Turning Research into Action: Using Factor Analysis to Enhance Program Evaluation

Ruth Wetta, Lisette T. Jacobson, Frank Dong

Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, USA.

DOI: 10.4236/ojapps.2013.34038                

Abstract

Purpose: Sexual activity among adolescents in the United States remains high. Nearly 46% of students grades 9-12 have engaged in sexual intercourse. One of the more recent statistical tools employed in evaluation efforts includes factor analysis. The objective of this study was to investigate the underlying dimensions of a survey instrument that assesses a youth character development program, which focuses on avoiding high-risk behaviors. Method: The 76-item survey instrument was administered to adolescents (age 12-18). During the 2009-2010 school year, 652 participants in the intervention group and 1110 participants in the comparison group completed the pre-, post-, and 6-month follow-up survey. Results: Using Ajzen’s theory of planned behavior groupings, 27 survey items were selected. Through iterative principal axis factoring, four factors were extracted and rotated. A visual scree plot was generated to determine the number of acceptable factors. The extracted factors accounted for 52.53% of the total variance. Factors were subjected to Equimax rotation with Kaiser normalization and converged after six iterations. Variables with patterned weights less than 0.44 were excluded. A reliability analysis demonstrated internal consistency. Conclusions: Identified factors included: 1) Teenagers’ attitudes toward sexual health behaviors; 2) Teenagers’ perceptions of the consequences of sexual health behaviors; 3) Parental or guardian expectations; and 4) Teenagers’ relationships with parents or guardians. This study’s results indicated that all factors can be described within Ajzen’s theoretical framework consistent with previous research findings. Results may be used to enhance delivery of the intervention.

Keywords

Adolescent Behavior; Adolescent Health Services; Evaluation Methodology; Evaluation Studies;Factor Analysis; Program Evaluation; Teen Sexual Health

1. Introduction

Sexual activity among adolescents in the United States remains high. Nearly 46% of students grades 9 - 12 have engaged in sexual intercourse [1]. Recent estimates reveal that approximately 19 million new cases of sexually transmitted diseases (STDs) are diagnosed each year, almost half of them are among youth ages 15 to 24 [2]. Specifically, Forhan and colleagues [3] estimate that one in four 14 to 19-year-old has a sexually transmitted disease including chlamydia, herpes, trichomoniasis, or human papilloma virus. Teen STDs including human immunodeficiency virus (HIV) cost the United States $6.5 billion indicating its huge economic impact on American society [4].

Despite recent declines in the birth rate for US teenagers, teen birth rates continue to bear concern because of the socioeconomic burden of teen pregnancy and childbearing [5]. Teen mothers are less likely to graduate high school and more likely to depend on public assistance [6]. Additionally, children born to out-of-wedlock teenage mothers are more likely to experience poor health, poverty, delinquency, educational failure, and higher dropout rates [7,8].

Overall, the literature reports on a variety of interventions aimed to reduce adolescent risk behaviors [9-12]. In an attempt to reach youth within their social environment, interventions are offered within schools [13], faith-based organizations [14,15], and after-school settings [16]. Each intervention must be rigorously evaluated for its impact through the systematic use of various research methods.

Assessment of adolescent attitudes toward sexual health behaviors forms a critical component in the evaluation efforts of teens’ decision making ability to engage or not engage in sexual activity [17-19]. One of the statistical tools employed in evaluation efforts includes factor analysis. Previous studies have successfully used factor analysis to:

1) Identify the nature of the constructs underlying responses in attitudes towards sexual debut and adolescent decision-making about sexual behavior [20-22], and 2) Produce a more precise instrument [23].

Against this background, the objective of this article is to describe the results of factor analysis of a survey instrument that assesses a youth character development program. This study identifies four dimensions of teens’ attitudes about high-risk sexual health behaviors.

1.1. Program Background

Pure & Simple Health Education, Inc., a 501 (c) (3) nonprofit organization based in a Midwestern metropolitan area, is a faithand community-based agency that educates communities, parents, and youth on the value of: 1) refraining from sexual activity and other high-risk behaviors including alcohol, tobacco, and/or pornography; and 2) development of self-control for the purpose of developing positive, healthy relationships [15]. The organization regularly provides services to high-risk youth including adolescents from troubled families, unwed mothers, and youth transitioning back into society from detention centers. Active since 1997, professional staff and volunteers have educated the community on topics related to human sexuality serving more than 15,000 youth and adults. The curriculum, Pure & Simple Lifestyle (PSL), is a federally funded program. Since its inception, PSL is assessed by a third-party that uses quantitative and qualitative research methods to evaluate the curriculum’s effectiveness in reaching its goal of promoting self-restraint from high-risk behaviors among youth.

1.2. Theoretical Framework

This study’s conceptual framework is guided by Ajzen’s [24,25] Theory of Planned Behavior (TPB), which is an extension of the Theory of Reasoned Action [26-28] in that TPB includes measures of control belief and perceived behavioral control. Ajzen specifies that behavior depends on a person’s intention and perceived ability. In other words, behavioral intentions can only be expressed in actual behavior if a person voluntarily decides to perform or not perform the behavior. An adolescent’s decision not to engage in sexual activity is a direct function of his/her intention to avoid or resist situations in which sexual activity may occur as long as he/she interprets the behavior as under his/her control. Thus, sexual activity depends to some degree on non-motivational factors (e.g., cooperation, time of day, location, communication, etc.).

Figure 1 describes Ajzen’s theory in more detail. Based on this model, intentions are preceded by: 1) atti-

Conflicts of Interest

The authors declare no conflicts of interest.

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