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Archives of Sexual Behavior

, Volume 48, Issue 8, pp 2305–2320 | Cite as

Using Composite Scores to Summarize Adolescent Sexual Risk Behavior: Current State of the Science and Recommendations

  • David H. BarkerEmail author
  • Lori A. J. Scott-Sheldon
  • Daniel Gittins Stone
  • Larry K. Brown
Original Paper

Abstract

Composite scores offer the advantage of summarizing across multiple sexual risk behaviors to both simplify results and better capture the influence of core contextual, interpersonal, and intrapersonal dynamics that affect multiple sexual risk behaviors. There is inconsistency in how researchers utilize composite scores with minimal guidance on the advantages and disadvantages of frequently used approaches. Strengths and weaknesses of each approach are discussed in the context of assessing adolescent sexual risk behavior. A latent variable model and three commonly used composites were applied to data combined across four clinical trials (n = 1322; 50% female). Findings suggested that the latent variable approach was limited due to minimal correlations among sexual risk behaviors, that choice of composite had minimal impact on cross-sectional results so long as there is sufficient variability in risk behavior in the sample, but composite choice could impact results from clinical trials particularly for subgroup analyses. There are unique challenges to creating composites of adolescent risk behavior, including the fluidity and infrequency of adolescent sexual relationships that result in many participants reporting no sexual behavior at any given assessment and a low correlation between the number of partners and condomless sex acts. These challenges impede application of data-driven approaches to defining sexual risk composites. Recommendations to improve consistency in reporting include: (1) reporting each type of risk behavior separately prior to forming a composite, (2) aggregating across assessments to increase the chance of observing sexual risk behaviors, and (3) continued work toward a unified definition of adolescent sexual risk behavior that can guide the development of appropriate measurement models.

Keywords

Adolescence Sexual risk behavior HIV Clinical trials 

Notes

Acknowledgements

This work was supported by the National Institute of Mental Health (K23MH102131 to David H. Barker) and by the National Institute on Alcohol Abuse and Alcoholism (R01AA021355 to Lori A. J. Scott-Sheldon) of the National Institutes of Health. The work was facilitated by the Providence/Boston Center for AIDS Research (P30AI042853). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding

This study was funded by the following grants: National Institute of Mental Health (K23MH102131); National Institute on Alcohol Abuse and Alcoholism (R01AA021355), and National Institute of Allergy and Infectious Diseases (P30 AI042853).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all parents/caregivers, and assent was obtained from all participants under the age of 18.

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Authors and Affiliations

  1. 1.Department of Psychiatry and Human Behavior, The Warren Alpert Medical SchoolBrown UniversityProvidenceUSA
  2. 2.Division of Child and Adolescent PsychiatryRhode Island HospitalProvidenceUSA
  3. 3.Centers for Behavioral and Preventive MedicineThe Miriam HospitalProvidenceUSA
  4. 4.Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceUSA
  5. 5.Department of Applied Psychology, Bouvé College of Health SciencesNortheastern UniversityBostonUSA

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