Adverse childhood experiences and sexual health among young adults: Examining the roles of regulatory focus and patient activation

• Published in: Children and youth services review Vol. 127; p. 106131
• Main Authors: Hubel, Grace S., Goodrum, Nada M., Sundstrom, Beth L.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.08.2021; Elsevier Science Ltd
• Subjects: Adverse childhood experiences; Childhood experiences; Childhood factors; College students; Embarrassment; Emerging adults; Health behavior; Health problems; Health status; Path analysis; Patients; Polls & surveys; Prevention; Self-efficacy; Sexual behavior; Sexual health; Student attitudes; Young adults; Emerging adults; Adverse childhood experiences; Sexual health
• ISSN: 0190-7409; 1873-7765
• DOI: 10.1016/j.childyouth.2021.106131

•College students surveyed on: ACEs, regulatory focus, patient activation, sexual health.•ACEs were strongly related to prevention focus.•Prevention focus predicted few sexual partners, high condom self-efficacy.•ACEs predicted lower patient activation.•Low patient activation predicted low condom self-efficacy, high condom embarrassment. Adverse childhood experiences (ACEs) are a prevalent concern linked to poor health outcomes, including in the area of sexual health. The current study explored factors that might impact sexual health attitudes and behaviors among college students exposed to ACEs. We examined: a) regulatory focus (i.e., type of goals that individuals are likely to pursue), and b) patient activation (i.e., degree of skills, knowledge, beliefs, and motivations that a person has related to their health). College students (N = 503) completed an online survey. The survey assessed exposure to ACEs, regulatory focus, patient activation, condom use self-efficacy, condom embarrassment, and number of past year sexual partners. Reporting a higher number of ACEs was related to greater prevention regulatory focus (p < .001) and lower patient activation (p < .01). In a path analysis examining the indirect effect of ACEs on sexual health through prevention regulatory focus, higher ACEs predicted greater prevention focus which, in turn, predicted fewer sexual partners (β = −0.02, p = .041) and higher condom use self-efficacy (β = 0.03, p = .024). In a path analysis examining the impact of ACEs on sexual health through patient activation, ACEs predicted lower patient activation which, in turn, predicted lower condom use self-efficacy (β = −0.02, p = .048) and higher condom embarrassment (β = 0.02, p = .042). Prevention-focused health messages and improving patient activation may be useful components of interventions targeting sexual health among young adults exposed to ACEs.