DOI

10.17077/etd.30dsmtzv

Document Type

Dissertation

Date of Degree

Spring 2017

Access Restrictions

Access restricted until 07/13/2019

Degree Name

PhD (Doctor of Philosophy)

Degree In

Nursing

First Advisor

Lehan Mackin, Melissa

Second Advisor

Ayres, Lioness

First Committee Member

Campo, Shelly

Second Committee Member

Segre, Lisa

Third Committee Member

Clark, Mary Kathryn

Fourth Committee Member

Lehan Mackin, Melissa

Fifth Committee Member

Ayres, Lioness

Abstract

The concept of responsible sexual behavior (RSB) gained popularity when it was introduced in Healthy People 2010 as a leading health indicator. The Healthy People initiatives organize the top health priorities and create guidelines for improving the health of Americans. Promoting RSB was intended to address problems such as unintended pregnancy and sexually transmitted infections (STIs), however the guidelines never conceptually define behavior that would be considered sexually responsible. Thus, the purpose of this dissertation research was to examine how responsible sexual behavior (RSB) was defined in the context of public health literature, collegiate women, and rural women with the intention to contribute to a clearer conceptual understanding of RSB.

First, an evolutionary concept analysis was conducted to define the attributes of RSB and develop a conceptual definition of responsible sexual behavior (RSB) as it applies to women 18 years and older who have sex with men from a synthesis of lay and public health literature. According to the literature, RSB is a desirable and deliberative pattern of behaviors that promote sexual health, manage risk, and foster respect of sexual partners within the context of community influences. This study also concludes that a purposeful redefinition maybe necessary to maintain a concept that is useful for guiding and evaluating sexual behavior.

Second, a secondary data analysis was completed to identify college women definition of “sexual responsibility.” Data came from interviews collected as part of a mixed methods study of college women and unintended pregnancy. A total of 35 interviews were analyzed using within and across case methodology to derive a working definition of RSB for collegiate women. Women in this sample described being sexually responsible as self-advocating through actions that were consistent with personal goals and values while being aware of consequences that could threaten those goals or values. Actions included mindful partner selection, communicating boundaries, and preventing pregnancy. Women’s academic goals were closely linked to women’s sexual health decision making.

Third, an exploratory descriptive study was completed to identify how rural women who have sex with men define RSB and to understand the role of the rural context on definitions and enactment of RSB. A total of ten rural Iowa women aged 18-29 participated in phone interviews. Within and across case analysis was used to describe the contextual influences of how rural dwelling women defined and enacted responsible sexual behavior. For rural women in this sample, RSB is understanding the consequences of sex and taking action to manage risks by preventing pregnancy and STIs, mindfully selecting of partners, and seeking appropriate resources. The social context of the rural environment acted as both a facilitator and barrier for women to acquire information enact RSB.

In conclusion, RSB was an accessible concept for college and rural women to define and understand. However, the collective research indicated that a new definition of RSB was necessary to maintain its purpose in improving sexual and reproductive health. Thus, being sexually responsible is having an awareness of consequences and managing risks in a way that is reflective of a woman’s personal experiences, beliefs, values, and goals. How BSR is defined is fluid and subject to redefinition based on personal experiences and movement through the lifespan. Future research should focus on understanding how other populations of women define and manage BSR and that public health interventions and policy support women’s ability to be sexually responsible.

Public Abstract

The concept of responsible sexual behavior (RSB) gained popularity when it was introduced in Healthy People 2010 as an indicator for sexual health. Promoting RSB was intended to address problems such as unintended pregnancy and sexually transmitted infections, however the guidelines never clearly defined what they meant by sexually responsible. Thus, the purpose of this dissertation research was to examine how RSB was defined in the collective context of public health literature, collegiate women, and rural women with the intention to contribute to a clearer conceptual understanding of RSB. RSB definitions included an awareness of consequences and managing risk as central attributes in all three studies. The familiarity of the term contributes to a shared understanding but is limited by the potential for judgement that can be extended to a person’s character. Because of this, the collective research suggests that a new definition of RSB may be necessary to continue to be used to improve sexual and reproductive health. It is proposed that RSB be replaced by the concept being sexually responsible which is defined as having an awareness of consequences and managing risk in a way that is reflective of a woman’s personal experiences, beliefs, values, and goals.

Keywords

adult women, collegiate women, qualitative research, responsible sexual behavior, rural woman, unplanned pregnancy

Pages

xi, 133 pages

Bibliography

Includes bibliographical references (pages 128-133).

Copyright

Copyright © 2017 Nicole Mary Loew

Included in

Nursing Commons

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