Condom use self-efficacy with Indigenous youth: the integration of factor analysis with participatory research

Indigenous youth in the United States are at elevated risk of infection with Human Immunodeficiency Virus (HIV) and other sexually transmitted infections (STIs) compared to non-Indigenous youth populations. Condom use is an effective strategy to mitigate HIV and STI transmission, and condom use self-efficacy (CUSE) is a key focal point of sexual and reproductive health interventions for Indigenous youth. CUSE scales can be used to measure CUSE, but most CUSE scales have been validated with non-Indigenous youth. The current study utilized a community-based participatory research framework to involve Indigenous research partners in validating a 12-item CUSE scale used with Indigenous youth using exploratory factor analysis and structural equation modeling. Results were co-interpreted with tribal research partners. Co-interpretation sessions were recorded and relevant quotes were matched to quantitative results. The 12-item CUSE scale had good model fit, and tribal research partners provided tribally specific interpretations of the study results. The study highlights a decolonial process that empowers Indigenous research partners to assert their values and culture during quantitative results interpretation. Other Indigenous researchers and allies can use this study as an example for validating and using existing psychometric scales in their research.