Introduction

Issues of sexual and reproductive health are complex, particularly during adolescence. They represent a global cause for concern, especially in developing countries ¹. Research has focused on sexual relations and their results, namely sexually transmitted diseases, unintended pregnancies, and HIV ². In low and average-income countries, the pregnancy rate among girls younger than 15 is roughly one million ³, hence the need for new approaches to preventing pregnancy before the middle or late adolescence, focused on early adolescent women aged between 10 and 14. Girls in this age range face the biggest obstacles to achieving their full potential and development and display a lower ability to make good life decisions related to their sexual and reproductive health ⁴.

This population of early adolescent girls is generally considered sexually inactive but is indeed the opposite ⁵. A study in Taiwan revealed that this population displayed a high level of sexual activity regarding kisses, caresses, and contemplating the possibility of sexual relations ⁶. These results showed that adolescent girls were conscious of their erotic feelings and sexual desire ⁶.

According to the social cognitive theory, a person's self-efficacy and belief in their ability to adopt a particular behavior in a specific situation are related to their skills and knowledge of their actual conduct ⁷. Therefore, adolescents' favorable opinions of themselves as sexual beings improve their ability to identify sexual risks and take actions to ensure the safety of their sexual health and well-being ⁸. This way, the consolidation and development of the sexual self-concept during early adolescence become essential.

The sexual self-concept comprises sexual behaviors, attitudes, feelings, self-esteem, and self-confidence ⁹. Moreover, it is a multidimensional construct that includes negative or positive perceptions and feelings about oneself as a sexual being ⁸. During adolescence, a person's sexual self-concept evolves along with their development and growth and becomes established in future sexual conduct ¹⁰.

Presently, scales have been devised to analyze the sexual self-concept among women. Nonetheless, despite it being necessary, few studies have focused on measuring the sexual self-concept as a predictor of sexual activity among early adolescent girls ^10,11.

In healthcare, measurements carried out in the biophysical dimension have been predominant, but the biophysical approach does not consider the subjective attributes of the different phenomena ¹². Consequently, there arises the need for instruments that evaluate the subjective properties of constructs and dimensions, which are necessary to direct actions for treating, preventing, or promoting health. Scales allow for analyzing the unmeasurable physical, social, and psychological dimensions through observation. The information must be obtained validly and reliably ¹³.

In our search for instruments, particularly those related to the sexual and reproductive health of early adolescent girls, we performed the transcultural adaptation of the Sexual Self-concept Inventory (SSCI) in English ¹⁴ to analyze how prepared the girls were in terms of sexual maturity. This instrument helps predict sexual health and well-being, including positive affect and the assessment of sexual desire ^15,16. Previous studies showed that sexual arousability and agency were linked to sexual self-esteem and future orientation toward positive sexuality, with a low desire to engage in sexual relations ⁵.

Sexual arousability is the feeling or right to engage in sexual activities. When adolescent women have a people-oriented perspective on sexuality, pregnancy and early-first-sexual-relation rates diminish. The sexual agency represents the positive assessments of sexuality through thoughts, feelings, behaviors, and body perceptions within the sexual context. Generally, adolescents with higher sexual self-esteem feel safer in sexuality-related situations ^5,10.

Sexual anxiety refers to tensions, nuisances, and negative assessments of sexuality. It manifests through abstinence, low possibility of engaging in sexual relations soon, not having a partner, or taking very little part in erotic expressions. As mentioned earlier, this SSCI is valid for analyzing the opinions of early adolescent girls on their sexuality and sexual behavior and could be helpful in healthcare studies and risk-related decision-making ^5,10,17.

This study aims to establish the validity and reliability of the SSCI in Spanish among the Colombian population of Santander.

Materials and methods

In this methodological study, we used psychometric samples to determine the reliability and dependability of the SSCI in Spanish. Reliability refers to the accuracy with which the instrument evaluates the attributes for which it was built. Those attributes show a correlation between the items that make up the construct, which need to be homogenous ¹⁸. Dependability is the ability of an instrument to consistently measure an element reflected by Cronbach's alpha coefficient, which reveals how far the items go in measuring the construct. This property is related to the validity of the instrument ¹⁹.

Results

We administered the Spanish version of the SSCI to 308 adolescent girls from two schools. The girls were between 10 and 14 years old and had an education level that ranged between sixth (31 °%), seventh (32 °%), eighth (22 °%), ninth (10 °%), and tenth grade (4 °%).

We analyzed the baseline Cronbach's alpha to establish the internal consistency of the instrument. For the full scale, it was 0.89, whereas, for factors one, two, and three, it was 0.908, 0.812, and 0.572, respectively. We noticed that factors one and two displayed an acceptable coefficient, while factor three displayed a lower score, which can be explained by the fact that it had fewer items than the other factors (Table 1).

The Kolmogorov-Smirnov test for assessing normality was significant for the SSCI (p = .001). The median score on the SSCI among the participant population was 3.17, while the sexual arousability factor was 2.52, the sexual agency factor was 3.8, and the negative sexual affect factor was 3.9 (Figure 1).

Source: Own elaboration

Figure 1 Median showing the scores of the SSCI and its factors 

We used the sample adequacy tests from the KMO data matrix (sample adequacy measure) and Bartlett's test of sphericity to analyze the data. In our case, the KMO indicated that the variables measured common factors with a value of 0.85 and a Bartlett test with p = 0.000. Thus, the data was suitable for the analysis.

Using factor analysis with the extraction of the principal components and varimax rotation of the three factors, we considered the items with a value higher than 0.4. When revising the communality of the 34 items, we discovered that not all of them corresponded with the initial factor (Table 2).

The total explained variance for the factor variables stands at 43.261 % for the 34 items that make up the SSCI, as seen below in Table 3.

Considering that for the sexual arousability factor, which included items between 1 and 17 in the original version, three items, namely, 7, 11, and 15, are now excluded and subsequently assigned to factor two. In addition, items AS1, AS2, AS7, and AS9 are moved from factor two (sexual agency) to factor one, leaving factor one with 18 items. Therefore, factor two keeps six original items, plus items 7, 11, and 15 from factor one, and items ESN1 and ESN5 from factor three (negative sexual affect), totaling eleven items. Lastly, factor three keeps five items from the original scale and item ES5, which has a similar value within two factors left there according to the original scale. Table 4 shows the scale with the rearranged items.

Discussion

The thorough methodological process developed throughout this psychometrics-based study allows us to evaluate the SSCI in Spanish, for which we frequently used Cronbach's alpha coefficient. This enabled us to identify the level of accuracy of the adaptation process, after which we would be able to interpret the scores obtained appropriately to generate more accurate, unquestionable knowledge ^26,27.

The sexual self-concept has been considered a predictor of the sexuality of early adolescent girls⁶, departing from the definition of the sexual self-concept as a person's perception of their sexual self ⁸. In present times, sexual self-concept scales in the adoles cent population have been developed ⁵, which require validation within the various contexts that involve early adolescents. That is why our study in Colombia, whose sample of 308 participants from a school environment was lower than the one in Taiwan (590) and higher than the one in New York (180), highlighted the fact that the instrument obtained similar reliability ⁵ overall, although lower when it came to the negative sexual affect dimension ²⁸. The explained variance in our study (43.261 °%) is different from the one in the New York version, reflecting a higher development of the scale. In addition, we did not include data on puberty-, family- or religious-related development.

The SSCI for early adolescent girls adapted in this study represents a tool to analyze dimensions like sexual arousability, which has been studied and referred to as a trait and component of sexual response, aiding the development of a positive assessment of sexual ability. Knowledge of its response tendency will allow us to evaluate interactions with others and the pleasant experience of sexuality with improvements in sexual self-esteem ²⁹.

The sexual self-concept significantly influences knowledge related to sexual health, as it represents a mediatory factor for the protection and treatment of adolescents' sexual behaviors ²⁸. A different study ³⁰ has analyzed the direct correlation between the positive/negative sexual self-concept and safe intercourse, enabling people to adopt healthy sexual behaviors. According to other authors, self-concept and self-efficacy contribute to developing self-care conduct, motivating people to adopt behaviors beneficial to their health ³¹.

The results showcase good reliability of the factors, with the exploratory factor analysis reproducing the structure in the original version of the scale, which indicated that it was suitable for use among the Colombian population. The results are promising; thus, further research on other validity evidence could make the Colombian version of the scale more solid, following the established psychometric standards.

Conclusions

The SSCI, designed as a sexual predictor among early adolescent girls, displays an excellent psychometric quality in our study. Further studies on its predictive capacity, with evidence of validity based on the link with other variables, can contribute to this instrument becoming useful for predicting sexual conduct in diverse cultural contexts.

Our adapted instrument helps develop research and comparison with other similar instruments, including the participation of parents and teachers in interventions related to sexual and reproductive health.

In the results obtained through exploratory factor analysis, the items were rearranged based on the observed interrelations and higher affinity with the respective factor. This modified the original scale, which means that further studies should be conducted using the adjusted scale and comparing the results to verify the scale's internal structure.