title: Inequitable Gender Norms From Early Adolescence to Young Adulthood in Uganda: Tool Validation and Differences Across Age Groups.
abstract: OBJECTIVE
  We aimed to describe and compare gender norms among 10- to 14-year-olds versus 15- to 24-year-olds and to conduct a rigorous evaluation of the GEM Scale's performance among these two age groups.
  
  
  METHODS
  We conducted a two-stage cluster-sampled survey among 387 females and 583 males, aged 10-24 years, in rural and urban communities near Kampala, Uganda. We applied, assessed, and adapted the GEM Scale (Pulerwitz and Barker, 2008), which measures views toward gender norms in four domains. We describe levels of support for (in)equitable norms, by gender and age, and associations with key health outcomes (partner violence). Confirmatory factor analysis and multi-group measurement invariance analysis were used to assess scale performance.
  
  
  RESULTS
  All participants reported high levels of support for inequitable gender norms; 10- to 14-year-olds were less gender equitable than their older counterparts. For example, 74% of 10- to 14-year-olds and 67% of 15- to 24-year-olds agreed that "a woman should tolerate violence to keep her family together." Comparing responses from males and females indicated similar support for gender inequity. Analyses confirmed a one-factor model, good scale fit for both age groups, and that several items from the scale could be dropped for this sample. The ideal list of items for each age group differed somewhat but covered all four scale domains in either case. An 18-item adapted scale was used to compare mean GEM Scale scores between the two age groups; responses were significantly associated with early sexual debut and partner violence.
  
  
  CONCLUSIONS
  Young people internalize gender norms about sexual and intimate relationships, and violence, at early ages. Programs to address negative health outcomes should explicitly address inequitable gender norms and more consistently expand to reach younger age groups. In this first application of the GEM Scale among 10- to 14-year-olds, we confirm that it is a valid measure in this setting.
authors.affiliation: Population Council, Washington, D.C.. Electronic address: lvu@popcouncil.org.
authors.forename: Lung
authors.initials: L
authors.lastname: Vu
authors.affiliation: Population Council, Washington, D.C.. Electronic address: jpulerwitz@popcouncil.org.
authors.forename: Julie
authors.initials: J
authors.lastname: Pulerwitz
authors.affiliation: Population Council, Washington, D.C.
authors.forename: Brady
authors.initials: B
authors.lastname: Burnett-Zieman
authors.affiliation: Child Health and Development Center, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Cecily
authors.initials: C
authors.lastname: Banura
authors.affiliation: Population Council, Nairobi, Kenya.
authors.forename: Jerry
authors.initials: J
authors.lastname: Okal
authors.affiliation: Population Council, Washington, D.C.
authors.forename: Eileen
authors.initials: E
authors.lastname: Yam
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D017579:Domestic Violence / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D046269:Reproductive Rights / Q000523:psychology*; D012737:Sex Factors; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D066262:Social Norms; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult
keywords: Adolescents; Confirmatory factor analysis; GEM scale; Gender norms; Scale validation; Uganda