency and
protective factors are youth development interventions. Recent research provides evidence that
de®cit-only-focused strategies are not comprehensive and lack the valuable empowering
components of approaches grounded in youth
development theory (Roth et al., 1998). The
emergence of the youth development approach
(with its focus on positive adolescent competencies, protective factors and resources) has shown
promise in adolescent pregnancy prevention
(Kirby, 1999) and other adolescent health issues.
The youth development approach considers the
Development of a youth survey
Methods
Questionnaire development and pilot
testing
The development of the AHABS instrument was
conducted in phases. First, we searched the literature for other instruments measuring adolescent
risk-taking behaviors, attitudes and adolescent
development, including youth developmental assets. Second, based on the literature review, we
identi®ed the following instruments: CDC Youth
Risk Behavior Survey (YRBS) (Kolbe, 1990), the
Adolescent Curriculum Evaluation (ACE)
Questionnaire (Locke and Vincent, 1995), the
Youth Sensitive Survey (McLeroy et al., unpublished), and the Survey of Student Resources and
Assets by the Search Institute (Leffert et al., 1998).
Two of the instruments have been used nationally
(CDC-YRBS and Search Institute Survey), the
ACE survey had been used with teens living in
South Carolina and the Youth Sensitive Survey
was used in a teen pregnancy prevention project
evaluation. Therefore, these four surveys provided
either well-tested items or concepts relevant to teen
pregnancy prevention evaluation that made them
useful in the development of another tool.
However, none of these instruments provided the
full compilation of measures needed for our
evaluation efforts.
Next, through a group process, we identi®ed the
need for ®ve different sections on the AHABS
instrument. A similar process of examining which
assets and adolescent attitudes would be most
affected by community-based teen pregnancy
prevention projects was suggested by McLeroy
et al. (pers. commun.) in the development of their
evaluation tools. The ®ve sections of the AHABS
instrument also re¯ect individual, environmental
and behavioral factors described in Bandura's
Social Cognitive Theory (Bandura, 1986). These
sections include: demographics, health risk behaviors, attitudes towards adolescent sexual behavior, youth assets, and another section measuring
psychosocial and knowledge variables related to
sexuality behaviors. [Original survey available
upon request from the ®fth author and Principal
Investigator of the evaluation study (M. L. V.).]
During the last phase of development, we pilot
tested the original version of the instrument in a
classroom setting with 755 high school students
(composed of students in six classes, primarily in
Grades 9±12, from ®ve schools) demographically
similar to the study population for the validation
463
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instruments with strong psychometric properties
exist that assess both risk and protective factors.
The Search Institute's framework and instrument
provide a partial foundation for psychometrically
sound instrumentation (Benson et al., 1998);
however, further subscale development based on
factor analysis results and strong reliability estimates are still needed. Therefore, the purpose of
this paper is to describe the development, validity
and reliability of the Adolescent Health Attitude
and Behavior Survey (AHABS) that measures risk
behaviors, attitudes towards adolescent sexual
behavior and youth developmental assets. This
instrument was developed as an impact evaluation
instrument for a statewide evaluation examining
the effectiveness of county-based teen pregnancy
prevention programs. As an impact evaluation
instrument, the survey was designed to assess
intervention effectiveness in producing change in
knowledge, attitudes, beliefs and behaviors
(Windsor et al., 1994) in the counties. This survey
also includes two other subscales that measure
sexual knowledge and other psychosocial variables
related to adolescent sexual behaviors. These two
subscales are not described in this paper because
they are less relevant to broad-based youth prevention activities.
For the purpose of this paper, we will describe
three sections of the survey: (1) health risk
behavior section, (2) the attitudes towards adolescent sexual behavior subscales and (3) the youth
developmental assets subscales. Each section will
be described individually and in relationship to one
another. The results of correlating one of the
measures of risk taking, the level of sexual activity,
to the attitudes and assets subscales also will be
presented.
B. Reininger et al.
Description of instrument
Demographics
Based on the CDC-YRBS instrument (Kolbe,
1990), items in the demographic section of the
AHABS were included to capture essential data on
age, gender, grade level and race/ethnicity. In
addition, one item measuring family structure
`Who are the primary adults who live in your
home?' and one item serving as a proxy measure
for socioeconomic status (SES) `At school, are you
eligible for free or reduced price lunch?' were also
included in this section.
Health risk behaviors
Because this survey had an evaluation purpose of
measuring effectiveness of county-based teen
pregnancy prevention initiatives, this section contained 12 items on sexual risk-taking and 14 items
measuring other risk behaviors including intentional/unintentional injury (n = 6), tobacco use (n =
1), alcohol use (n = 2), and marijuana and other
illicit drug use (n = 3). A variety of risk behaviors
were included because of their documented association with risk for unintended pregnancy (Richter
et al., 1993; Coker et al., 1994; Baker et al., 1995;
Valois et al., 1999).
The majority of items measuring risk behaviors
were selected from the CDC-YRBS (Kolbe, 1990).
The CDC-YRBS behavioral items have shown no
signi®cant difference in responses from Time 1 to
Time 2, indicating good reliability especially for
high school students (Brener et al., 1995).
Response options for the risk questions were
designed so that lower numbers represented
lower risks.
464
One risk behavior item, the level of sexual
activity (based on number of lifetime sexual
partners), was used to examine validity with the
scales measuring attitudes toward adolescent sexual behavior and youth assets. Past research has
suggested that risks and assets are inversely
correlated (Jessor et al., 1995; Scales and Leffert,
1999). Level of sexual activity among the respondents was measured through an item asking how
many people the survey respondent has had sex
with in their lifetime. The seven response options
ranged from `I have never had sex' to `six or more
people'.
Attitudes towards adolescent sexual
behavior
Eleven items measuring attitudes towards sexual
intercourse during adolescence were included in
the survey. Ideas for items speci®cally focused on
sexual attitudes were based on the ACE
Questionnaire (Locke and Vincent, 1995) and the
Youth Sensitive Survey (McLeroy et al., unpublished), but no speci®c items were taken from
either of these surveys. Instead, the investigators
created new items to measure sexual attitudes.
These items measured attitudes regarding self and
peer sexual behavior. The items were on ®ve-point
Likert scales with choices such as `strongly agree'
to `strongly disagree', `only after marriage' to `on a
®rst date if the girl/boy agrees' and `none of them'
to `all of them'. Higher scores indicated higher
risks. Because the attitude items were new,
psychometric evaluation was needed along with
analyses of the associations between risks, assets
and attitudes.
Youth assets
Items in this section of AHABS were chosen
because they measured assets that a teen pregnancy
prevention project in a community setting would
be most likely to change. Based on the desire to
measure certain assets, concepts or actual items
from the survey of Student Resources and Assets
by the Search Institute (Leffert et al., 1998) were
used. Several items, with permission, were taken
from the Search Institute survey; some modi®ed
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study. Based on the results from the pilot test, the
wording for several items was altered to clarify the
meaning of the questions. Reliability and validity
estimates were calculated for the scales measuring
attitudes towards adolescent sexual behavior and
youth assets. Based on those calculations, several
items were dropped for the ®nal version of the
instrument.
Development of a youth survey
The categories (or the asset subscales) represent
the way in which the assets are used for public
communication and education purposes; they
are generally too multidimensional to `hang
together' psychometrically within the categories. [(Leffert et al., 1988), p. 217]
With the primary purpose of this study being to
develop a psychometrically sound instrument
measuring risks, attitudes and assets, the AHABS
instrument selected or created multiple items to
measure each asset in the hope of creating
psychometrically based subscales that would create useful subscale scores.
The AHABS asset items had response options
based on a ®ve-point Likert scale with choices such
as `strongly agree' to strongly disagree', `delighted' to `terrible', `none' to `all', `0' to `11 or
more'. Higher scores indicated lower assets.
Data collection
Participants were recruited from public high
schools in 45 South Carolina counties that received
funding for the Adolescent Pregnancy Prevention
Initiative. In counties that had three or fewer high
schools, all of the high schools were contacted
regarding participation. In counties with four or
more high schools, three high schools that `best
represented' the total population aged 14±17 years
were asked to participate. Best representation was
based on race/ethnicity and school size. Once a
school agreed to participate, a number of second
period classes were randomly selected. All stu-
dents in those classes received a passive parental
consent form. Questionnaires were administered
by trained evaluation staff during Period 2.
Teachers were asked to remain present for survey
administration; however, staff handled all aspects
of data collection as one method for assisting in
ensuring student anonymity. Most important in
assuring student anonymity was that students were
asked not to provide their name or any other
identifying information on the answer sheets.
Completion of the questionnaire took 30±40 min.
These procedures were deemed appropriate by the
referent university's review board for the rights of
human subjects in research.
Analysis
All survey items measuring youth assets and
attitudes towards sexual behavior included in the
analysis used Likert-type response options.
Examples of these response options included
`strongly agree' to `strongly disagree', `very
much like me' to `not at all like me' and `terrible'
to `delighted' with mid-point options such as `not
sure', `somewhat like me' or `equally satisi®ed or
disatis®ed'. Data were analyzed descriptively such
that mean scores, standard deviations, frequencies
and ranges were calculated. Exploratory factor
analysis identi®ed two subscales measuring
Attitudes Towards Adolescent Sexual Behavior
and seven subscales measuring Youth Assets. All
factor analyses utilized principal axis with promax
rotation. Factor analysis was initially performed on
the entire sample (n = 4368). However, due to the
large sample size, we also divided the sample into
two randomly assigned groups and re-ran the factor
analysis to examine if the initial factor pattern was
maintained with the subsamples.
An item was assigned to a factor when its
loading was at least 0.34 or higher and had no other
loadings at 0.30 or higher on any other factor.
Analysis of the eigenvalues in the scree plot was
also used to con®rm the number of factors
identi®ed by the factor loadings (Cattell, 1965a,b;
Kim and Mueller, 1978; Hatcher, 1996). We
created subscale scores by averaging the item
scores for each scale. To assess internal consist465
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based on formatting or content. Other items were
developed based on the description of the assets
provided by the Search Institute. Past reporting of
the psychometric properties of the Search Institute
surveys does not speci®cally delineate which
survey items are measuring which assets and
some assets are measured by single items (Leffert
et al., 1998). Moreover, the Search Institute's
measurement of assets is driven primarily by
literature review, expert understanding and ease
of understanding for the public. Additionally, the
individual asset categories are not scored in any
analyses.
B. Reininger et al.
Table I. Descriptive properties of attitudes towards adolescent sexual behavior subscales and youth assets subscales
Subscale
Minimum value
in response
category
Maximum value
in response
category
Mean
SD
Variance
4323
3696
4363
1
1
1
5
5
5
2.71
2.21
3.44
1.0
0.89
0.83
1.03
0.79
0.69
4362
4331
4353
4327
4367
4347
4357
1
1
1
1
1
1
1
5
5
5
5
5
5
5
2.56
2.67
2.22
2.43
2.35
2.79
2.47
0.83
0.87
1.1
1.0
0.90
0.93
0.81
0.69
0.76
1.20
1.00
0.81
0.86
0.66
ency of the items, Cronbach a coef®cients were
calculated for each subscale. To further validate
the scales, relationships between each subscale and
one risk item were explored. The relationships
between the continuous subscales representing
attitudes towards youth sexual behavior and
youth assets was explored using Pearson correlations (signi®cance level was set at 0.01).
Relationships between the continuous scales and
one ordinal risk item, the level of sexual activity of
the respondents, was explored using Spearman
correlations.
Results
Sample population
Our sample included 4368 public high school
students with a median age of 15 and approximately 53% of the participants (n = 2299) being
female. Grade 9 and 10 students made up 60.7% of
the respondent population. The students represented 43 high schools. Most participants were
African-American (47%) and white (46%). Other
ethnic groups included Hispanic (2%), American
Indian (1%) and Asian (1%). All grades were
evenly
distributed
by
race/ethnicity.
Approximately 41% of the participants were
466
eligible for free or reduced lunch, and 48%
reported living with both mother and father (real
or adoptive). Nineteen percent reported living with
mother only, and 15% reported living with mother
and stepfather. Males and females were equally
represented in all grades except Grade 9, with 67%
of the respondents being female and 33% being
male. The student response rate for schools that
agreed to participate in the survey was approximately 87%. However, only 38% of schools asked
to participate in the study did so. Schools in the
upstate counties of the state, typically more
conservative with a higher proportion of
Caucasians, declined to participate in the study
more often than other schools in the state. This was
the only school/county characteristic that discerned
school participation rates. Reasons for declining
included: (1) school policies do not allow for
`outside' surveys, (2) lack of time to do the surveys
due to other educational priorities and (3) prior
agreement to participate in other health surveys.
Descriptive results
Table I displays the descriptive characteristics of
the subscales measuring attitudes towards adolescent sexual behavior and youth assets. Mean scores
on the subscales ranged from 2.21 to 3.44 on a ®vepoint Likert scale. Descriptive results also indi-
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Attitudes Towards Adolescent Sexual Behavior Subscales
Perceived Sexual Norms
Perceived Birth Control Use
Perceptions of Others Sexual Involvement
Youth Assets Subscales
Youth's Accountability to Parents and Other Adults
Youth Empowerment
Quantity of Other Adult Support
Youth's Empathetic Relationship
Youth's Perceived Support by Parents and Other Adults
Youth's Perceived School Support
Self Peer Values Regarding Risk Behaviors
n
Development of a youth survey
Table II. Subscales measuring attitudes towards adolescent sexual behavior: items, factor loadings and Cronbach's as
Scale items
Factor
loading
Factor
loading
Factor
loading
Cronbach's
a
Perceived Sexual Norms
I think it's okay for a boy to have sex
I think it is okay for a girl to have sex
I intend to have sex while I am young teen
I think it's ok for unmarried teenagers to have
sexual intercourse if they use birth control
0.84
0.81
0.66
0.64
0.02
0.02
0.10
±0.122
±0.03
±0.04
0.06
0.04
0.81
Perceived Birth Control Use
If I were to have sex before marriage, I or my
partner would use birth control every time
If I were to have sex before marriage, I or my
partner would use a condom every time
Teens who have sex and don't use birth control
are NOT showing respect for each other
±0.15
0.79
0.06
0. 61
0.01
0.53
0.06
0.01
0.48
±0.02
±0.01
±0.02
0.78
±0.01
0.02
0.74
Content cluster
Grouped items
Perceptions of Others Sexual
Involvement
In your school, about how many girls your age
do you think have had sexual intercourse
In your school, about how many boys your age
do you think have had sexual intercourse
cated respondents used all response options available, thus decreasing the likeliness of subscales
being skewed. Standard deviations ranged from
0.81 to 1.10 and variance ranged from 0.69 to 1.20.
Behavioral results
Items to measure risky health behaviors such as
sexual intercourse, intentional/unintentional injury, tobacco use, and alcohol and drug use were
assessed. Although not reported here, the prevalences of these behaviors in this study population
are similar to other published studies of national
and statewide adolescent health risk behaviors
(Kolbe, 1990; Valois et al., 1999). One health
behavior that was chosen to include in this
psychometric study was level of sexual activity
measured by the number of lifetime sexual partners. Thirty-nine percent of the respondents had
never had sexual intercourse. Approximately 18%
reported having had sexual intercourse with only
one sexual partner, while 10.9% reported having
had two sex partners. Additionally, 19% of the
respondents reported having had three to ®ve sex
partners during their lifetime and an additional
0.73
13% reported having sexual intercourse with six or
more people during their lifetime.
Factor analysis results
Attitudes towards adolescent sexual behavior
subscales
The attitudes towards adolescent sexual behavior section of the survey emerged with seven
items (11 originally) which created two subscales. Two items were discarded because they
did not load high enough on any one factor and
two other items created a content cluster. The
two subscales are Perceived Sexual Norms and
Perceived Birth Control Use. Factor loadings
for these two scales ranged from 0.48 to 0.84
(Table II). The a coef®cient for Perceived
Sexual Norms was 0.81 and the a coef®cient
for Perceived Birth Control Use was 0.61.
Signi®cant correlations were observed among
the two attitudes towards adolescent sexual
behavior subscales of the survey (r = 0.32),
indicating that youth who perceive sex as less
normative are also more likely to agree that
467
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Subscales
B. Reininger et al.
Table III. Subscales measuring youth assets: items and psychometric properties
Subscale items
Eigenvalue
Percent of
variance
Cronbach's
a
Youth's Perceived Support by
Parents and Other Adults
I get along well with my parents or other adults in
my household
My parents or other adults in my household give me
support when I need it
I would describe my satisfaction with my family life
as
My parents or other adults in my household often
tell me that they love me
In my family, I feel useful and important
If you had an important concern about drugs,
alcohol, sex, or some other serious issue, would you
talk to your parents or other adults in your
household about it?
I have had lots of good conversations with my
parents or other adults in my household about
waiting until I am older, or married, to have sexual
intercourse
How often do your parents or other adults in your
household ask you about your homework
How often do your parents or other adults in your
household talk to you about what you are doing in
school
How often do your parents or other adults in your
household help you with your school work
How often do your parents or other adults in your
household go to meetings or event at your school
In my family, there are clear rules about what I can
and cannot do
Your parents or other adults in your household ask
you where you are going or who you are going with
I feel that I could work with other young people and
adults in my neighborhood to make it better
Young people my age are able to make a difference
in my school
Young people my age are able to make a difference
in my neighborhood
I feel that I could work with teachers and
principal(s) in my school to make it better
If I felt strongly about an issue, I would talk to
people in power (such as the mayor, school board,
city council, etc.) about my opinion
I get a lot of encouragement at school
My teachers really care about me
Teachers at school push me to be the best I can be
I would describe my satisfaction with my school
experience as
Among the people you consider your closest friends,
how many would you say, drink alcohol once a
week
8.8
20.5
0.85
3.2
7.5
0.76
2.5
5.8
0.78
1.9
4.4
0.78
1.8
4.2
0.73
Youth's Accountability to
Parents and Other Adults
Youth's Empowerment
Youth's Perceived School
Support
Self and Peer Values Regarding
Risk Behaviors
468
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Assets subscales
Development of a youth survey
Table III. Continued
Assets subscales
Youth's Empathetic
Relationships
Content clusters
Youth's Responsibility
Youth's Planning
Youth's Satisfaction with Life
Among the people you consider your closest friends,
how many would you say have used drugs such as
marijuana or cocaine
It is against my values to drink alcohol while I am a
teenager
Among the people you consider your closest friends,
how many would you say get in trouble at school
It is against my values to have sexual intercourse
while I am a teenager
How many adults have you known for two or more
years who encourage you often
How many adults have you known for two or more
years who you look forward to spending time with
How many adults have you known for two or more
years who talk with you at least once a month
People who know me would say I feel really sad
when one of my friends is upset
People who know me would say that I care about
other people's feelings
People who know me would say I am good at
making and keeping friends
Grouped items
How important is it to you to do your best even
when you have to do a job you don't like?
How important is it to you to accept responsibility
for your actions when you make a mistake or get in
trouble?
People who know me, would say that I think
through the possible good and bad results of
different choices before I make a decision
People who know me would say I am good at
planning ahead
I would describe my satisfaction with my friendships as
I would describe my satisfaction with my overall
life as
they would use birth control. This correlation
provide some evidence for discriminate validity
(Hatcher, 1996) in that the scales are associated. However, the correlations are not so
strong to indicate that they are measuring the
same construct.
Two items clustered together creating a content
cluster labeled Perceptions of Others Sexual
Involvement. This content cluster had only two
Eigenvalue
Percent of
variance
Cronbach's
a
1.6
3.7
0.79
1.4
3.4
0.69
1.2
2.9
0.67
1.2
2.7
0.61
1.1
2.7
0.51
items and a reliability of 0.73 (Table II), but did
show a distinct and consistent conceptual arena.
Therefore, the content cluster is presented to show
an area of promise for future scale development.
Youth assets subscales
The assets section of the survey initially contained
43 items. In the end, 33 items were retained and
yielded seven subscales (Table III). Factor load469
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Quantity of Other Adult Support
Subscale items
±0.16
±0.002
0.02
0.07
0.15
±0.02
0.04
0.84
0.80
0.65
0.55
0.35
0.34
±0.01
±0.02
0.01
±0.03
0.90
0.86
0.69
0.64
0.64
0.54
0.46
±0.07
0.05
0.10
±0.09
0.04
±0.03
0.01
±0.03
0.06
±0.04
I get along well with my parents or other adults in
my household
My parents or other adults in my household give me
support when I need it
I would describe my satisfaction with my family life
as
In my family, I feel useful and important
My parents or other adults in my household often
tell me that they love me
If you had an important concern about drugs,
alcohol, sex, or some other serious issue, would you
talk to your parents or other adults in your
household about it?
I have had lots of good conversations with my
parents or other adults in my household about
waiting until I am older, or married, to have sexual
intercourse
How often do your parents or other adults in your
household ask you about your homework
How often do your parents or other adults in your
household talk to you about what you are doing in
school
How often do your parents or other adults in your
household help you with your school work
How often do your parents or other adults in your
household go to meetings or event at your school
In my family, there are clear rules about what I can
and cannot do
Your parents or other adults in your household ask
you where you are going or who you are going with
I feel that I could work with other young people and
adults in my neighborhood to make it better
Young people my age are able to make a difference
in my school
Young people my age are able to make a difference
in my neighborhood
I feel that I could work with teachers and
principal(s) in my school to make it better
YAPA
YPSPA
0.66
0.70
0.75
0.76
0.008
0.04
0.03
0.02
±0.03
±0.01
0.05
0.06
0.001
±0.07
0.006
±0.01
±0.15
YE
0.08
±0.08
0.07
±0.09
±0.05
±0.02
0.08
0.03
±0.03
±0.03
0.01
0.04
0.06
0.01
±0.07
±0.002
±0.04
YPSS
0.02
0.002
0.02
0.002
0.13
0.10
0.04
±0.007
±0.05
±0.04
0.03
±0.03
±0.04
±0.09
0.05
±0.01
±0.03
SPV
YER
±0.04
±0.04
±0.007
±0.09
0.09
0.09
0.08
±0.03
±0.03
±0.009
0.02
±0.06
0.13
±0.008
±0.02
±0.05
0.03
QAS
±0.03
0.004
±0.008
0.03
0.03
0.009
0.003
±0.03
0.03
±0.05
0.07
±0.03
±0.03
0.04
±0.03
±0.01
±0.002
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470
Scale Items
Table IV. Scales measuring youth developmental assets: items and factor loading
B. Reininger et al.
0.002
±0.06
0.06
±0.03
0.03
±0.003
±0.05
0.0005
0.06
±0.02
±0.01
0.03
±0.01
±0.06
0.005
±0.01
0.01
±0.03
0.07
±0.04
±0.04
0.04
0.03
0.04
±0.01
0.01
0.01
±0.05
±0.04
0.003
0.0009
±0.02
0.007
0.01
0.02
±0.01
0.02
0.007
0.04
±0.04
±0.01
±0.05
±0.04
0.02
0.03
0.41
YE
±0.002
0.01
±0.05
±0.02
0.01
0.02
0.004
0.01
0.003
±0.04
0.008
0.86
0.76
0.69
0.48
±0.02
YPSS
±0.08
0.06
±0.05
±0.02
±0.01
0.04
0.41
0.48
0.55
0.79
0.80
±0.05
0.01
0.003
0.06
±0.10
SPV
±0.02
±0.03
±0.01
0.71
0.74
0.82
0.02
±0.03
0.04
±0.01
0.007
0.02
0.01
±0.03
0.03
0.05
QAS
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0.50
0.71
0.75
0.03
±0.06
±0.02
0.14
0.11
±0.008
±0.06
±0.08
±0.02
0.08
±0.08
0.04
0.07
YER
YPSPA = Youth Perceived Support by Parents and Other Adults; YAPA = Youth's Accountability to Parents and Other Adults; YE = Youth's Empowerment; YPSS =
Youth's Perceived School Support; SPV = Self Peer Values Regarding Risk Behavior; QAS = Quantity of Other Adult Support; YER = Youth's Empathetic
Relationships.
0.07
±0.06
If I felt strongly about an issue, I would talk to
people in power (such as the mayor, school board,
city council, etc.) about my opinion
I get a lot of encouragement at school
My teachers really care about me
Teachers at school push me to be the best I can be
I would describe my satisfaction with my school
experience as
Among the people you consider your closest friends,
how many would you say have used drugs such as
marijuana or cocaine
Among the people you consider your closest friends,
how many would you say, drink alcohol once a
week
It is against my values to drink alcohol while I am a
teenager
Among the people you consider your closest friends,
how many would you say get in trouble at school
It is against my values to have sexual intercourse
while I am a teenager
How many adults have you known for two or more
years who you look forward to spending time with
How many adults have you known for two or more
years who encourage you often
How many adults have you known for two or more
years who talk with you at least once a month
People who know me would say I feel really sad
when one of my friends is upset
People who know me would say that I care about
other people's feelings
People who know me would say I am good at
making and keeping friends
YAPA
YPSPA
Scale Items
Table IV. Continued
Development of a youth survey
471
B. Reininger et al.
Table V. Pearson correlation results between youth assets subscales, attitudes towards adolescent sexual behavior subscales
and level of sexual activitya
YAPA
YE
QAS
YER
YPSS
SPV
PSN
PBU
LSAc
1
0.56b
0.31b
0.37b
0.15b
0.33b
0.28b
0.22b
0.26b
0.17b
1
0.28b
0.26b
0.12b
0.27b
0.28b
0.21b
0.25b
0.19b
1
0.14b
0.13b
0.40b
0.33b
0.12b
0.12b
0.07b
1
0.19b
0.17b
0.14b
0.12b
0.12b
0.10b
1
0.15b
0.14b
0.30b
0.15b
0.18b
1
0.33b
0.24b
0.22b
0.15b
1
0.48b
0.26b
0.32b
1
0.32b
0.52b
1
0.33b
1
YPSPA = Youth Perceived Support by Parents and Other Adults; YAPA = Youth's Accountability to Parents and Other Adults;
YE = Youth's Empowerment; QAS = Quantity of Other Adult Support; YER = Youth's Empathetic Relationships; YPSS =
Youth's Perceived School Support; SPV = Self Peer Values Regarding Risk Behavior; PSN = Perceived Sexual Norms; PBU =
Perceived Birth Control Use; LSA = Level of Sexual Activity.
aContent clusters are excluded.
bIndicates signi®cance at the P < 0.01.
cAnalyzed using Spearman correlation.
ings ranged from 0.34 to 0.90 with over half of the
items in each scale having factor loadings of at
least 0.50. Four items were dropped either because
their loadings were below 0.34 or their loadings did
not discriminate between two different factors. All
remaining items loaded at 0.34 or above on one of
the factors and no higher than 0.30 on any other
factor (Table IV). The factor pattern was consistent
for the factor analysis using the entire sample and
for the two randomly selected subsamples. The
scree plot also showed an elbow at the seven-factor
solution. Additionally, these seven factors all had
eigenvalues greater than 1. Subscale items were
also examined to determine if they factored
together due to similarity in wording or placement
in the survey. It was determined that three
subscales, Youth Accountability to Parents and
Other Adults, Quantity of other Adult Support, and
Youth Empathetic Relationship may be loading
together because they were presented as a group in
the survey and because the response options were
the same. Therefore, more examination of these
subscales will be done in the future to assess their
limitations. a coef®cients for the seven youth
assets subscales ranged from 0.69 to 0.85.
Signi®cant correlations were found among each
472
of the asset scales. The correlations were not so
strong to indicate that the subscales were measuring the same constructs, thus providing discriminant validity (Hatcher, 1996).
Six items clustered together creating three
content areas that did not meet the criteria to be
considered a subscale because of the number of
items and their reliability; however their factor
patterns were distinct and consistent conceptually.
Thus, the content clusters are presented in Table III
as areas that show promise of possibly being
developed into subscales in the future.
Relationship among attitude subscales,
assets subscales and level of sexual
activity
The Pearson correlation between the attitudes
towards adolescent sexual behavior subscales and
the assets subscales yielded primarily signi®cant
correlations (P < 0.01). The Perception of Others
Sexual Involvement content cluster was not signi®cantly correlated with two other content clusters: Youth's Responsibility and Youth Planning.
All correlations between attitudes towards adolescent sexual behavior subscales and assets subscales
were in a positive direction, indicating that as
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YPSPA
YAPA
YE
QAS
YER
YPSS
SPV
PSN
PBU
LSAc
YPSPA
Development of a youth survey
Discussion
The AHABS was created for use with high-schoolaged youth from different ethnic backgrounds and
SES status. Assessed in this survey are several
health risk behaviors, attitudes towards other
adolescents' sexual behaviors and protective factors or assets.
The psychometric analysis yielded interpretable
subscales for the attitudes towards sexual behaviors and assets sections of the survey, most with
acceptable evidence for validity and internal
consistency. The reliability and validity obtained
within the asset scales are better or comparable to
those obtained in similar scales for adolescents
(Leffert et al., 1998).
More speci®cally, the attitudes towards adolescent sexual behavior items were identi®ed and
re®ned. Factor analysis identi®ed two subscales:
Perceived Sexual Norms (a = 0.81) and Perceived
Birth Control Use (a = 0.61). The Perceived Birth
Control Use subscale and the content cluster
labeled
Perceptions
of
Others
Sexual
Involvement (a = 0.73) will require more development in the future to obtain better conceptual
representation and internal consistency.
Asset items examined in this study yielded seven
subscales through exploratory factor analysis.
These scales had a coef®cients ranging from 0.69
to 0.85. Three of the seven subscales, Youth
Accountability to Parents and other Adults,
Quantity of other Adult Support, and Youth
Empathetic Relationship, need further study to
ensure that they are behaving as true subscales
rather than appearing to due so because of survey
format. Additionally, psychometric development
should be done with the three content cluster areas:
Youth's Responsibility, Youth's Planning and
Youth's Satisfaction with Life. These content
clusters require further development to enhance
their conceptual representativeness and internal
consistency.
In comparison to the Search Institute's psychometric analysis results on their asset items (Leffert
et al., 1998), the AHABS asset subscales tend to be
broader than any given asset and narrower than
their domains. However, each of the eight domains
suggested by the Search Institute are measured to
some extent by the AHABS. Additionally, the
AHABS subscales cover more of the external
factors affecting youth than the internal factors,
although with further development of the content
clusters more internal factors would be measured
accurately. Finally, the topics measured by each of
the AHABS subscales are easy to understand and
can be scored by subscale, providing useful
information to practitioners for program planning
purposes.
Beyond the psychometric ®ndings of our study,
we also found signi®cant correlations between the
two subscales representing attitudes towards adolescent sexual behavior and all of the subscales
representing youth assets. This ®nding suggests
that the more assets an adolescent reports, the less
likely they are to report attitudes re¯ecting support
for their peers engaging in sexual behaviors. In
473
Downloaded from http://her.oxfordjournals.org/ at Gelman Library - George Washington University on November 28, 2011
assets increased, so did healthy attitudes towards
adolescent sexual behavior. The strongest correlation (r = 0.56) was between the Youth Perceived
Support by Parents and Other Adults Subscale and
Youth's Accountability to Parents and Other
Adults Subscale, indicating that students perceive
more support from parents who also hold them
accountable for their actions. The correlation
between Self Peer Values Regarding Risk
Behaviors Subscale and Perceived Sexual Norms
Subscale also was strong (r = 0.48), indicating that
if youth report norms for adolescents to have
sexual intercourse then they are more likely to also
report that their closest friends are engaging in
risky behaviors.
Level of sexual activity was signi®cantly correlated with attitudes towards adolescent sexual
behavior subscales and youth assets subscales
(Table IV). The strongest correlation (r = 0.52)
was observed between the item measuring level of
sexual activity and the Perceived Sexual Norms
Subscale, indicating that youth who perceived that
it is okay for youth to have sex reported higher
numbers of lifetime sexual partners.
B. Reininger et al.
474
program practitioners and evaluators a promising
tool with primarily acceptable psychometric properties and a range of items covering risks, attitudes
and assets. This instrument contributes to the
current need for psychometrically sound instrumentation measuring not only the risk behaviors of
adolescents, but also their attitudes and assets.
Additionally, after additional developmental work
has been completed, the tool should be useful to
researchers/evaluators trying to work in school
settings because school administrators tend to be
more comfortable asking students about assets than
risks. Finally, the AHABS could prove useful in
program development and evaluation because it is
based on a holistic approach to youth programming. Speci®cally, the tool examines individual
factors such as knowledge, environmental factors
such as peer norms and presence of other adults,
and behavioral factors such as risk taking and
constructive use of time. All of these factors
reciprocally affect the health of youth and thus
serve as important intervention points. Just as
youth intervention programs continue to recognize
and intervene across multiple in¯uences in a
youth's life, evaluation tools must also become
increasingly comprehensive in their measurement
of a program's impact. The AHABS provides one
example of a youth questionnaire striving to
soundly measure multiple factors in¯uencing
youth today.
Acknowledgements
This research was conducted as a component of a
statewide adolescent pregnancy prevention initiative evaluation funded through 1998 South
Carolina legislation. AHABS survey items 48±
57, 59±63, 67, 69±71, 73, 85, 86 and 88±93 were
taken from the Search Institute Pro®les of Student
Life: Attitudes and Behaviors (ã 1996 Search
Institute, Minneapolis, MN) and used by permission. The authors would also like to acknowledge
Dr Ruth Saunders (Norman J. Arnold School of
Public Health, University of South Carolina) for
her guidance and assistance with analysis for this
Downloaded from http://her.oxfordjournals.org/ at Gelman Library - George Washington University on November 28, 2011
addition, the signi®cant correlations (P < 0.01)
between the attitudes towards adolescent sexual
behavior subscales and the item measuring level of
sexual activity as well as the signi®cant correlations (P < 0.01) between the youth assets
subscales and the item measuring level of sexual
activity indicate a relationship between behaviors,
attitudes and assets that had been suggested by past
research on adolescent behaviors (Jessor and
Jessor, 1977; Leffert, 1998). Therefore, youth
with more assets and more protective attitudes
about sex, engage in fewer risk behaviors.
Some limitations of this study are in need of
discussion. First, all information collected in this
study is self-reported and although multiple procedures were used to ensure con®dentiality, it is
possible that the bias of providing socially desirable answers is present. Two other limitations,
which have been previously mentioned, are the
need for further exploration of the in¯uence of item
wording and response options on factor analysis
results, and the need for further development of
survey items labeled as `content clusters' or that
fall in subscales with low reliability so as to
enhance psychometric soundness. While the large
sample size and the large number of items included
in the analysis present limitations, the procedure of
randomly selecting two subsamples and running
the analysis on these samples helps to provide
stronger evidence that the factor pattern that
emerged was truly representative of the underlying
structure. Finally, another limitation of this study is
the lack of examination of construct validity. The
survey results were not compared to measures of
actual behavior. Additionally, the instrument was
not validated against other established instruments
so as to examine convergent and divergent validity.
In addition, future studies may want to examine the
stability of the constructs measured with this
instrument using test±retest analysis. Therefore,
caution should be taken when using this instrument
in the future, especially until further studies can
provide additional evidence of appropriate validity
and reliability of the various subscales.
At this point, even though additional psychometric work is needed, the AHABS can provide
Development of a youth survey
manuscript. Lastly, the authors would like to
acknowledge the thoughtful comments of the
blind reviewers in developing this manuscript.
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