Measuring the Condom Use Self-Efficacy of Deployed, Enlisted Male U.S. Naval Personnel
Norris, Anne E., Phillips, Raymond E., Grady, Kelly, Journal of Nursing Measurement
This article summarizes the development and psychometric analysis of a condom use self-efficacy measure for deployed, enlisted male U.S. Naval personnel. Sample ethnic subgroups included European American, Latino/Hispanic, African American, Asian American, Native American, Pacific Islander, and Biracial/Multiracial. Excellent reliability statistics were obtained for the full sample (alpha = .93, N = 2,722) and various ethnic subgroups (alpha = .93 to .95, n = 44 to 1,383). Correlations between self-efficacy scores and measures of condom use were similar in magnitude to effect sizes reported in research involving civilian populations (r = .18 to .34). Significant differences in self-efficacy scores for groups of condom users (e.g., consistent and nonconsistent users) for the full sample of men and ethnic subgroups provided further support for construct validity (p < .05). Study findings support the reliability and validity of the condom self-efficacy measure in this population and indicate its usefulness and the need for investigating its psychometric properties in other populations.
Keywords: condom use; self-efficacy; ethnicity; reliability; validity
Understanding condom use behavior and promoting condom use in sexually active, high-risk populations is important for HIV/AIDS prevention and the prevention of other sexually transmitted diseases (STDs) (McKay, 2004; Sheeran, Abraham, & Orbell, 1999). Individuals on active duty in the Armed Forces may be at high risk for HIV and other STDs because of their youth and frequent deployments (Booth-Kewley, Minagawa, Shaffer, & Brodine, 2002). When U.S. Naval personnel are deployed, they spend anywhere from 3 months to a year at sea, depending on their vessel and home port. Prior to the September 11 attacks on the United States, a typical deployment for an aircraft carrier whose home port was in the United States was 6 months. During deployment, it is common for these personnel to seek sexual relationships in the foreign ports that they visit. It is against military code for them to engage in sexual relationships while at sea under conditions of deployment.
HIV seroconversion rates have increased among active duty U.S. Naval personnel, with rates in 2002-2005 (28-30 per 100,000) being the highest observed since 1994, when they were 30 per 100,000 (Navy Environmental Health Center, Sexual Health and Responsibility, 2006). Bandura (1992) has identified condom use self-efficacy as a key determinant of condom use behavior. This theoretical position is supported by empirical research: Sheeran et al.'s (1999) meta-analysis of condom behavior literature identified a consistent effect for self-efficacy on condom use. Accordingly, we believe the measurement of condom use self-efficacy to be an important topic for research.
The purpose of this study was to examine the reliability and validity of a measure of condom use self-efficacy developed for a survey of enlisted male U.S. Naval personnel deployed on one of three aircraft carriers. Also of interest was whether the measure's psychometric properties were consistent across the various ethnic subgroups (European American, Latino/Hispanic, African American, Asian American, and Biracial/Multiracial) in the sample. The study sample was unique in that it was composed of U.S. men who varied in ethnicity but were fairly similar in socioeconomic status. All men were from the E1 to E4 pay grades, which are the lowest pay grades in the military. These men represented the largest proportion of the Navy active duty force at the time of the study (2002-2003).
BACKGROUND AND CONCEPTUAL FRAMEWORK
Self-efficacy is generally defined as a sense of one's ability to engage in a set of behaviors (microbehaviors) that represent a larger behavioral goal (Bandura, 1986). Condom use self-efficacy is one's confidence in the ability to procure a condom, put a condom on, negotiate with a partner regarding condom use, and so forth. …