Original aryticle
Reliability of adolescents’ self-reported sexual behavior: a comparison of two diary methodologies

https://doi.org/10.1016/S1054-139X(00)00218-4Get rights and content

Abstract

Purpose: To evaluate techniques for measuring high-risk sexual behaviors by comparing the reliability and acceptability of two daily sexual behavior diary modes: a written calendar and an automated telephone interview.

Methods: This randomized controlled study included 105 sexually active female adolescents aged 15–19 years recruited from among teens seeking reproductive health care services at a family planning clinic in the San Francisco Bay Area. Participants completed a standardized sexual behavior questionnaire each day for 4 weeks. Contraceptive use by method type was recorded. Reporting differences between the two diary modes were assessed using generalized estimating equations, concordance of diary and retrospective interview responses was evaluated using kappa statistics, and contingency table analysis and Poisson regression models were constructed to examine mode acceptability.

Results: Respondents randomized to the telephone diary cohort reported less frequent use of barrier contraceptive methods, specifically less spermicide use (odds ratio 0.27, 95% confidence interval 0.08, 0.95), and decreasing male condom use over time, whereas reports of male condom use increased for written diary respondents (p = .007). Participant characteristics associated with diary acceptability, defined as the frequency of diary completion, were assessed and teens classified as higher risk provided fewer diary reports (p < .01). Regardless of mode completed, 65% of respondents believed the telephone diary would be preferable to the written diary for most teens.

Conclusions: The automated telephone diary offered an acceptable, even preferred, methodologic alternative to the written diary calendar and elicited more accurate reporting of selected contraceptive behavior.

Section snippets

Study population

Female participants ranged in age from 15 to 19 years and were recruited from among clients seeking reproductive health care services at a Planned Parenthood teen clinic in San Rafael, California, and through community outreach during May through December 1998. This study originated from a larger prospective cohort study of contraceptive use that investigated the acceptability of barrier contraceptive methods among sexually active young women and their male partners. Eligibility (determined

Participant characteristics

Of 139 adolescents, 118 were eligible (21 ineligible primarily because not sexually active currently) and 107 agreed to participate in the study. Females who declined participation did not differ from those who did enroll with regard to demographic characteristics or current sexual risk behaviors. Fifty-four participants were randomized to the written calendar cohort and 53 were assigned the automated telephone diary. Two participants did not complete the baseline interview, and thus the final

Discussion

The comparisons of diary data obtained through the written and telephone modes suggest that, apart from spermicide use, the overall likelihood of reporting specific contraceptive method and alcohol/drug use did not vary significantly by collection mode. Use of any contraceptive method during vaginal sex, however, was reported, but not significantly, somewhat more frequently among the telephone diary cohort. This difference appeared to be driven by the higher reported use of hormonal

Acknowledgements

This research was supported by Institute for Child Health and Human Development, NIH, Grant 1R01HD32789-01A1. Many thanks are extended to the dedicated research staff: Jessica Bowen, Lilia Cardenas, Mary de la Roca, Sarah Glass, Heather Gould, Margaret Handley, Cı́o Hernandez, Jill Johnson, Janet Jonte, Abigail Norris, Andrea Raider, Judy Quan, April Vogensen, and Jane Wong. In addition, the authors are grateful to the study participants who volunteered for the Reproductive Health Project and

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