Predisposing, enabling and need-for-care predictors of adolescents' intention to use sexual health services

Background: The study aimed to understand the influence of predisposing, enabling and need-for-care factors on adolescents' intention to use sexual health services, using Andersen's Behavioural Model of Health Service Utilisation to organise and test these factors. Methods: A sample of predominantly Hispanic teens (n = 600) in Los Angeles, California completed a self-report survey about their sexual health knowledge, beliefs, intentions, and behaviours. Hierarchical regression modelling was used to examine the incremental influences on adolescents' intention to use sexual health services of: 1) predisposing sociodemographic factors; 2) predisposing knowledge and beliefs about sexual health; 3) enabling factors regarding perceived access to sexual health services; and 4) a need-for-care factor (sexual experience). Results: Adolescents reported high intentions to use sexual health services (3.25 on a 4-point scale), yet only 42% reported knowing where to access services. Sexual health knowledge and beliefs significantly predicted adolescents' intention to use services beyond the effect of sociodemographics (P < 0.001). Enabling factors indicating awareness of and importance attributed to accessibility significantly predicted intention to use services incremental to predisposing factors (P < 0.001). However, need for care - that is, sexual experience - was not statistically associated with intention to use services (P = 0.402). Conclusions: Sexual health interventions are needed to provide sexual health information, promote positive beliefs about health care, and ensure adolescents' awareness of and access to sexual health services.