The application of the Transtheoretical Model of Change to adolescent sexual decision-making

The Transtheoretical Model of Change (TTM) was examined for its applicability to the study of adolescent sexual abstinence behaviors. This investigation involved a cross-sectional secondary analysis of 7th grade students (N = 694) participating is a school-based program funded by the Virginia State Abstinence Initiative. The purpose was to explore the relationships among the concepts and variables of the TTM in an adolescent population with regard to sexual decision-making in abstinence behaviors. The relationship of the different stages of change among virgins and nonvirgins to the decisional balance variable was examined. Results demonstrated significant difference in the decisional balance variable among virgin adolescents in the precontemplation, contemplation, preparation, and action stages of sexual abstinence using ANOVA testing. However, these differences were not seen in the nonvirgin subjects. The virgins followed a highly predictable pattern of sexual decision-making following the graphing of T scores, but this decision-making pattern was not apparent in the nonvirgin subjects. These results support the applicability of the TTM to the behavior of sexual abstinence. Nurses must be aware of the differences in adolescent decision-making processes and incorporate a knowledge of these differences into intervention strategies. Future research will focus on the replication of results in older adolescents and the development of stage-matched interventions to promote healthy sexual behaviors.