Assessing Risk and Protection for Diverse Adolescent Outcomes: Do Risk and Protective Factors for Adolescent Delinquency and Substance Use Also Predict Risky Sexual Behavior?

Introduction:  Assessing risk and protection is an essential component of many science-based approaches to prevention. The Evidence2Success Youth Experience Survey (E2S survey) measures youth wellbeing, problem behaviors, and risk and protective factors in community, school, family, peer and individual domains. Most risk and protective factors included in this survey have been shown to predict adolescent substance use, delinquency and violence, and there is recent evidence for their prediction of depressive symptoms, but little is known as to whether they can predict other youth outcomes. This study seeks to expand the applicability of these identified risk and protective factors by establishing how they relate to adolescent risky sexual behaviors.

Methods:  We use cross-sectional data from 2150 10^th and 12^th grade students who completed the 2012 E2S survey in a mid-sized Northeastern U.S city.  The E2S survey includes the majority of the risk and protective factors that comprise the Communities That Care Youth survey—a reliable and valid instrument widely used in the U.S. and internationally—plus a set of additional risk and protective factors and outcomes.  The sexual behavior outcomes examined here include an index of past year risky sexual behavior (multiple sex partners, inconsistent birth control or condom use), and an index of negative sexual behavior consequences (ever having a sexually transmitted infection or teen pregnancy).  Correlation analyses explored the relationships between risk and protective factors and these two outcomes across grades and genders. Logistic regressions were used with the dichotomized indices and control variables, and interactions between gender and the risk and protective factors were examined.

Results:  We observed high prevalence of risky sexual behavior among 10^th and 12^th graders (23.4%, 44.9%, respectively).  Analyses found significant relationships of low to moderate magnitude between risk and protective factors in all domains with both sexual behavior outcomes.  Some variation was observed between genders and grade level, as well as some significant gender interactions. 

Conclusions:  Results suggest that the same risk and protective factors that predict other adolescent problems (e.g., substance use, delinquency) may also be related with risky sexual behavior. Although conclusions may be limited by use of cross-sectional data from a single city, our findings increase confidence in the utility of the E2S survey in examining relationships between multiple domains of risk and protection and diverse outcome areas. Targeting risk and protection through preventive interventions may have positive impacts on multiple behavioral outcomes, including risky sexual behaviors, thus enhancing the reach and influence of effective programming.