AIDS and Behavior

, Volume 19, Issue 10, pp 1850–1859 | Cite as

Mediation Analysis of an Effective Sexual Health Promotion Intervention for Spanish Adolescents

  • S. Escribano
  • J. P. Espada
  • A. Morales
  • M. Orgilés
Original Paper


The objective of this study is to determinate the factors that mediate in the self-reported consistent condom use over the 24-months post-intervention period in adolescents who received COMPAS, a sexual health promotion intervention targeted to Spanish adolescents. Twelve high schools located in Spain were randomized to an intervention or a control group with baseline, immediate-post, 12 and 24-month post-intervention assessments. Self-reported consistent condom use by 24 months post-intervention was the primary outcome. Based on the theory of planned behavior, we identified which theory-based variables mediated the intervention’s effect on consistent condom use. Serial multiple mediation analysis indicated that attitudes toward condom use, when there are obstacles to use it, and self-efficacy mediated the COMPAS’s effect in increasing consistent condom use. This is the first study that identifies the theoretical constructs that mediate the efficacy of a school-based intervention to promote sexual health in adolescents from Spain.


Consistent condom use Sexual health promotion intervention Adolescents Mediation analysis Theory of planned behavior 


El objetivo de este estudio es determinar los factores que median el uso consistente del preservativo en los adolescentes tras 24 meses de haber recibido COMPAS, una intervención para promover una sexualidad saludable dirigida a los adolescentes españoles. Fueron seleccionados 12 centros educativos de España, donde se realizó una evaluación en la línea base, post-implementación, a los 12 y 24 meses de seguimiento. El uso consistente del preservativo fue la conducta final evaluada mediante autoinforme a los 24 meses de la implementación. Basado en la teoría de la conducta planeada, se identificaron las variables que median el efecto de la intervención sobre el uso consistente del preservativo. El análisis de mediación múltiple indica que las actitudes hacia el uso del preservativo cuando hay obstáculos para su uso y la autoeficacia mediaron el efecto del programa COMPAS en el incremento del uso consistente del preservativo. Éste es el primer estudio que identifica los constructos teóricos que median la eficacia de una intervención de promoción de hábitos sexuales saludables en adolescentes españoles.

Palabras clave

Uso consistente del preservativo Intervención de promoción de la salud sexual Adolescentes Análisis de mediación Teoría de la conducta planeada 



This research was financed by the Fundación para la Investigación y la Prevención del Sida en España (Foundation for Research and Prevention of Aids in Spain) (FIPSE 360971/10) and by the Program VALi + d for Research Staff training of the Conselleria de Cultura, Educació, y Ciència de la Generalitat Valenciana (Council of Culture, Education, and Science of the Valencian Autonomous Government) (ACIF/2012/132). We thank professor Jimena Y. Ramírez-Marín for her statistical assistance and discussion.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • S. Escribano
    • 1
  • J. P. Espada
    • 1
  • A. Morales
    • 1
  • M. Orgilés
    • 1
  1. 1.Department of Health PsychologyMiguel Hernández UniversityElcheSpain

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