Table of Contents
Correct Condom Use Self-Efficacy Scale
RICHARD A. CROSBY,1 University of Kentucky CYNTHIA A. GRAHAM, University of Oxford ROBIN R. MILHAUSEN, University of Guelph STEPHANIE A. SANDERS AND WILLIAM L. YARBER,2 Indiana University
Consistent and correct male condom use has been noted as one effective method for preventing the transmission of HIV and reducing the risk of other STDs (Centers for Disease Control and Prevention, 2009). Although a number of psychosocial constructs have been associated with condom use, a central construct, from a theoretical and an empirical perspective, has been condom use self-efficacy. Bandura (1994) defined self-efficacy as beliefs about one’s capabilities to produce designated levels of performance and suggested that self-efficacy largely determined how individuals feel, think, motivate themselves, and behave. Condom use self-efficacy, therefore, refers to an individual’s confidence in the ability to exert control over his or her motivation, behavior, and social environment to use condoms (Forsyth & Carey, 1998).
A number of previous measures of self-efficacy assess knowledge, behavioral intentions, or attitudes, but not an individual’s perception about his or her ability to perform specific behaviors (e.g., Goldman & Harlow, 1993; Lux & Petosa, 1994; Schaalma, Kok, & Peters, 1993). Other measures of self-efficacy are limited by their conceptualization of self-efficacy as a stable trait across different contexts (e.g., St. Lawrence, Brasfield, Jefferson, Alleyne, & Shirley, 1994) as opposed to a more domain-specific behavior. Many researchers also have relied on a single- item measure of self-efficacy that may limit the precision of measurement (e.g., Wulfert & Wan, 1993). Therefore, a scale that measures individuals’ perceptions of their ability to perform behaviors specific to correct condom use would have utility in public health research.
The Correct Condom Use Self-Efficacy Scale (CCUSS) is a 7-item scale designed to measure an individual’s perception of the ease or difficulty with which he or she can apply and use male condoms correctly. This scale emerged from our earlier research on the prevalence and predictors of male condom use errors and problems (e.g., Crosby, Milhausen, Sanders, Graham, & Yarber, 2008; Crosby, Sanders, Yarber, Graham, & Dodge, 2002; Graham et al., 2006; Milhausen et al., 2009; Sanders et al., 2003; Sanders, Milhausen, Crosby, Graham, & Yarber, 2009; Yarber,
Graham, Sanders, & Crosby, 2004; Yarber et al., 2005). CCUSS items reflect the condom use errors and problems that might occur before, during, and after sex.
Response Mode and Timing
Respondents are asked how easy or difficult it would be for them to perform various correct condom use tasks. Responses are provided using a scale ranging from 1 (Very Difficult) to 5 (Very Easy).
Items are summed such that a higher score indicates greater self-efficacy for correct use of male condoms. The mean score among a sample of 278 adult male clients attending a sexually transmitted infections (STI) clinic was 27.61 (SD = 4.37, range = 8–35; Crosby, Salazar, et al., 2008).
The scale produced a Cronbach’s alpha of .70 among the aforementioned STI clinic sample (Crosby, Salazar, et al., 2008).
Crosby, Salazar, et al. (2008) found that greater self- efficacy for correct use of condoms was associated with fewer condom use errors and problems.
Directions: Please circle the number that represents how easy or difficult it would be to do what each question asks. For example, if you thought a behavior in the statement would be very easy, you would circle number “5.”
1. How easy or difficult would it be for you to find condoms that fit you properly?
2. How easy or difficult would it be for you to apply condoms correctly? Very Difficult
3. How easy or difficult would it be for you to keep a condom from drying out during sex? Very Difficult
4. How easy or difficult would it be for you to keep a condom from breaking during sex? Very Difficult
5. How easy or difficult would it be for you to keep an erection while using a condom? Very Difficult
6. How easy or difficult would it be for you to keep a condom on when withdrawing after sex? Very Difficult
7. How difficult would it be for you to wear a condom from start to finish of sex with your partner?
Address correspondence to William L. Yarber, Department of Applied Health Science, Indiana University, Bloomington, Indiana 47405; e-mail: [email protected]
Bandura, A. (1994). Social cognitive theory and exercise of control over HIV infection. In R. J. DiClemente & J. Peterson (Eds.), Preventing AIDS: Theories and methods of behavioral interventions (pp. 25–59). New York: Plenum.
Centers for Disease Control and Prevention. (2009). Condoms and STDs: Fact sheet for public health personnel. Retrieved May 18, 2009, from http://www.cdc.gov/condomeffectiveness/latex.htm
Crosby, R., Milhausen, R., Sanders, S., Graham, C., & Yarber, W. (2008). Two heads are better than one: The association between condom decision-making and condom use errors and problems. Sexually Transmitted Infections, 84, 196–201.
Crosby, R. A., Salazar, L. F., Yarber, W. L., Sanders, S. A., Graham, C. A., Head, S., et al. (2008). A theory-based approach to understanding condom errors and problems reported by men attending an STI clinic. AIDS and Behavior, 12, 412–418.
Crosby, R. A., Sanders, S. A., Yarber, W. L., Graham, C. A., & Dodge, B. (2002). Condom use errors and problems among college men. Sexually Transmitted Disease, 29, 552–557.
Forsyth, A. D., & Carey, M. P. (1998). Measuring self-efficacy in the context of HIV risk reduction: Research challenges and recommendations. Health Psychology, 17, 559–568.
Goldman, J. A., & Harlow, L. L. (1993). Self-perception variables that mediate AIDS-preventive behavior in college students. Health Psychology, 12, 489–498.
Graham, C. A., Crosby, R. A., Yarber, W. L., Sanders, S. A., McBride, K., Milhausen, R. R., et al. (2006). Erection loss in association with condom use among young men attending a public STI clinic: Potential correlates and implications for risk behavior. Sexual Health, 3, 255– 260.
Lux, K. M., & Petosa, R. (1994). Using the health belief model to pre- dict safer sex intentions of incarcerated youth. Health Education Quarterly, 21, 487–497.
Milhausen, R. R., Wood, J., Crosby, R. A., Graham, C. A., Sanders, S. A., & Yarber, W. L. (2009). A novel home-based intervention to pro- mote condom use among young heterosexual males: A pilot study. Manuscript in preparation.
Sanders, S. A., Graham, C. A., Yarber, W. L., Crosby, R. A., Dodge, B., & Milhausen, R. R. (2003). Condom use errors and problems among women who put condoms on their male partners. Journal of the American Medical Women’s Association, 58, 95–98.
Sanders, S. A., Milhausen, R. R., Crosby, R. A., Graham, C. A., & Yarber, W. L. (2009). Do phosphodiesterase type 5 inhibitors protect against condom-associated erection loss and condom slippage? Journal of Sexual Medicine, 6, 1451–1456.
Schaalma, H., Kok, G., & Peters, L. (1993). Determinants of consistent condom use by adolescents: The impact of experience of sexual inter- course. Health Education Research, 8, 255–269.
St. Lawrence, J. S., Brasfield, T. L., Jefferson, K. W., Alleyne, E., & Shirley, A. (1994). Social support as a factor in African American adolescents’ sexual risk behavior. Journal of Adolescent Health, 9, 292–310.
Wulfert, E., & Wan, C. K. (1993). Condom use: A self-efficacy model. Health Psychology, 12, 346–353. Yarber, W. L., Graham, C. A., Sanders, S. A., & Crosby, R. A. (2004). Correlates of condom breakage and slippage among university stu- dents. International Journal of STD and AIDS, 15, 467–472.
Yarber, W. L., Kennedy, J., Sanders, S. A., Crosby, R. A., Graham, C. A., Heckman, T. G., et al. (2005). Prevalence of condom use errors and problems among Indiana rural men: An exploratory telephone survey. The Health Education Monograph, 22(3), 36–38.