Measuring Concurrency Attitudes: Development and Validation of a Vignette-Based Scale

• Published in: PloS one 2016-10, Vol.11 (10), p.e0163947-e0163947
• Main Authors: Cope, Anna B, Ramirez, Catalina, DeVellis, Robert F, Agans, Robert, Schoenbach, Victor J, Adimora, Adaora A
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Adults; African Americans; African Americans - statistics & numerical data; Age Factors; AIDS; Alcohol Drinking; Alcohol use; Alcoholic beverages; Analysis; Attitude - ethnology; Attitudes; Behavior; Biology and Life Sciences; Cognitive ability; Concurrency; Condoms; Disease transmission; Drug abuse; Epidemiology; Exploratory factor analysis; Factor analysis; Factor Analysis, Statistical; Female; Focus Groups; HIV; HIV Infections - diagnosis; HIV Infections - transmission; Human immunodeficiency virus; Humans; Imprisonment; Infectious diseases; Interviews as Topic; Lentivirus; Male; Measurement; Measures; Medicine and Health Sciences; Mental health; Minority & ethnic groups; Participation; Partnerships; People and places; Performance evaluation; Personality; Physical Sciences; Polls & surveys; Primaries & caucuses; Public health; Qualitative research; Quantitative psychology; Radio; Reliability; Reliability analysis; Research and Analysis Methods; Research methodology; Retroviridae; Self Efficacy; Sex Factors; Sexual Behavior; Sexual Partners; Sexually transmitted diseases; Social research; Social Sciences; STD; Substance-Related Disorders - pathology; Surveys and Questionnaires; Telephone; Telephone surveys; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0163947

Concurrent sexual partnerships (partnerships that overlap in time) may contribute to higher rates of HIV transmission in African Americans. Attitudes toward a behavior constitute an important component of most models of health-related behavior and behavioral change. We have developed a scale, employing realistic vignettes that appear to reliably measure attitudes about concurrency in young African American adults. Vignette-based items to assess attitudes about concurrency were developed following focus groups and cognitive testing of items adapted from existing scales assessing psychosocial constructs surrounding related sexual behaviors. The new items were included in a telephone survey of African American adults (18-34 years old) in Eastern North Carolina immediately before and after a radio campaign designed to discourage concurrency. We performed an exploratory factor analysis on each sample (pre- and post-campaign) to cross-validate results. We retained factors with a primary loading of ≥0.50 and no secondary loading >0.30. Cronbach's coefficient alpha was used to evaluate internal reliability. Associations in the predicted direction between the mean responses to items on the final factor and known correlates of concurrency validated the scale. Factor analysis in a random pre-campaign subsample yielded a one-factor 6-item scale with acceptable internal consistency (Cronbach's α = 0.79). As expected, the attitude factor was positively associated with participation in concurrent partnerships, whether assessed by self-report (r = 0.298, p