Confidence as a predictor of sexual and reproductive health outcomes for youth.
OBJECTIVE
To assess the association between four positive youth development (PYD) constructs of confidence and adolescent sexual and reproductive health (ASRH) outcomes.


METHODS
We searched nine online databases to locate behavioral research that examined the association between four constructs of confidence (belief in the future, self-determination, clear and positive identity, and self-efficacy) and ASRH outcomes (e.g., ever had sex, condom use, contraception use, number of partners, pregnancy/birth, and sexually transmitted infection). Findings were coded as "protective," "risk," or "no association." The presence of at least two longitudinal studies reporting consistent significant associations for at least one ASRH outcome indicated evidence for a protective or risk association.


RESULTS
We found evidence to support two of the four PYD constructs of confidence (belief in the future and self-determination) as protective factors for ASRH outcomes. Evidence was insufficient to draw conclusions about clear and positive identity as a protective factor, and was mixed for self-efficacy. Measures of confidence varied considerably across the studies reviewed, reflecting varying definitions; often, the measures used had limited information on reliability. Few longitudinal investigations were identified, and available studies were inconsistent in how they examined the association between the PYD constructs and ASRH outcomes. Evidence for most constructs was insufficient to identify their influence on specific sub-groups of youth.


CONCLUSIONS
Despite the need for additional research, this review suggests that belief in the future and self-determination are promising protective factors. Further research is needed to better understand the potential for self-efficacy and clear and positive identity as protective factors.
Gloppen
Kari M
KM
Division of Adolescent and School Health, CDC, Atlanta, GA 30341, USA. kgloppen@cdc.gov
David-Ferdon
Corinne
C
Bates
Jessica
J
D000293:Adolescent; D000294:Adolescent Behavior; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D018456:Reproductive Medicine; D020377:Self Efficacy; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control