The Sexual Health Survey<\/strong> (SHS), developed by Heather Eastman-Mueller, Deborah Carr, and Steve Osterlind at the University of Missouri, Columbia<\/a>, is an empirically validated multidimensional psychometric instrument designed to evaluate the tripartite matrix of sexual health among emerging adults enrolled in higher education institutions. Grounded in holistic models of health psychology and behavioral medicine, the instrument assesses three core domains: Sexual Health Knowledge<\/em> (SHK), Sexual Health Attitudes<\/em> (SHA), and Sexual Health Behaviors<\/em> (SHB). The initial 200-item experimental pool was derived from rigorous construct explication, focus groups, and expert content validity indexing across five priority domains: contraception, pregnancy prevention, sexual health communication, sexual behavior, and sexually transmitted infections<\/a> (STIs) alongside institutional barriers to diagnostic testing.<\/p>\n Following pilot administration among a randomized cohort of N<\/em> = 600 undergraduate and graduate university students, psychometric item analysis refined the instrument to a 127-item comprehensive assessment battery. Subsequent dimensionality investigations via principal axis factoring<\/a> (PAF) with orthogonal varimax rotation isolated a robust five-factor psychometric core comprising 17 high-loading items that account for 71.46% of total construct variance. These latent dimensions encompass: (1) Perceived Sexual Readiness<\/em> (α = .88), (2) Comfort Sexual Communication<\/em> (α = .91), (3) Comfort with Barrier Methods<\/em> (α = .79), (4) Latex Barrier Effectiveness<\/em> (α = .79), and (5) Belief in Rape Myths<\/em> (α = .74), yielding an overall structural internal consistency coefficient of α = .79. The SHS provides student health professionals, epidemiologists, and university administrators with an empirically grounded diagnostic tool capable of informing targeted health promotion interventions, identifying sexual violence risk perceptions, and quantifying safer-sex behavioral practices across diverse collegiate demographics<\/span>.<\/p>\n Sexual Health Survey, collegiate sexual health, sexual health knowledge, sexual health attitudes, sexual health behavior, barrier contraception, STI prevention, condom negotiation, rape myth acceptance, psychometrics, emerging adulthood, higher education health promotion.<\/p>\n The Sexual Health Survey was conceptualized, psychometrically developed, and standardized by a multidisciplinary team of scholars and clinical health promotion specialists at the University of Missouri, Columbia<\/strong>:<\/p>\n Emerging adulthood represents a developmental epoch characterized by identity exploration, shifts in interpersonal autonomy, and escalating sexual experimentation. Within collegiate environments, students encounter unique interpersonal dynamics, peer norms, and environmental factors that elevate vulnerability to unintended pregnancies, human immunodeficiency virus (HIV<\/a>), and other sexually transmitted infections such as chlamydia, gonorrhea, and human papillomavirus (HPV<\/a>). Despite the availability of medical resources, pervasive informational deficits, communication apprehension, and normative rape myth endorsements persistently undermine proactive sexual safety. The Sexual Health Survey (SHS)<\/strong> was engineered to furnish a methodologically rigorous, multi-tiered diagnostic instrument specifically calibrated to the cognitive, affective, and behavioral characteristics of university students.<\/p>\n The programmatic purpose of the SHS is threefold:<\/p>\n By measuring knowledge, attitudes, and concrete behaviors within a unified instrument, the SHS enables researchers to model complex causal pathways and structural relationships. Rather than treating sexual safety as a unidimensional construct, the survey disentangles subjective readiness, partner-level communication efficacy, mechanical barrier competence, and socio-cultural belief systems surrounding sexual violence.<\/p>\n The SHS conceptualizes collegiate sexual wellbeing through an integrated tri-component behavioral health paradigm spanning cognitive, affective\/normative, and action-oriented behavioral domains:<\/p>\n This cognitive dimension operationalizes an individual's objective retention of biological facts and empirical risk probabilities across 24 specific items. It assesses knowledge concerning:<\/p>\n Spanning 48 items, the affective domain evaluates emotional valences, self-efficacy beliefs, socio-normative standards, and perceived barriers. Rather than indexing mere theoretical approval of safe sex, it interrogates interpersonal friction points, including:<\/p>\n Comprising 17 multiple-choice items and 16 dichotomous indicators (33 items total), this domain measures concrete, self-reported behavioral epidemiology. Assessed parameters include age at sexual debut, lifetime partner counts, 30-day behavioral frequencies (oral, anal, and vaginal sex), systematic barrier non-compliance etiologies (e.g., substance intoxication, spontaneous encounters, lack of barrier availability), clinical testing histories, and experiences with nonconsensual sexual contact.<\/p>\n The structural architecture of the Sexual Health Survey synthesizes three prominent theoretical frameworks in health psychology and behavioral science:<\/p>\n Formulated by Fisher, Fisher, and colleagues (1992, 2002), the Information-Motivation-Behavioral Skills Model<\/a> asserts that sexual risk-reduction behavior is directly determined by behavioral skills, which are in turn jointly determined and enacted via relevant sexual health information and motivation. The SHS operationalizes this tripartite paradigm directly:<\/p>\n Under Ajzen's Theory of Planned Behavior<\/a> (1991), intentional human action is governed by attitudes toward the behavior, subjective normative beliefs, and perceived behavioral control<\/a>. Within the SHS, items measuring comfort in requesting condom usage or querying past sexual partners represent subjective operationalizations of perceived behavioral control within emotionally charged, sexually intimate scenarios.<\/p>\n Albert Bandura's construct of self-efficacy<\/a> underpins the communicative dimensions of the survey. Bandura posited that individuals must possess not only knowledge of what actions to take, but the conviction that they can successfully execute those actions in the face of psychosocial obstacles. The SHS explicitly separates abstract knowledge (e.g., knowing condoms prevent disease) from communicative self-efficacy (e.g., comfort demanding condom adherence when a partner objects).<\/p>\n The psychometric integrity of the SHS was established through an extensive multi-phase validation methodology meeting modern educational and psychological testing standards:<\/p>\n Initial item generation originated from comprehensive bibliographic literature reviews paired with qualitative focus groups that performed construct explication on collegiate sexual priority areas. The preliminary 200-item pool was submitted to a structured expert panel of five specialists selected for broad interdisciplinary representation:<\/p>\n The panel reviewed every candidate item for clinical accuracy, item clarity, cultural competency, and gender sensitivity, eliminating ambiguous, coercive, or heteronormative phrasings.<\/p>\n Empirical construct validation was executed using an online pilot administration across a randomized sample of N<\/em> = 600 university students. Classical item analysis evaluated item-total correlations, item endorsement rates, and discrimination indices, paring the instrument from 200 to 127 items. The structural dimensionality of the refined instrument was examined via principal axis factoring. Sampling adequacy was verified by a Kaiser-Meyer-Olkin (KMO) index of .784<\/strong> and a statistically significant Bartlett's Test of Sphericity (χ², p<\/em> < .001). The five-factor solution extracted accounted for 71.46%<\/strong> of the cumulative variance, with all retained item loadings exceeding the .30 threshold (ranging from .60 to .96)<\/span>.<\/p>\n The subscales exhibited strong patterns of theoretical divergence and convergence. Factor 2 (Comfort Sexual Communication<\/em>) converged substantially with Factor 3 (Comfort with Barrier Methods<\/em>), demonstrating that interpersonal communicative self-efficacy tracks physical barrier assertiveness. Conversely, Factor 5 (Belief in Rape Myths<\/em>) demonstrated discriminant divergence from technical barrier efficacy (Factor 4), confirming that adherence to gender-role myths operates as an independent socio-cognitive schema distinct from mechanical health literacy.<\/p>\n Internal consistency for the SHS subscales and overall structural model was assessed using Cronbach's alpha<\/a> (α) along with corrected item-total correlation coefficients across the validation sample (N<\/em> = 600)<\/span>:<\/p>\n To detect underlying structural dimensions and determine the latent architecture of the instrument, Eastman-Mueller and colleagues conducted Exploratory Factor Analysis utilizing Principal Axis Factoring (PAF)<\/strong>. Given that inter-variable correlations among the items largely fell below .32 (as recommended by Tabachnick & Fidell, 2001), an orthogonal Varimax rotation<\/strong> was executed to maximize factor interpretability and facilitate distinct conceptual separation.<\/p>\n The mathematical extraction yielded five primary factors possessing initial eigenvalues exceeding 1.0 (Kaiser's criterion), which cumulatively accounted for 71.46%<\/strong> of the total variance. Because relying solely on Kaiser's criterion can occasionally over-extract or under-extract factors, Cattell's scree test was inspected as a confirmatory criterion; the scree plot break unambiguously supported the five-factor structural solution.<\/p>\nKeywords<\/h2>\n
Authors<\/h2>\n
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Purpose<\/h2>\n
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Psychological Construct<\/h2>\n
1. Sexual Health Knowledge (SHK)<\/h3>\n
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2. Sexual Health Attitudes (SHA)<\/h3>\n
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3. Sexual Health Behaviors (SHB)<\/h3>\n
Theoretical Framework<\/h2>\n
The Information-Motivation-Behavioral Skills (IMB) Model<\/h3>\n
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The Theory of Planned Behavior (TPB)<\/h3>\n
Bandura's Social Cognitive Theory<\/h3>\n
Validity<\/h2>\n
Content Validity<\/h3>\n
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Construct and Factorial Validity<\/h3>\n
Convergent and Discriminant Validity<\/h3>\n
Reliability<\/h2>\n
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Factor Analysis<\/h2>\n