Condom Embarrassment Scale

Condom Embarrassment Scale

KAREN VAIL-SMITH1 AND THOMAS W. DURHAMEast Carolina University

H. ANN HOWARDUniversity of North Carolina at Chapel Hill

Embarrassment as a construct inhibiting effective contraceptive use has been supported in the literature (Baffi, Schroeder, Redican,& McCluskey,1989; Beckman, Harvey, & Tiersky, 1996; Bell, 2009; Dahl, Gorn, & Weinberg, 1998; Herold, 1981; Hingson, Strunin, Berlin, & Heeren, 1990; Hughes & Torre, 1987; Kallen & Stephensen, 1980; Moore, Dahl, Gorn, & Weinberg, 2006; Moore et al., 2008; Valdiserri, Arena, Proctor, & Bonati, 1989). The Condom Embarrassment Scale (CES) was developed to measure the level of embarrassment in college men and women regarding condom use (Vail-Smith, Durham, & Howard, 1992). Condom embarrassment is here defined as the psychological discomfort, self-consciousness, and feeling of being ill at ease associated with condom use. The researchers hypothesized that this psychological discomfort would be experienced when an individual makes an acquisition of condoms, negotiates with a partner to use condoms, and actually uses a condom as a part of a sexual encounter.

Description

The 18-item CES employs a Likert scale (5-point) with response options labeled from Strongly Disagree to Strongly Agree. From the responses of a sample of 256 college students, a principal factor analysis with varimax rotation revealed three major components of condom embarrassment that accounted for 59.4% of the total variance. Items 1, 2, 3, 4, 5, 6, 7, and 12 loaded heavily on the first fac- tor. This factor accounted for 45.0% of the shared variance explained by the three factors and appears to be characterized by embarrassment associated with acquiring, purchasing, obtaining or possessing condoms. Items 14, 15, 16, 17, and 18 loaded on the second factor, which accounted for 30.1% of the common variance and appears to be associated with actually using condoms. Items 8, 9, 10, 11, and 13 loaded on the third factor. Factor three appears to be associated with negotiating the use of condoms and accounts for 24.9% of the explainable variance.

Response Mode and Timing

Respondents indicate their level of agreement with each item by circling the letter (A-E) corresponding with their answer choice. The CES requires approximately 10 minutes to complete.

Scoring

Each item on the CES is scored from 1 to 5 with 1 corresponding to Strongly Disagree (low embarrassment) and 5 corresponding to Strongly Agree (high embarrassment). Point values for all answers were summed to provide the CES score. The possible range of CES scores is from 18 to 90, with 90 indicating the highest embarrassment and 18 indicating the lowest. Among the 256 college students who participated in the original study, the mean score on the CES was 44.88 (SD = 14.85). Women (= 46.54, SD = 14.65) scored significantly higher than men (= 41.81, SD = 14.74), t(254) = 2.48, = .01.

Reliability

To assess the stability of the test over time, a Pearson prod- uct-moment correlation coefficient was computed using the scores from the 226 college students who completed two administrations of the CES. The obtained reliability coefficient was .78, < .001. The Cronbach’s alpha for the summed scores from the 18 items was .92.

Validity

A sexpected, VailSmith, Durham, and Howard(1992) found that the summed score of the CES was significantly correlated with the Sex Anxiety Inventory (Janda & O’Grady, 1980), = .39. It was also predicted that those persons with greater knowledge about condom use and sexually trans- mitted diseases (STDs) would feel less embarrassed about buying, discussing, and using condoms. When comparing the scores on an STD/condom knowledge test (Solomon & DeJong, 1989) and the CES across both men and women, the Pearson product-moment correlation for these two variables was .34, < .01, also indicating a significant correlation in the predicted direction. The relationship of CES scores with the STD/condom knowledge test scores differs by gender, however. For the 163 women, the correlation between the two variables was −.35, .001, indicating that women who scored higher on the knowledge test felt less embarrassment about condom acquisition and use. For the 93 men, this correlation was −.13, > .20, revealing no significant relationship between the variables.

In addition to the attitude measures described above, variation on CES scores as a function of various behaviors was also examined. As expected, those who have actually purchased a condom do feel less condom embarrassment than those who have not made such a purchase and consequently scored significantly lower on the CES. Another factor supporting construct validity is that sexually active respondents have a lower embarrassment score than those who are not sexually active.

Other Information

The use of the CES for educational or research purposes is encouraged. The authors would appreciate receiving information about the results.

Address correspondence to Karen Vail-Smith, Department of Health Education and Promotion, East Carolina University, Greenville, NC 27858; e-mail: [email protected]

Instructions: The following items assess how embarrassed you do feel (or would feel) about condom use. Using the following scale, please respond to each of the items listed below.

A = Strongly Disagree B = Disagree

C = Neither Agree nor Disagree D = Agree

E = Strongly Agree

  1. I am embarrassed or would be embarrassed about buying a condom from a drug store near campus.

  2. I am embarrassed or would be embarrassed about buying a condom from a drug store close to where my parents live.

  3. I am embarrassed or would be embarrassed about buying a condom from a place where I could be certain no one I know would see me.

  4. I am embarrassed or would be embarrassed about obtaining condoms from Student Health Services (School Infirmary).

  5. I am embarrassed or would be embarrassed about obtaining condoms from a local health department.

  6. I am embarrassed or would be embarrassed about asking a pharmacist or drug store clerk where condoms are located in the store.

  7. I am embarrassed or would be embarrassed about asking a doctor or other health care professional questions about condom use.

  8. I am embarrassed or would be embarrassed about stopping during foreplay and asking my partner to use a condom.

  9. I would be embarrassed if a new partner insisted that we use a condom.

  10. I am embarrassed or would be embarrassed to tell my partner during foreplay that I am not willing to have sexual intercourse unless we use a condom.

  11. I am embarrassed or would be embarrassed about being prepared and providing a condom during lovemaking if my partner didn’t have one.

  12. I am embarrassed or would be embarrassed about carrying a condom around in my wallet/purse.

  13. I am embarrassed or would be embarrassed about talking to my partner about my thoughts and feelings about condom use.

  14. I am embarrassed or would be embarrassed if my partner watched me dispose of a condom after we had used it.

  15. I am embarrassed or would be embarrassed about watching my partner put on a condom OR if my partner watched me put on a condom.

  16. I am embarrassed or would be embarrassed about helping my partner put on a condom OR if my partner helped me put on a condom.

  17. I am embarrassed or would be embarrassed about watching my partner remove a condom OR if my partner watched me remove a condom.

  18. I am embarrassed or would be embarrassed about helping my partner remove a condom OR if my partner helped me remove a condom.

References

Baffi, C. R., Schroeder, K. K., Redican, K. J., & McCluskey, L. (1989). Factors influencing selected heterosexual male college students’ con- dom use. Journal of American College Health, 38, 137–141.

Beckman, L. J., Harvey, S. M., & Tiersky, L. A. (1996). Attitudes about condoms and condom use among college students. Journal of American College Health, 44, 243–249.

Bell, J. (2009). Why embarrassment inhibits the acquisition and use of condoms: A qualitative approach to understanding risky sexual behav- iour. Journal of Adolescence, 32, 379–391.

Dahl, D. W., Gorn, G. J., & Weinberg C. B. (1998). The impact of embar- rassment on condom purchase behaviour. Canadian Journal of Public Health, 89, 368–370.

Herold, E. S. (1981). Contraceptive embarrassment and contracep- tive behavior among young single women. Journal of Youth and Adolescence, 10, 233–242.

Hingson, R. W., Strunin, L., Berlin, M., & Heeren, T. (1990). Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents. American Journal of Public Health, 80, 295–299.

Hughes, C. B., & Torre, C. (1987). Predicting effective contraceptive behavior in college females. Nurse Practitioner, 12, 44–54.

Janda, L. H., & O’Grady, K. E. (1980). Development of a sex anxiety inventoryJournal of Consulting and Clinical Psychology, 48, 169– 175.

Kallen, J. D., & Stephensen, J. (1980). The purchase of contraceptives by college students. Family Relations, 29, 358–364.

Moore, S. G., Dahl, D. W., Gorn, G. J., & Weinberg, C. B. (2006). Coping with condom embarrassment. Psychology, Health and Medicine, 11, 70–79.

Moore, S. G., Dahl, D. W., Gorn, G. J., Weinberg, C. B., Park, J., & Jiang, Y. (2008). Condom embarrassment: Coping and consequences for condom use in three countries. AIDS Care, 20, 553–559.

Solomon, M. Z., & DeJong, W. (1989). Preventing AIDS and other STDs through condom promotion: A patient education intervention. American Journal of Public Health, 79, 453–458.

Vail-Smith, K., Durham, T. W., & Howard, H. A. (1992). A scale to mea- sure embarrassment associated with condom use. Journal of Health Education, 29, 209–214.

Valdiserri, R. O., Arena, V. C., Proctor, D., & Bonati, F. A. (1989). The relationship between women’s attitudes about condoms and their use: Implications for condom promotion programs. American Journal of Public Health, 79, 499–501.