1.) Was this a qualitative or quantitative study?

2.) What was the sample size?

3.) What was the age range of the sample?

4.) What sampling methods were utilized and why?

5.) Was this a probability or non-probability sample?

6.) The authors decide to follow up this study with one that randomly selects 100 abstinent female adolescents and assigns half of them to a group that offers creative activities and the other half receive a traditional sex education program. They then follow the group to determine how many of the adolescents initiate sexual activity within the next year. Write an appropriate null hypothesis for this study.

7.) Write an appropriate alternative hypothesis for this study.

8.) The follow up study has an alpha of 0.05 and reports that the group of adolescents who were offered the creative activities waiting on average 10 months before initiating sexual activity while the group that had the traditional sex education program waiting on average seven months before initiating sexual activity. Was this a statistically significant difference?

9.) You analyze the difference in months before initiating sexual activity using a t-test to compare the group means and determine that the p value is 0.08. Is the difference statistically significant?

10.) If your conclusion is not correct, what type of error might you be making?

JOURNAL OF COMMUNITY HEALTH NURSING, 2007, 24(4), 215-236 Copyright @ 2007, Lawrence Erlbaum Associates, Inc. The Experience of Having Become Sexually Active For Teen Mothers Vicki Ellison Burns, PhD, RN, APRN-BC School of Nursing, University of Louisville Eileen J. Porter, PhD, RN School of Nursing, University of Missouri-Columbia The purpose of this phenomenological study was to describe teen mothers' experience of having become sexually active. Most scholars who have studied teen sexual behavior have used quantitative methods and measured constructs such as self-esteem. Prior to data-gath- ering, literature about teen sexual behavior was reviewed and set aside to enable a more di- rect focus on data. Parental consent for participation was obtained for participants under 18. Of the 10 participants (aged 16 to 19 years), all had at least one living child. Each participant took part in 3 audiotaped interviews. Data about perceptions, actions, and intentions were compared across each participant's interviews and interviews of all participants. Four phe- nomena were discerned as ways in which participants had structured their experiences: (a) making a safe place, (b) redefining myself, (c) creating my own life story, and (c) engaging with the unknown. Compared to prior literature, the phenomena offer a richer and deeper perspective on teen sexual behavior. Findings suggest that efforts to increase perceptions of safety, to support personal identity, to bolster creativity, and to offer exploratory opportuni- ties beyond sexual encounters could enhance effectiveness of programs designed to prevent early-onset sexual activity. The overall purpose of this phenomenological study was to describe the experience of having become sexually active for teen mothers. There is a dearth of current research fo- cused on teens' experiences related to sexual behavior. Rather than studying the experi- ences of sexually active teens, most scholars have focused on measuring constructs such as self-esteem (Salazar et al., 2005), family environment factors (Nash, McQueen, & Bray, 2005), and history of abuse (Windle & Maxon, 2004). This lack of attention to the unique voices of teens has created a critical gap in the knowledge base of nursing science. There are few data about the experience of having become sexually active; such informa- tion could be useful in designing focused interventions for preventing pregnancy. Be- Correspondence should be addressed to Vicki Ellison Burns, PhD, RN, APRN-BC, University of Louis- ville School of Nursing, 550 S. Floyd Street, Louisville, KY 40292. E-mail: veburn01 @louisville.edu216 Burns and Porter cause this study illuminates important features of teen sexual behavior, it is a potential source of guidance for practitioners. REVIEW OF THE LITERATURE About one million teen girls (11% of all 13-19 year-olds) become pregnant each year (McFeely, 2005). Pregnancy rates among girls aged 15 to 19 fell between 1991 and 2004 from 61.8 per 1000 to 41.2 per 1000 (Hamilton, Brady, Ventura, Martin, & Sutton, 2005) However, teen pregnancy remains a serious health-related issue, because the decline is not uniform across groups within the population. The most notable decline (24.2%) was for urban teens, whereas pregnancies among rural teens declined only 11.5%. Teen preg- nancy rates have been higher among Blacks than Whites or Hispanics (Hamilton et al., 2005). Pregnancy during the teen years can be a catalyst for a lifetime of social, psychologi- cal, and economic problems (Marx & Hopper, 2005). Of qualitative studies relevant to teen sexuality, most are focused on pregnancy, childbirth, and parenting (Dallas, 2004; Levin & Helfrich, 2004). Scholars have studied teen perspectives on social and familial risk factors for pregnancy (Young, Turner, Denny, & Young, 2004), pregnancy preven- tion strategies (Kalmuss, Davidson, Cohall, Laraque, & Cassell, 2003; Marx & Hopper, 2005), and efficacy of educational and supportive programs for teen parents (McFeely, 2005; Scott et al., 2004). The main scholarly emphasis, however, has been decision-mak- ing relative to sexual behavior (Brown & Simpson, 2000; Galotti, 2005). Decision-Making And The Initiation Of Sexual Activity By Teens In decision-making situations, teens and adults have a similar core process-diagnosing the problem, evaluating possible actions, selecting an action, and reevaluating the choice (Borcherding & Schaefer, 1982; Michels, Kropp, Eyre, & Halpern-Felscher, 2005) However, teens and adults differ in appraising the potential seriousness of a situation and its risk/benefit ratio (Brown & Simpson, 2000; Norris, Clark, & Magnus, 2003). Whether teens frame decisions in terms of negative consequences or positive outcomes is a critical factor in their choices (Galotti, 2005; Gardner & Steinberg, 2005). In this context, the perceptions, actions, and intentions of teens relative to sexuality take on an essential im- portance-an emphasis that is fully consistent with the philosophy underlying descrip- tive phenomenology. Phenomenology is focused on discerning the actions, perceptions, and intentions of persons relative to an experience (Husserl, 1913/1962). Persons structure experience through intentional acts (Husser], 1913/1962; Kohak, 1978). According to Kohak (1978), "intentionality is an internal structure of lived experience" (p. 63). People intend by go-Teen Mothers Becoming Sexually Active 217 ing toward and constituting the objects in their world (Kohak, 1978), and it is the task of the researcher to understand this "thrust" (Kohak, 1978, p. 110) or intention. Intentions are what a person "seeks to do with his world" and "the way the subject grasps and molds his experience" (Kohak, 1978, p. 110). In this context, perceiving is not passive in nature; instead, it is "something a subject does to and with the world" (Kohak, 1978, p. 121). Any specific perception of an object is a synthesis by one's consciousness of endless varia- tions of views about it (Kohak, 1978). Therefore, the phenomenological researcher at- tempts to discern and to describe what participants are trying to do pertaining to an exper rience of interest. In addition to directly inviting discussion of intentions, the researcher also seeks to understand actions and perceptions pertaining to the experience, because actions and perceptions are sources of knowledge about intentions (Porter, 1998). Be- cause descriptive phenomenology is concerned with actions, perceptions, and intentions (Porter, 1994), the remainder of the literature review is focused accordingly. Actions. Scholars have used a variety of developmental approaches to explain or predict teen behavior in terms of choices and actions. In a meta-analysis of relevant litera- ture, Hall and Jugovich (1997) concluded that these cognitive skills increased dramati- cally from age 10 to age 14: (a) imagining risks and future consequences, (b) being will- ing to consult professionals, (c) being aware of vested interests, (d) managing personally relevant situations to make a decision, (e) engaging in complex thought regarding com- mitments, and (f) knowing problem-solving strategies and acting accordingly. Indeed, by age 14, teens might be able to think about medical treatment decisions at an adult level. However, that same level of competence is not necessarily evident with decisions involv- ing risk-taking behaviors (Schmitt, 2006; Stephenson, Quick, Atkinson, & Tschida, 2005). The thinking of teens in emotionally-charged situations is likely to be much less sophisticated than in less arousing circumstances (Flores, Tschann, & Van Oss, 2002; Tortolero et al., 2005). Factors like loneliness (Mahon, Yarcheski, & Yarcheski, 2004) also impact the perception of risk and, therefore, affect the decision-making of teens. Perceptions. The unique ways in which teens perceive themselves and their world affect their choices (Ginzberg & Rogers, 1992; Unger, Molina, & Teran, 2000). Gender has been a variable of interest, because, compared to boys, girls have been found to be (a) less permissive in their perception of premarital sexuality, (b) less likely to perceive ac- cess to birth control or strong emotional bonds as justification for sexual involvement, (c) more likely to see sexual urges as controllable, and (d) more likely to view sexual in- volvement as an obstacle to future goal attainment (DeGaston, Weed, & Jensen, 1996; Williams & Vines, 1999). However, many teens have viewed risks that could accompany abstinence (insecurity, possible loss of the relationship, and being alone) as greater than the potential risks of pregnancy or sexually transmitted diseases (Norris et al., 2003).218 Burns and Porter Intentions. To explain and predict intentions of teens regarding lifestyle choices (Tremblay & Frigon, 2004), scholars have used various models such as the theory of rea- soned action (Ajzen & Fishbein, 1980) and the theory of planned behavior (Ajzen, 1991). Both models are grounded in the idea that attitudes are a function of beliefs and the evalu- ation of those beliefs. Their central premises are based upon the notion that social norms are extremely influential when people decide on a course of action (Ajzen & Fishbein). In addition, the effects of family environment on decision-making have been found to be substantial. Dysfunctional family environment, characterized by a high degree of con- flict, has been associated with impaired ability of teens to make decisions (Giannone, Medeiros, Elliot, Perez, Carlson, & Epstein, 2004; Kellogg, Hoffman, & Taylor, 1999). Validity Of Constructs Relevant To The Research Problem It has been well established that adolescents differ developmentally, emotionally, and perceptually from adults in myriad ways (Newman & Newman, 1975). Newman and Newman stated that adolescents define situations and events according to a unique set of rules, and that the way they conceptualize things such as time, values, and intensity of feeling cannot be realistically compared on the same scale as that of adults. The assump- tion that an instrument whose validity was established on adult samples will serve adoles- cent research in a similar manner creates the possibility that erroneous results could be obtained. Among the constructs viewed as predictors of sexual behavior in teens, self-esteem has been a key indicator of risk (Kershaw, Ethier, Niccolai, Lewis, & Ickovics, 2003; Young, Donnelly, & Denny, 2004). Poor self-esteem has been linked to early-onset sex- ual activity. The Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965), a 10-item, self-administered, Guttman scale that measures self-esteem as a global self-attitude, has been widely used in such research. Although Rosenberg obtained acceptable reproduciblety and scalability coefficients for the RSES with high school students, most subsequent psychometric testing has been done with adults (Crandall, 1973; Kaplan & Pokorny, 1969; Silber & Tippett, 1965). In studies summarized by Curbow and Summerfield (1991), internal consistency of the RSES, as measured by coefficient alpha, ranged from .76 to .87 for persons aged 18 to 50. When initial reliability is estimated with only one age group, an instrument might not be suitable for measuring the construct in all age groups (Brink & Wood, 1998). Never- theless, the RSES has had acceptable reliability and validity in numerous studies with teens (Birndorf, Ryan, Avinger, & Aten, 2005; Gaff-Smith, 2004; Salazar et al., 2005). It is surely useful to consider self-esteem and its impact on sexual decision-making among teens, but the measurement of such constructs does not yield data about teens' personal experiences. Exploring the actions, perceptions, and intentions of teens relative to be- coming sexually active could shed new light on their choices and decisions.Teen Mothers Becoming Sexually Active 219 The Research Problem Scholars have focused upon decision-making of teens as the premier framework for un- derstanding sexual behavior among teens. Yet there is no evidence that teens consider the onset of sexual behavior to be the result of a conscious process of decision-making. Therefore, it cannot be assumed that the initiation of sexual activity among teens is best understood as a deliberative cognitive process. Because the experience of becoming sex- ually active is foundational to all other topics related to sexual activity and teen preg- nancy, the absence of descriptive studies about it is problematic. Without such data, dis- course about decision-making relative to sexual activity will remain speculative. Practitioners could use empirical data about the experience of having become sexually active to better understand important personalsocial circumstances of teenage mothers, such as those already highlighted here, including family environment and loneliness. Such data could also be used preventively as a resource in educational efforts to prevent teenage pregnancy. Teen mothers could provide useful information about the experience from a retrospective standpoint. Therefore, the research question of this study was: What is the experience of having become sexually active for teen mothers? METHOD The study was approved by the Health Sciences Institutional Review Board at the Univer- sity of Missouri-Columbia. Porter's (1994, 1995, 1998) descriptive phenomenological method was used. It had been based on the book Ideas (Husserl, 191331962) and other pertinent resources (Kohak, 1918; Spiegelberg, 1994). The method involves eight re- search activities, including some carried out prior to data collection. These activities are: (a) \"explore the diversity of one's consciousness,\" (b) \"reflect on experiences,\" (c) \"bracket, or perform phenomenological reduction,\" (d) \"explore the participant's life-world,\" (e) \"intuit the structures through descriptive analysis,\" (f) \"engage in intersubjective dialogue about the phenomena and contextual features,\" (g) \"attempt to ll out the phenomena,\" and (h) \"determine uses for phenomena and features\" (Porter, 1998, p. 20}. An interest in the personal and social context of experience also is basic to the method (Porter, 1995). Prior to data-gathering, the first author reflected upon relevant personal experiences, including the parenting of teens and prior scholarly work with teen mothers. Documenting those reflections enabled her to recognize those facets of experi- ence as her own and to pursue data collection with an open mind. Literature about con- structs pertinent to teen sexual behavior, such as self-esteem and decision-making, was reviewed and set aside prior to data gathering. That is, interview questions were not de- signed to explore the construct of self-esteem or the decision-making process. This effort to bracketboth personal experiences and scientic constructs enabled a sharper focus on the participants' experiences. To ensure that this focus was retained throughout 220 Burns and Porter data-gathering, the first author sought participants' views as to whether emergent inten- tions were consistent with their experiences. Likewise, the authors often engaged in that dialogue that is essential to lling out or refining the understanding of an experience and its personalsocial context. Last, potential uses for the phenomena and features were identied as implications for practice and research. Sampling Data were gathered from in-depth, one-on-one interviews, and the phenomenologist con- sidered and reconsidered data carefully to intuit phenomena directly presented in experi- ence (Kohak, 19'!8). Therefore, a small sample (in general, no more than 10 participants, as long as no new data are being obtained after interviews with that number} is appropri- ate for descriptive phenomenological studies (Field & Morse, 1995), and that sample size was selected. TWo data-gathering interviews were conducted with each participant, each of them lasting between 45 min and 2 hr, and one final interview was conducted with each teen, which was designed to validate the research findings. These final interviews are called member checks (Field and Morse, 1995), and each of these lasted an average of 45 min. Because of the in-depth nature of the three interviews that were conducted with each participant, the first author was able to establish that no new data were being obtained from any participant by the time the last interviews were completed. Therefore, before the study was closed to enrollment, the sample size of 10 was considered adequate. In a descriptive phenomenological study, participants also must share unique charac- teristics basic to the research problem and be willing and able to share pertinent data (Porter, 1999). To explore the diversity of experience within commonality (Husserl, 1913:1962), a sample must be delimited by certain demographic characteristics. There- fore, a three-stage sampling strategy was used that involved sequential phases of conve- nience, purposive, and quota sampling (Porter, 1999). Convenience sampling. First, convenience was considered in defining the \"geo- graphically accessible population\" (Porter, 1999, p. 798) as teenage girls living within 75 miles of the interviewer's home. Description of experiences requires multiple contacts with participants over time (Porter, 1998), so participants had to be accessible to the in- terviewer. Purposive sampling. Purposive sampling was involved in that potential partici- pants had to be 13 to 19 years of agethe age range of adolescence (Newman & Newman, 1986). Further inclusion criteria were then applied. The maxim of avoiding po- tential harm to participants was basic to the decision to enroll only teens who had borne a Teen Mothers Becoming Sexually Active 221 child. The parent of a teen younger than 18 years of age had to consent to her participa- tion. By volunteering, minors could have revealed to parents that they had initiated sexual activitya revelation that could have had a problematic impact upon the family. Teens who had terminated a pregnancy, had a spontaneous abortion, given ababy up for adop- tion, or had lost a child to death were not included; loss and grieving can alter recall of events (Bosticco 81. Thompson, 2005; Cody, 2000). Pregnant teens were not excluded if they met the other criteria. Potential participants were not asked whether the initial en- counter was consensual. However, during interviews all participants said that they had consented to their first sexual experience. Quota sampling. Quota sampling is indicated, to \"represent the conditions to be studied rather than the proportion of people in the universe\" (Luborsky & Rubinstein, 1995, p. 104), when the experience of interest might vary with demographic characteris- tics (Sandelowski, 1995). Such a variation was possible relative to the experience of hav- ing become sexually active because, in Missouri, birth rates had declined more for urban teens than for rural teens (Missouri Department of Health, 2003), and the teen birth rate was higher for Blacks than for Whites. Accordingly, quota sampling was done based on residence location (ruralurban) and ethnicity (BlackWhite). The United States Depart- ment of Commerce, Bureau of the Census (2002), defined a rural person as one who lives outside a city with fewer than 2500 residents, and an urban person is one who lives in an urbanized area or in a place of 2500 or more residents outside an urbanized area. Al- though Blacks comprise 1 1% of Missouri residents, 30% of pregnant teens in the state in 2003 were Black (Missouri Department of Health). Accordingly, Black teens (about 11 % of teen females in Missouri) and rural teens (about 25% of teen females in Missouri) were oversampled. Ethnicity was considered rst in stratifying the sample, followed by residence location. Of the 10 participants, five teens were Black and 5 were White. Five were from rural towns of fewer than 2500 per- sons and 5 lived in acity of 125,000 persons. An importantconsideration was that very few Blacks live in rural areas in Missouri (Missouri Departmentof Health, 2000). Of the 5 Black participants, we were able to recruit only 2 who resided in rural areas. Eight teens were mothers of one child, 2 teens were mothers of two children, and 1 teen was pregnant with her second child. The reported age of initiation of sexual activity ranged from 12 to 15 years. Teen mothers are a vulnerable population (Lutz, Shelton, Robrecht, Hatton, & Beckett, 2000), so special ethics considerations governed study enrollment and data-gathering. Over a 3-month period, notices about the study were posted at acompre- hensive educational and support program for teen parents, Women Infants and Children clinics, local health departments, high schools, and alternative high schools for at-risk teens. To express interest, volunteers called the first author or sent a letter in a preaddressed, stamped envelope. Volunteers were contacted by telephone or mail, as they 222 Burns and Porter preferred. In a preliminary telephone conversation or interview, the inclusion criteria were reviewed. 0f 1'! volunteers, 10 met all inclusion criteria. After the informed consent was reviewed with those 10 volunteers, 6 teens, aged 18 and 19, agreed to take part. For those 4 teens who were under the age of 18 (2 were age 16 and 2 were age 1?), legal guardians were included in every phase of the informed consent procedure. Volunteers under 18 were given two copies of an information sheet about the study, invited to talk with a parent or legal guardian about the study while reviewing the information sheet, and asked to contact the first author thereafter. When those volunteers informed the rst author that the parentor legal guardian was willing to give consent, she contacted the parent by telephone to verify that information, to answer questions about the study, and to schedule an appointment to review both the minor assent and parental consent forms and to obtain both signatures. Confidentiality was safeguarded. Each participant was assigned a code number to identify the taped interviews. The first author kept the lists of names, addresses, tele- phone numbers, and code numbers in a locked le cabinet; interviews and transcripts were stored in a separate locked file. Participants were informed that all identifying in- formation would be destroyed after data were analyzed. However, participants were told that condentiality would not be maintained if they shared information that the in- terviewer was obligated to report to parents, to law enforcement, and to social welfare authorities, such as evidence of (a) child abuse or neglect, (b) substance abuse, (d) mental illness, or (e) potential danger to self or others. No such reports were necessary during the study. Participants also were told that if it was revealed that their first sexual experience might have resulted from statutory rape, this would have to be reported in accordance with state laws (Findholt & Robrecht, 2002). None of the participants re- ported such information. There were also plans in place to initiate referrals for coun- seling if the interview experience caused undue emotional distress, but no such refer- rals were needed. Data Gathering The descriptive phenomenological researcher tries to discern the intentional acts through which persons structure their experiences (Husserl, 191311962; Kohak, 1918; Porter, 1994, 1998). Data of interest were perceptions, actions, and intentions (Porter, 1994, 1998) about the experience of having become sexually active. The rationale for those three foci emerged from phenomenological philosophy. Kohak wrote this about the im- portance of perceptions: \"It is not simply the passive presence of an object in a subject's eld of vision but his act of perceiving that constitutes the perceived as intelligible" (pp. 122123). Husserl wrote about actions as data sources: \"We 'behold the living expe- riences of others' through the perception of their bodily behavior\" (p. 46). Finally, inten- Teen Mothers Becoming Sexually Active 223 tions are what a person \"seeks to do with his world" (Kohak, 1978, p. 110). Participants tend to directly report some intentions, but other intentions can be discerned from data about perceptions and actions (Porter, 1998). The interview guide was based on three broad, open-ended questions: 1. \"Tell me about the rst time you had sex and what that was like for you.\" 2. \"Were there certain things about you as a person that you believe may have influ- enced you to become sexually active?\" 3. \"Were there things about the world around you and the people in it that you believe may have contributed to your becoming sexually active?\" Relevant probes included: 1. \"Describe your feelings about relationships and sex at the time you became sexu- ally active.\" 2. \"Tell me about the relationship you had with the partner with whom you became sexually active.\" 3. \"Tell me aboutother relationships in your life at the time you became sexually ac- tive." The interview guide was designed to yield information about the action of having be- come sexually active, any intention(s) associated with the action, the perceptions of both self and others that might have influenced the action and the intentions, and the per- sonalsocial context of the experience. Probes were developed and used to enable clari- cation and expansion of preliminary responses to questions. To enhance its efficacy, the interview guide was shared with a community health nurse who had extensive experience with teens, a teen mother who was not a participant, and five doctorally-prepared nurse researchers. The interview guide was pretested with a teen mother who did not partici- pate in the study, and some minor changes were made. The first interview was scheduled after informed consent was obtained. Participants were asked to choose an interview setting that was comfortable, quiet, and private (Riesch, Tosi, & Thurston, 1999). Six teens lived independently with their children, so their interviews were done in their homes. Four participants lived with another person, so their interviews took place in a private conference room at a local library. Three audiotaped interviews were conducted with each participant. Interviews ranged in length from 45 min to 2 hr. The first author transcribed the tapes within 24 hr to pro- mote accuracy and recall (Miles & Huberman, 1994). Because participants' actions during the interview process are an important data source, observations of relevant nonverbal behaviors, such as a tearful expression, were documented within interview transcripts. 224 Burns and Porter Data Analysis Analysis activities specied in the method (Porter, 1994, 1998) were undertaken by the rst author in consultation with the second author. Initially, participants' actions were differentiated from their perceptions; intentions associated with those actions and per- ceptions were isolated. Then similar intentions in each participant's interviews could be identied. Intentions within each interview, across interviews of each participant, and across the sample were grouped based on identified similarities and differences. For example, with regard to the phenomenon creating my own We story, several teens described the perception that the sexual relationships of their mothers and other female relatives had been almost universally negative. An action they performed relative to that perception was becoming sexually active, with the intention of separating them- selves and their sexual realities from those of other signicant women in their lives thereby creating an experience that was uniquely their own. Thus, emergent phenom- ena were discerned (Porter, 1998) that were representations of the essence of the expe- rience. Using both inductive and deductive analysis (Porter, 1994), the parts or compo- nents of phenomena were differentiated from larger phenomena Phenomena were descriptors of the experience of the sample, whereas components pertained to the ex- periences of some participants. The researcher cannot know in advance that a given data example will yield a more specic intention than that yielded by another data ex- ample, so both inductive and deductive reasoning are employed. Having claried that an intention is part of a broader intention, we explore other data to determine whether that larger intention is, itself, part of something more general. The grouping of inten- tions into categories (component phenomena) and yet larger categories (phenomena) thereby reveals the structure of the experience. The philosophical underpinning of the method dictates that the researcher must seek to discern and reveal this underlying structure. To establish an audit trail (Guba & Lincoln, 1985), the rst author documented all pro- cedures undertaken, insights attained, and revisions made in the analysis over time. To ll out or expand upon the description of the phenomena, the rst author shared ideas about emergent phenomena with participants (Porter, 1998) and reviewed ndings with them during their nal interviews. For example, with regard to the phenomenon of making a safe place, the rst author initiated this discussion with one teen: \"One of the things I heard you saying about your experience was that for you, becoming sexually active was a way to feel safe in a world that felt scary and unpredictable a lot of the time. Does that make sense to you?\" The participant responded, \"Yeah, it makes a lot of sense. I felt like having sex gave me a relationship I could count on, something I could depend on to be there even if nothing else was.\" We engaged in dialogue about emergent ndings to deepen the rst author's understanding of the phenomena. After analyzing data, the au- thors reconsidered the literature pertaining to the experience of interest (Porter, 1998), as reported in the discussion. Teen Mothers Becoming Sexually Active 225 RESULTS There were four phenomena of the experience of having become sexually active for the 10 teen mothers. The phenomena were: (a) making a safe place, (b) redening myself, (c) creating my own itfe story, and (d) engaging with the unknown. Data examples are shared relative to each phenomenon. As noted earlier, because the experience of having become sexually active might have varied relative to demographic characteristics, rural and urban teens were recruited, as well as Black and White teens. No such distinctions in the experi- ence, based on demographic characteristics, were evident in data. Accordingly, we pres- ent common facets of the experience shared by participants of both ethnic groups and res- idence locations. Making a 3an Place The teens spoke of becoming sexually active as a means of making a safe place for them- selves in a chaotic and uncertain world. They reported life circumstances, such as alien- ation from family members, which led them to feel adrift and alone. They perceived in- volvement in a sexual relationship as a way to feel connected, to establish closeness with someone warm and lovinga person who would be present for them in tough times. One teen said: \"I wanted to be a couple with somebody, a real couple. That way, I wouldn't feel like I was dangling out there on my own.\" Another said, \"It was like I was in some kind of bubble or something when I was with him. We just checked out of whatever else was going on out there, and [could pretend all the crap I had to deal with was a bad dream.\" Unfortunately, most of the teens found that, although sexual involvement ini- tially functioned as a means of attaining a sense of safety and connection, thereby repre- senting their intention at the time, it did not provide the safe harbor they had sought long-term. There were four component phenomena of making asafe place. First, the teens were try- ing tomake asafe place by establishing abond upon which they could count. \"There wasn't adoubt in my mind that this thing, having sex, was going tobond me to him for life. I wasn't sure we'd get married or anything, but I always thought there'd be something special be- tween us.\" By moving a relationship to the level of physical intimacy, they sought to be comfortable with conding fears, especially fears about growing up, new role expecta- tions, and the challenges of forming adultrelationships and being on their own. \"I felt like I could nally talk to someone about sex and relationships and how much everything was changingwithout worrying they were going to judge me or make like [did something wrong.\" Another key partof making asafe place had todo with lling an empty space inside thema space created by the absence of friends and family with whom to discuss intimacy and relationships. \"He wasn't any older than I was, but he was strong, and to me, he did some of the things I'd always wished my dad would do, like hug me and listen to me and get 226 Burns and Porter mad when other people hurt my feelings. . .things like that.\" Finally, the initiation of sexual activity was a way of retreating from the everydaya way to escape a world of chaos and confusion. \"I could just be close to somebody, have somebody think I was pretty and sexy and fun to be with. The world went away for awhile, you know?\" Redefining Myself The teens also viewed the initiation of sexual activity as a means of redening them- selves. They spoke about how their bodies, emotions, and priorities had changed dramati- cally as they grew into the teen years. They spoke of taking a new and different look at themselves as people. They described the sensation of being in a state of limbo, unsure how to proceed. Becoming sexually active was one way to cross an invisible line between childhood and adulthood. I had really crossed over somehow. and I was on my own. I knew it was important to be able to pull itoff. too. to make it without counting on anybody else. The sex part. that was like my way of saying. \"Hey. I'm grown now. I'm making my own decisions. and I don't need any- body's approval or help with this." There were four component phenomena of redening myself. As these teens became sexually active, they were embracing a new selfgetting comfortable with themselves as changing people. \"It was a way to really say good-bye to the old and put on the newifI was going to be somebody's lover, I sure as heck wasn't a little girl anymore, was I?" Re- defining themselves also involved crossing a line between the children they had been and the women into whom they were blossoming. \"It was a really weird feeling, when I think about itlike making a move that changed things forever, crossing over some boundary line that you didn't even know was there before.\" Through becoming sexually active, they were walking the walk of womanhood. \"I started thinking about what I should do to make sure he knew I was grown-up enough to be a lover. You know, writing sexy notes, buying little stuff, getting some sexy underwear, wearing perfume all the time." Finally, the teens were redefining themselves by feeling the power associated with celebrating, revealing, and making the mostof their sexuality. \"All of a sudden, I had hips and breasts, and I wanted to show them off. I liked the looks I got, and I liked feeling that I had some- thing somebody wanted.\" Creating My Own Life Story The teens described a strong desire to experience intimate relationships that were stron- ger, healthier, and more fulfilling than most of those they had witnessed in their homes Teen Mothers Becoming Sexually Active 227 and neighborhoods. Many had been disillusioned by those observations. They were fear- ful that their intimate relationships would follow the same patterns, but they were deter- mined to prevent that trajectory. They wanted to move beyond those familiar but unpleas- ant realities to create their own unique, special relationships that would be unspoiled by the past. For them, becoming sexually active was a first step toward those new lives; it was to be their initial opportunity to create something better. One teen put it this way: Here my mom was. three divorces. three kids by different guys. living with an alcoholic who hadn't had ajob since she met him. I gured the worst mistake [could make on my own wouldn't be as bad as all thatso where did she get off telling me not to trust guys? What I didn't trust was her opinion! Another said. \"Having sex was my way of making a life, a romantic life I guess, that was all mineone that wasn't about my mom or my sister or all their crazy boyfriends. My own story, if you know what I mean.\" There were four component phenomena of creating my own life story. Through estab- lishing their uniqueness, the teens tried to emphasize differences between themselves and certain female relatives and acquaintances. \"Just me, myself, doing my own thing. I wanted to prove that I may be my mother's daughter, but I'm not just my mother's daugh- ter.\" They were also letting go of the pastmaking a conscious effort to disengage from painful memories and unrealized expectations. \"When all you know about sex and rela- tionships is what you've seen, and almost all of that's bad... well, then, that's just what you know, isn't it? [couldn't get up around that, [couldn't let go of that idea about things, until I started doing my own thing and seeing for myself.\" They were pursuing an ideal of what they hoped life could be like. \"Sex was like that big rst step, the thing you did to make it all happen, you know? You get this boyfriend, he really wants you, you give each other everything, and then you have a shot at what you've had all those dreams about. Or so I thought, anyway.\" Finally, the teens had previously thought about sexual encounters, but their experience was one of making it real. Becoming sexually active was a gateway from fantasy to reality. \"I was ready to live that fantasy, to let everybody know I had a plan and I was going for it. Nobody was going to do it for me. It was my show.\" Engaging with the Unknown The teens had been very curious about the mysteries of intimate involvement and sexual connection. This curiosity had been fueled by romance novels and stories, movies depict- ing sexual encounters, and stories told by older siblings and sexually active peers. How- ever, the teens emphasized that their sexuality felt like something they were born with. They wanted to explore the unknown landscape of sexual activity. For them, physical in- timacy, and intimacy in general, had almost mythic qualities. \"I had this whole movie go- 228 Burns and Porter ing on in my mind, and I couldn't wait to see ifit could be real. I wasn'tjust curious about what I'd heard of. [was curious about what I'd made up for myself.\" In spite of problems they had witnessed with other relationships, they wanted to test out such fantasies and nd out for themselves. I had seen so much bad stuff that comes from sex. you know. My mom getting left by my dad and all the boyfriends. My sister getting knocked up and left with nothing by some guy who said he wasn't even the father. But to me. the way to make it work for me was to start doing it myself. There were three component phenomena of engaging with the unknown. First, the teens were satisfying their curiosity. \"You could read about it, talk about it, watch it in a movie, whatever. But until you've done it for yourself... .you don't know nothing.\" They had questions about what it would be like, and they wanted to devise their own personal answers. Becoming a sexual partner allowed them to take on the role for themselves, giv- ing them a sense of autonomy. In becoming sexually active, the teens also were testing the fantasies that they wanted to believe about relationships and sexual activity. \"You get all these ideas that you want to try out, sort of. You get a picture in your mind about how you want it to be, how you think it maybe could be, but there's a lot of that you don'teven know enough about to imagine it right.\" Each teen had struggled with the discrepancies between the fantasy world of sex and relationships portrayed in the media, and the real world they had observed rst-hand in their families and neighborhoods. Finally, by en- gaging with the unknown, they were holding their own in an unfamiliar world ofintimacy and sexual involvement. \"I wanted to be that somebody that other people knew was a grown-up with a boyfriend... and knew how to be like that. Having sex, that gave me a place there, and I knew how to keep it. Or at least I thought I didat the time.\" DISCUSSION A description of the experience of having become sexually active for teen mothers had not been reported previously in the literature. The purpose of this study was to obtain and present that description. However, some issues with sampling, recruitment, and the na- ture of the experience itself are possible limitations of the study. After those issues are ad- dressed, findings are compared to the literature and implications are considered. Limitations First, as noted earlier, quota sampling was done for residence location and ethnicity in the event that marked differences in the nature of the experience had surfaced. It was not a Teen Mothers Becoming Sexually Active 229 goal of the study to seek such differences, but it would have been necessary to describe them if they had emerged. The quota sampling strategy might not have been necessary in a study with a sample of 10 teens. In other descriptive studies with larger samples, such issues should be considered. Findings were derived from the experiences of 10 teens who might have differed in im- portant ways from teens who did not volunteer. People who volunteer for research pro- jects tend to be more articulate, better educated, and more expressive than their peers, as well as having higher self-esteem (Omery & Mack, 1995). All participants were pursuing an education; they were verbal and very comfortable talking about sexual behavior. All participants under the age of 18 were able to obtain parental consent to take part in the project; their experiences might have been very different from those of teens who were estranged from their parents. Thus, the phenomena reported here cannot be considered representative of the experiences of other teens. Finally, the study pertained to the experience of having become sexually active, rather than to the experience of becoming sexually active. This is a potential limitation from the standpoint of applicability of ndings to practice. Although the experience had occurred in the past, it is likely that participants' recall was quite good for those particular data, so validity of data was not aconcem. However, a different description would have resulted if the experience of becoming sexually active had been unfolding at the time data were gathered. Therefore, it cannot be assumed that data regarding the two respective experi- ences would have the same applicability to practice. A Comparison of Findings to the Literature Findings suggest that teens might not necessarily employ a linear process when making decisions regarding sexual behavior. That is, data gathered in this study were not fully consistent with a model such as identifying a problem, weighing the risks and benets of several courses of action, making a decision, and evaluating the choice (Borcherding & Shaefer, 1982; Michels et al., 2005). Although certain components of that model are present in some of the teens' stories, data suggest a broader array of thought processes and emotions associated with actions. For instance, becoming sexually active would not be a sensible outcome of an effort to make and secure a safe place in one's world. That ex- periential structure suggests a motivation rooted more in personal need rather than a step- wise prooess of deciding to become sexually active. As noted earlier, self-esteem has been considered a prime predictor of the initiation of sexual behavior in teens (Gaff-Smith, 2004; Kershaw et al., 2003). In this study, teens spoke about the personal impact of troubling life experiences, but they did not mention concepts or experiences directly related to self-esteem. It is beyond the scope of this study to discern if self-esteem issues might be at the core of some information shared by the teens; however, they did not use expressions such as self-worth, self-respect, or per- 230 Burns and Porter ception of self as a failure. That is, when talking about their experiences, they did not adopt language akin to the terms used to measure self-esteem in the RSES (Rosenberg, 1965). Instead, they spoke in personal idioms and phrases, painting a poignant, vivid, and nuanced picture of their reality. Insights suggested by each phenomenon, beyond those in the current literature, are explored next. Making a safe place. The need of teens to be heard and understood as a buffer against loneliness and depression (Joiner, Lewinsohn, & Seeley, 2002; Wu et al., 2004) is consistent with the experiential structure of making a safe place. There has been consid erable work on loneliness in teen girls and its impact on the need to bond with a signifi- cant person or persons to gain a sense of belonging (Kegler, Bird, Kyle-Moon, & Rodine, 2001; Larose & Bernier, 2001; Mahon et al., 2004). This need to bond has been cited as a partial explanation for the tendency of teens to turn to peers for support and guidance. However, findings about the phenomenon of making a safe place differ from the litera- ture in two ways. First, data revealed that participants were trying to establish a particular bond with a sexual partner. Second, the bonding intention went beyond a quest to belong and be understood; its focus was that of seeking stability amidst some chaotic per- sonal-social circumstances that were unique to each teen. For this reason, it might be dif- ficult to estimate the degree of relationship among generic variables such as belonging, family environment, and social bonding. The experiential structure of making a safe place reveals some of the complexity that is part of the experience of having initiated sex- ual activity, and as such, it represents a new perspective on teen sexual behavior. Redefining myself. Sexual activity and other high-risk behaviors among teens have been considered outcomes of insecurities, coupled with pressure to adapt to new chal- lenges (Kerhsaw et al., 2003; Larose & Bernier, 2001). However, few scholars have pro- posed that becoming sexually active might be a way to embrace changes perceived in the self. The component phenomenon, embracing a new me, is a novel way to understand the intentions of teens as they become sexually active. If teens indeed point to the redefini- tion of self as an intention for becoming sexually active, then alternative ways of meeting that end could be raised for discussion in focus groups or one-on-one counseling sessions with teens. Creating my own life story. There are many references to the need of teens to be individuals and to view themselves as separate from parents and family members (Giannone et al., 2004; Kellogg, Hoffman, & Taylor, 1999). However, there are no prior reports about the initiation of sexual activity as a specific means of achieving this individ- uation. Rather than simply experiencing an age-appropriate need to separate themselvesTeen Mothers Becoming Sexually Active 231 from adult family members, these teens described the intentional behavior of becoming sexually active as a vehicle by which to accomplish individuation. In so doing, they were working to create their own life stories. Engaging IM'Ih the unknown. The component phenomenon satistt'ng my curios- ity has some similarities to literature pertaining to curiosity and the desire to explore un- known territories as powerful motivating forces during the teen years (Barker, 1963; Erikson, 1968; Leckman, 2004). Bandura (1964) and Havighurst (1966) spoke of funda- mental curiosity as a building block of many developmental tasks of adolescence and as a critical component of risk-taking behaviors. Findings move beyond the recognition of curiosity as adevelopmental task. For these teens, curiosities fed elaborate fantasies that were one impetus for engaging with the unknown. Another component phenomenon of engaging with the unknown was testing the fanta- sies. Developmental literature relevant to teens' desire to assert themselves and to dis- cover things on their own (Newman & Newman, 1986; Piaget, 1969} is indicative that teens like to explore new territory in their own ways; the notion of testing fantasies is con- gruent with those concepts. Kershaw et al. (2003) discussed the need of teens to establish personal versions of the truth as a salient factor influencing their sexual behavior. How- ever, that conclusion, based on quantitative data, did not address the relevance of personal fantasy. Findings are grounds for considering a new perspective on the initiation of sex- ual activity among teensone that involves the intentional act of setting out to test unique, personal fantasies. Implications for Future Research Although new phenomena about the experience of having become sexually active were discerned, further inquiry about the experience is clearly indicated. Each phenomenon could be explored in depth in a longitudinal study extending over a period of a year or more. It was beyond the scope of this study to examine how interactions among race, class, and gender might have shaped participants' realities. For that reason a feminist ap- proach to the study of the experience could provide valuable insights. As noted earlier, studies should be done with larger samples to explore any differences in the experience linked to residence location and ethnicity. Because the youngest participants were 16 years of age, a study of the experiences of younger teen mothers could be done and the ndings compared to those of this study to consider age-related similarities and differences. It was not possible to discern how the experience of having become a mother influenced participants' reports about the experi- ence of having become sexually active. In future research, an effort should be made to ex- plore any relationships between those two experiences. It would be useful to conductde- 232 Burns and Porter scriptive phenomenological studies with sexually-active teen girls who have never been pregnantor had achild, as long as disclosure of their sexual activity would pose no threat of harm to them or to others. Further research is needed to explore several potentially important influences upon the personal-social context of the experience of having become sexually active for teens. Data specic to spiritual or religious factors that might impact sexual behavior did not emerge during this study. However, the relationship between spiritual beliefs and religi- osity and sexual decision-making among teens has been noted (Lammers, Ireland, Resnick, & Blum, 2000; McCree, Wingood, DiClemente, Davies, & Harrington, 2003; Nonnemaker, McNeely, & Blum, 2003). Therefore, spiritual and religious beliefs would be worthy of future study as possible contextual influences on the experience. Also, stud- ies with more ethnically diverse samples would represent an important direction for fu- ture research, so that the inuence of both culture and ethnicity on the experience of hav- ing become sexually active could be considered. Implications for Practice The major implication for practice of this study has to do with young teens who have not yet become sexually active. Most of the educational materials used with teens in school and public health settings are focused upon the dangers of sexually transmitted disease, the risk of pregnancy, and the socioeconomic disasters associated with giving birth (Kelly, Lesser, 81. Smoots, 2005; Parkes, Henderson, & Wight, 2005). Each of the four phenomena incorporates a suggestion for a different approach to prevention education beyond saturating teens with information about how to avoid the backlash of early-onset sexual activity. Efforts to increase perceptions of safety, to support personal identity, to bolster creativity, and to offer exploratory opportunities beyond sexual encounters could enhance effectiveness of programs designed to prevent early-onset sexual activity. Ef- forts such as these would represent a move away from emphasizing negative outcomes in favor of focusing on more positive outcomes. In conclusion, then, the findings of this descriptive study of the experience of becom- ing sexually active for teens are an invitation of sorts. The invitation, which is akin to the phenomenological research process, is to set aside the initiation of sexual activity as the focal point of nursing intervention and to concentrate, instead, on the underlying inten- tions of teen girls. It is important for nurses to look beyond traditionally-held beliefs about teens' motives and desires to engage in sexual activity. Nurses need to give teens the opportunity to discuss their own experiences. During those interactions, nurses might nd it necessary to acknowledge that teens are not necessarily engaged in logical deci- sion-making processes relative to becoming sexually active. Rather than trying to en- courage teens to avoid risks associated with the initiation of sexual activity, nurses could engage teens in conversation about what they are trying to do with their lives. When teens Teen Mothers Becoming Sexually Active 233 reveal those intentions, nurses will be in a better position to talk with them about ways in which they might fulfill those intentions, apart from becoming sexually active