The Natsal-SF Measure of Sexual Function: Comparison of Three Scoring Methods

The Natsal-SF is a psychometrically validated measure of sexual function for use in community health surveys, derived from 17 questions reflecting three components of sexual function. Scoring requires knowledge of complex statistical modeling and, given the methodological complexities, we assessed the validity of two simplified scoring methods calculated using the factor loadings produced when originally modeling the Natsal-SF items. Method 1 uses these factor loadings to three decimal places, while method 2 assigns whole numbers to each item based on the factor loadings. Scores from these simplified methods are compared to the original score using correlation coefficients, by comparing the distributions and the scores of each method in a linear regression model with key variables. We found scores from the simplified methods both correlate highly with the original score, and the distributions of scores closely match. The simplified methods result in different regression coefficients for gender and relationship context but estimate the coefficients of all other variables similarly to the original method. While the Natsal-SF should ideally be scored using latent variable modeling, the simplified methods perform well so can be used in similar contexts, increasing the utility of the Natsal-SF and enabling future studies to measure sexual function more comprehensively.     

Is “Sexual Competence” at First Heterosexual Intercourse Associated With Subsequent Sexual Health Status?

The timing of first sexual intercourse is often defined in terms of chronological age, with particular focus on “early” first sex. Arguments can be made for a more nuanced concept of readiness and appropriateness of timing of first intercourse. Using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), conducted in 2010–2012, this study examined whether a context-based measure of first intercourse—termed sexual competence—was associated with subsequent sexual health in a population-based sample of 17-to 24-year-olds residing in Britain (n = 2,784). Participants were classified as “sexually competent” at first intercourse if they reported the following four criteria: contraceptive protection, autonomy of decision (not due to external influences), that both partners were “equally willing,” and that it happened at the “right time.” A lack of sexual competence at first intercourse was independently associated with testing positive for human papillomavirus (HPV) at interview; low sexual function in the past year; and among women only, reported sexually transmitted infection (STI) diagnosis ever; unplanned pregnancy in the past year; and having ever experienced nonvolitional sex. These findings provide empirical support for defining the nature of first intercourse with reference to contextual aspects of the experience, as opposed to a sole focus on chronological age at occurrence.     

Pathways from origins to destinations: Stability and change in the roles of cognition,private schools and educational attainment

While much attention has been devoted to measuring levels of social mobility over time, less attention has been given to the possibility of changing pathways to social mobility. This paper examines pathways from social origins to socio-economic destinations in midlife for two British cohorts, born in 1958 and 1970 respectively, using Structural Equation Modelling (SEM). We address the roles of cognitive attainment, private schooling and educational attainment in mediating the link between social origins and destinations. Have these mechanisms become more or less important over time, in a context of structural change in the state schooling system and educational expansion? We find that private schools displayed greater academic selectivity and an increased link to high levels of educational attainment for the younger cohort. Essentially, private schools adapted to changing circumstances, becoming more academically selective and less socially selective, and more focused on educational credentials. Childhood social origins were less strongly linked to childhood cognitive scores in the younger cohort, but cognitive scores were also more weakly linked to educational attainment for this cohort. We also find a decreased association between social origins and educational attainment for the younger cohort. While the finding that educational inequalities weakened over this time period is positive, the lack of a corresponding reduction in the overall link between social origins and destinations suggests that reducing educational inequalities was not sufficient to increase social mobility when accompanied by countervailing changes in the role of private schools.     

Health Measurement in Population Surveys: Combining Information from Self-reported and Observer-Measured Health Indicators

Our primary aim is to develop and validate a population health metric for survey-based health assessment that combines information from both self-reported and observer-measured health indicators. A secondary objective is to use this index to examine gender and socioeconomic differentials in the health status of older people. We use data from the second wave of the English Longitudinal Study of Ageing (ELSA) conducted in 2004 (N = 8,870). Information from three observer-measured and three self-reported health indicators was combined, using a latent variable modeling approach. A model that decomposed the manifest health indicators to valid health, systematic error, and random error was found to fit the data best. The latent health dimension represented somatic health, and was tested against three external criteria: height, waist-hip ratio, and smoking status. We present the Latent Index of Somatic Health (LISH), as well as a procedure for deriving the LISH in surveys employing both self- and observer-measured health indicators. Observer-measured and self-reported indicators were found to be equally biased in indexing population somatic health, with the exception of self-reports of functional limitations, which was the most reliable somatic health indicator. As expected, results showed that women had worse health than men and that socioeconomic advantage is associated with better somatic health.