Predisposing, enabling and need-for-care predictors of adolescents’ intention to use sexual health services
Nancy F. Berglas A B E , Katherine Hucles C , Norman A. Constantine A D , Petra Jerman A and Louise A. Rohrbach CA Center for Research on Adolescent Health and Development, Public Health Institute, 555 12th Street, Oakland, CA 94607, USA.
B Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA.
C Institute for Health Promotion and Disease Prevention Research, University of Southern California, 2001 N Soto Street, Los Angeles, CA 90032, USA.
D Division of Community Health Sciences School of Public Health, University of California, Berkeley,50 University Hall, Berkeley, CA 94720, USA.
E Corresponding author. Email: nancy.berglas@ucsf.edu
Sexual Health 13(6) 540-548 https://doi.org/10.1071/SH16061
Submitted: 16 April 2016 Accepted: 21 June 2016 Published: 11 August 2016
Abstract
Background: The study aimed to understand the influence of predisposing, enabling and need-for-care factors on adolescents’ intention to use sexual health services, using Andersen’s Behavioural Model of Health Service Utilisation to organise and test these factors. Methods: A sample of predominantly Hispanic teens (n = 600) in Los Angeles, California completed a self-report survey about their sexual health knowledge, beliefs, intentions, and behaviours. Hierarchical regression modelling was used to examine the incremental influences on adolescents’ intention to use sexual health services of: 1) predisposing sociodemographic factors; 2) predisposing knowledge and beliefs about sexual health; 3) enabling factors regarding perceived access to sexual health services; and 4) a need-for-care factor (sexual experience). Results: Adolescents reported high intentions to use sexual health services (3.25 on a 4-point scale), yet only 42% reported knowing where to access services. Sexual health knowledge and beliefs significantly predicted adolescents’ intention to use services beyond the effect of sociodemographics (P < 0.001). Enabling factors indicating awareness of and importance attributed to accessibility significantly predicted intention to use services incremental to predisposing factors (P < 0.001). However, need for care – that is, sexual experience – was not statistically associated with intention to use services (P = 0.402). Conclusions: Sexual health interventions are needed to provide sexual health information, promote positive beliefs about health care, and ensure adolescents’ awareness of and access to sexual health services.
Additional keywords: youth, behavioural intentions.
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