Journal of Adolescent Health 58 (2016) 317e322
www.jahonline.org Original article
Rap Music Use, Perceived Peer Behavior, and Sexual Initiation Among Ethnic Minority Youth Kimberly A. Johnson-Baker, Dr.P.H. *, Christine Markham, Ph.D., Elizabeth Baumler, Ph.D., Honora Swain, Ph.D., and Susan Emery, Ph.D. Center for Health Prevention and Promotion Research, University of Texas School of Public Health, University of Texas Health Science Center, Houston, Texas
Article history: Received April 20, 2015; Accepted November 3, 2015 Keywords: Sexual behavior; Rap music; Media; Peers; Norms
A B S T R A C T
Purpose: Research shows that rap music use is associated with risky sexual behavior in ethnic minority youth; however, it is unknown whether rap music use impacts sexual initiation specifically and, if so, which factors mediate this impact. Thus, we investigated the longitudinal relationship between hours spent listening to rap music in seventh grade and sexual initiation in ninth grade. We also examined the role of perceived peer sexual behavior as a potential mediator of this relationship. Methods: We analyzed data from students (n ¼ 443) enrolled in a school-based randomized controlled trial of a sexual health education curriculum collected at baseline and at 18-month follow-up. Rap music use and perceived peer sexual behavior were assessed in seventh grade, whereas sexual initiation was assessed in ninth grade. Univariate, multivariate, and mediation analyses were conducted. Results: At baseline, rap music use was significantly associated with race/ethnicity, parental music rules, and sexual behavior, but not with gender or parental education. Rap music use was a significant predictor of sexual initiation on univariate analysis but not multivariate analysis. Mediation analysis showed that the association between hours spent listening to rap music and sexual initiation was significantly mediated by perceived peer sexual behavior. Conclusions: Rap music use in early adolescence significantly impacts sexual initiation in late adolescence, partially mediated by perceived peer sexual behavior. More research is needed to understand how rap music influences perceptions of peer sexual behavior, which, in turn, influence early sexual initiation. Ó 2016 Society for Adolescent Health and Medicine. All rights reserved.
Ethnic minority youth (black and Hispanic) initiate sex at an earlier age than youth from other racial/ethnic groups [1], putting them at risk for multiple negative sexual health outcomes, such as HIV, sexually transmitted infection (STI), and unplanned pregnancy [2e4]. Although all youth experience pressure to initiate * Address correspondence to: Kimberly A. Johnson-Baker, Dr.P.H., Center for Health Prevention and Promotion Research, University of Texas School of Public Health, University of Texas Health Science Center, 7000 Fannin St., Houston, TX E-mail address: [email protected] (K.A. Johnson-Baker). 1054-139X/Ó 2016 Society for Adolescent Health and Medicine. All rights reserved. http://dx.doi.org/10.1016/j.jadohealth.2015.11.003
IMPLICATIONS AND CONTRIBUTION
Overall, this study establishes the need for further research on the impact of rap music on perceived peer sexual behavior. Importantly, the findings do not support the censorship of rap music content; rather, interventionists should consider using rap music to improve the cultural relevance of current sexual health education programs.
sex early, ethnic minority youth express greater pressure to conform to sexual norms than white youth [5,6] and cite media as the source of sexual pressure (National Campaign, 2012). Ethnic minority youth consume a substantial amount of media including music, predominantly rap music [7,8]; most of which contains sexually explicit content [9e11]. Research shows that sexually explicit mediadmedia with extreme and/or subtle references to permissive sexual behaviordimpact sexual behavior among youth [10e18] and that rap music is more likely than other popular music genres (e.g., pop, rock) to contain sexually explicit
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K.A. Johnson-Baker et al. / Journal of Adolescent Health 58 (2016) 317e322
content [9,11,18]. Moreover, high exposure to rap music has been shown to be associated with less parental monitoring, permissive sexual attitudes, multiple sexual partnering, and STI acquisition [11,18e20]. However, previous research is limited to crosssectional studies [18,21] or to studies with older adolescents [17,19]. Furthermore, it is unknown whether rap music use impacts early sexual initiation, a predictor of subsequent risky sexual behavior [20], and, if so, which factors mediate this impact. Thus, more research is needed to understand the impact of rap music on ethnic minority youth who listen to a higher amount of such music than do white youth [7,8]. Social cognitive theory provides a theoretical basis for investigating the relationship between rap music and sexual behavior. According to social cognitive theory, children learn vicariously from media and are more likely to translate learning into behavior when (1) the role model is similar to the viewer in gender or ethnicity; (2) the behavior is perceived to be similar to real life; (3) the role model is attractive; and (4) the behavior is positively reinforced [22]. Through observational learning and modeling, adolescents may develop attitudes and beliefs that support the role model’s behavior [22], which, in turn, may influence their decision-making when in sexual possibility situations. This study assumed that through the use of rap music, adolescents (1) identify with rap music artists; (2) believe that sexual behavior is acceptable and reinforced in peer groups; and ultimately (3) act on the learned behavior when the opportunity is available. However, a greater understanding of how rap music influences adolescent sexual initiation is warranted. A possible mechanism underlying the relationship between rap music and sexual behavior is the influence of perceived peer behavior. Perceived peer behavior, the belief that one’s peer group is sexually active, is a consistent predictor of early sexual initiation regardless of socioeconomic status, neighborhood contextual factors, parental characteristics, intention, and self-efficacy [23e26]. Furthermore, sexually explicit media have been shown to function as a “super peer” for youth seeking guidance on sexual behavior [27], suggesting that media play a crucial role in setting norms for sexual behavior. To our knowledge, no study has examined the potential mediating role of perceived peer sexual behavior in the relationship between rap music use and sexual initiation. In this study, we investigated the longitudinal relationship between hours spent listening to rap music in seventh grade and sexual initiation in ninth grade, while controlling for significant covariates. We also examined the role of perceived peer sexual behavior as a potential mediator of this relationship among urban, ethnic minority youth. We hypothesized that seventh-grade youth who listened to more hours of rap music are more likely than those who listened to fewer hours of rap music or none to initiate sex by ninth grade and that perceived peer sexual behavior mediates the relationship between rap music use and sexual initiation. Methods Sample and study design We used longitudinal data from a school-based randomized controlled trial (RCT) that evaluated the effectiveness of a middleschool sexual health education curriculum in a large southern U.S. city [28]. We analyzed data collected at baseline (n ¼ 726) and at 18-month follow-up (n ¼ 509 for univariate analysis, n ¼ 443 for multivariate and mediational analyses) from control group participants to avoid any interference from the intervention. For the RCT, a standardized protocol including parental consent, student
assent, and data collector training, was followed [26]. Students completed computer-assisted surveys on laptops while being monitored by trained data collectors. For their participation, students received monetary incentives at each time point. This study was approved by the institutional review board of The University of Texas Health Science Center at Houston. Additional details about the RCT are provided elsewhere [26]. Measures Independent variable Rap music use. We used a single item to measure rap music use at baseline (seventh grade). Students were asked, “In a usual day, how many hours do you listen to rap or hip hop?” Responses included “I do not listen to rap music,” “Less than an hour a day,” “1e2 hours a day,” “3e4 hours a day,” “5e6 hours a day,” and “7 or more hours a day.” Responses were recoded as “I do not listen to rap music” (0 ¼ “no use”), “Less than 2 hours a day” (1 ¼ “low use”), and “3 or more hours a day” (2 ¼ “high use”). Dependent variable Sexual initiation. We assessed sexual initiation at 18-month follow-up (ninth grade). Sexual initiation was defined as “ever having any sex” (i.e., vaginal, oral, or anal sex). Only those students who reported “no sex” at baseline were included in the longitudinal analysis. Mediator variable Perceived peer sexual behavior. We used a single item to assess perceived peer sexual behavior at baseline (seventh grade). Students were asked, “How many of your friends have had vaginal sex?” Responses ranged from “none” (0) to “most” (3). Higher scores represented higher perceived sexual activity among friends. Covariates Several variables known to influence both the independent and dependent variables were included as covariates. Covariates included gender, race/ethnicity, age, parental education, and parental monitoring. To assess parental monitoring, we included a measure of parental music rules. Students were asked, “Do you have rules in your house about the kinds of music that you listen to?” Responses included “no” (0) and “yes” (1). Statistical analysis Bivariate correlational analyses were used to examine the relationships between rap music use, perceived peer sexual behavior, and covariates. Chi-square analyses were performed to assess subgroup differences among these variables. Logistic regression was conducted to examine the relationship between hours spent listening to rap music per day at baseline and any engagement in sexual activity at 18-month follow-up. The primary independent variable of interest was the number of hours spent listening to rap music per day. All data were analyzed using PASW Statistics 18 (IBM Corp., Armonk, NY). Steps outlined by Baron and Kenny [29e31] were used to test the mediational relationship between rap music use, perceived peer sexual behavior, and sexual initiation. The conceptual model of the mediation is presented in Figure 1. First, a regression analysis was conducted to determine if rap music use was a predictor of perceived peer sexual behavior (pathway a in Figure 1).
K.A. Johnson-Baker et al. / Journal of Adolescent Health 58 (2016) 317e322
Figure 1. Representation of the mediation model.
Second, a regression analysis was conducted to determine the effect of perceived peer sexual behavior on sexual initiation (pathway b in Figure 1), while controlling for rap music use. Third, a regression analysis was conducted to determine if rap music use was a significant predictor of sexual initiation, while controlling for perceived peer sexual behavior (pathway c in Figure 1). Significance testing to determine partial mediation was completed using the Sobel test [32]. Students who reported any sexual behavior at baseline, and those with missing data on priority variables, were excluded from the analyses, resulting in an analytic sample of 445 students. Results Baseline characteristics for the sample are presented in Table 1. The sample had a mean age of 13 years (standard deviation ¼ .60), was mostly female (56%), and was predominantly ethnic minority (42% Hispanic and 40% black). Most students reported rap music use; of these, 69% listened to 3 or more hours per day (high use), 17% listened to
www.jahonline.org Original article
Rap Music Use, Perceived Peer Behavior, and Sexual Initiation Among Ethnic Minority Youth Kimberly A. Johnson-Baker, Dr.P.H. *, Christine Markham, Ph.D., Elizabeth Baumler, Ph.D., Honora Swain, Ph.D., and Susan Emery, Ph.D. Center for Health Prevention and Promotion Research, University of Texas School of Public Health, University of Texas Health Science Center, Houston, Texas
Article history: Received April 20, 2015; Accepted November 3, 2015 Keywords: Sexual behavior; Rap music; Media; Peers; Norms
A B S T R A C T
Purpose: Research shows that rap music use is associated with risky sexual behavior in ethnic minority youth; however, it is unknown whether rap music use impacts sexual initiation specifically and, if so, which factors mediate this impact. Thus, we investigated the longitudinal relationship between hours spent listening to rap music in seventh grade and sexual initiation in ninth grade. We also examined the role of perceived peer sexual behavior as a potential mediator of this relationship. Methods: We analyzed data from students (n ¼ 443) enrolled in a school-based randomized controlled trial of a sexual health education curriculum collected at baseline and at 18-month follow-up. Rap music use and perceived peer sexual behavior were assessed in seventh grade, whereas sexual initiation was assessed in ninth grade. Univariate, multivariate, and mediation analyses were conducted. Results: At baseline, rap music use was significantly associated with race/ethnicity, parental music rules, and sexual behavior, but not with gender or parental education. Rap music use was a significant predictor of sexual initiation on univariate analysis but not multivariate analysis. Mediation analysis showed that the association between hours spent listening to rap music and sexual initiation was significantly mediated by perceived peer sexual behavior. Conclusions: Rap music use in early adolescence significantly impacts sexual initiation in late adolescence, partially mediated by perceived peer sexual behavior. More research is needed to understand how rap music influences perceptions of peer sexual behavior, which, in turn, influence early sexual initiation. Ó 2016 Society for Adolescent Health and Medicine. All rights reserved.
Ethnic minority youth (black and Hispanic) initiate sex at an earlier age than youth from other racial/ethnic groups [1], putting them at risk for multiple negative sexual health outcomes, such as HIV, sexually transmitted infection (STI), and unplanned pregnancy [2e4]. Although all youth experience pressure to initiate * Address correspondence to: Kimberly A. Johnson-Baker, Dr.P.H., Center for Health Prevention and Promotion Research, University of Texas School of Public Health, University of Texas Health Science Center, 7000 Fannin St., Houston, TX E-mail address: [email protected] (K.A. Johnson-Baker). 1054-139X/Ó 2016 Society for Adolescent Health and Medicine. All rights reserved. http://dx.doi.org/10.1016/j.jadohealth.2015.11.003
IMPLICATIONS AND CONTRIBUTION
Overall, this study establishes the need for further research on the impact of rap music on perceived peer sexual behavior. Importantly, the findings do not support the censorship of rap music content; rather, interventionists should consider using rap music to improve the cultural relevance of current sexual health education programs.
sex early, ethnic minority youth express greater pressure to conform to sexual norms than white youth [5,6] and cite media as the source of sexual pressure (National Campaign, 2012). Ethnic minority youth consume a substantial amount of media including music, predominantly rap music [7,8]; most of which contains sexually explicit content [9e11]. Research shows that sexually explicit mediadmedia with extreme and/or subtle references to permissive sexual behaviordimpact sexual behavior among youth [10e18] and that rap music is more likely than other popular music genres (e.g., pop, rock) to contain sexually explicit
318
K.A. Johnson-Baker et al. / Journal of Adolescent Health 58 (2016) 317e322
content [9,11,18]. Moreover, high exposure to rap music has been shown to be associated with less parental monitoring, permissive sexual attitudes, multiple sexual partnering, and STI acquisition [11,18e20]. However, previous research is limited to crosssectional studies [18,21] or to studies with older adolescents [17,19]. Furthermore, it is unknown whether rap music use impacts early sexual initiation, a predictor of subsequent risky sexual behavior [20], and, if so, which factors mediate this impact. Thus, more research is needed to understand the impact of rap music on ethnic minority youth who listen to a higher amount of such music than do white youth [7,8]. Social cognitive theory provides a theoretical basis for investigating the relationship between rap music and sexual behavior. According to social cognitive theory, children learn vicariously from media and are more likely to translate learning into behavior when (1) the role model is similar to the viewer in gender or ethnicity; (2) the behavior is perceived to be similar to real life; (3) the role model is attractive; and (4) the behavior is positively reinforced [22]. Through observational learning and modeling, adolescents may develop attitudes and beliefs that support the role model’s behavior [22], which, in turn, may influence their decision-making when in sexual possibility situations. This study assumed that through the use of rap music, adolescents (1) identify with rap music artists; (2) believe that sexual behavior is acceptable and reinforced in peer groups; and ultimately (3) act on the learned behavior when the opportunity is available. However, a greater understanding of how rap music influences adolescent sexual initiation is warranted. A possible mechanism underlying the relationship between rap music and sexual behavior is the influence of perceived peer behavior. Perceived peer behavior, the belief that one’s peer group is sexually active, is a consistent predictor of early sexual initiation regardless of socioeconomic status, neighborhood contextual factors, parental characteristics, intention, and self-efficacy [23e26]. Furthermore, sexually explicit media have been shown to function as a “super peer” for youth seeking guidance on sexual behavior [27], suggesting that media play a crucial role in setting norms for sexual behavior. To our knowledge, no study has examined the potential mediating role of perceived peer sexual behavior in the relationship between rap music use and sexual initiation. In this study, we investigated the longitudinal relationship between hours spent listening to rap music in seventh grade and sexual initiation in ninth grade, while controlling for significant covariates. We also examined the role of perceived peer sexual behavior as a potential mediator of this relationship among urban, ethnic minority youth. We hypothesized that seventh-grade youth who listened to more hours of rap music are more likely than those who listened to fewer hours of rap music or none to initiate sex by ninth grade and that perceived peer sexual behavior mediates the relationship between rap music use and sexual initiation. Methods Sample and study design We used longitudinal data from a school-based randomized controlled trial (RCT) that evaluated the effectiveness of a middleschool sexual health education curriculum in a large southern U.S. city [28]. We analyzed data collected at baseline (n ¼ 726) and at 18-month follow-up (n ¼ 509 for univariate analysis, n ¼ 443 for multivariate and mediational analyses) from control group participants to avoid any interference from the intervention. For the RCT, a standardized protocol including parental consent, student
assent, and data collector training, was followed [26]. Students completed computer-assisted surveys on laptops while being monitored by trained data collectors. For their participation, students received monetary incentives at each time point. This study was approved by the institutional review board of The University of Texas Health Science Center at Houston. Additional details about the RCT are provided elsewhere [26]. Measures Independent variable Rap music use. We used a single item to measure rap music use at baseline (seventh grade). Students were asked, “In a usual day, how many hours do you listen to rap or hip hop?” Responses included “I do not listen to rap music,” “Less than an hour a day,” “1e2 hours a day,” “3e4 hours a day,” “5e6 hours a day,” and “7 or more hours a day.” Responses were recoded as “I do not listen to rap music” (0 ¼ “no use”), “Less than 2 hours a day” (1 ¼ “low use”), and “3 or more hours a day” (2 ¼ “high use”). Dependent variable Sexual initiation. We assessed sexual initiation at 18-month follow-up (ninth grade). Sexual initiation was defined as “ever having any sex” (i.e., vaginal, oral, or anal sex). Only those students who reported “no sex” at baseline were included in the longitudinal analysis. Mediator variable Perceived peer sexual behavior. We used a single item to assess perceived peer sexual behavior at baseline (seventh grade). Students were asked, “How many of your friends have had vaginal sex?” Responses ranged from “none” (0) to “most” (3). Higher scores represented higher perceived sexual activity among friends. Covariates Several variables known to influence both the independent and dependent variables were included as covariates. Covariates included gender, race/ethnicity, age, parental education, and parental monitoring. To assess parental monitoring, we included a measure of parental music rules. Students were asked, “Do you have rules in your house about the kinds of music that you listen to?” Responses included “no” (0) and “yes” (1). Statistical analysis Bivariate correlational analyses were used to examine the relationships between rap music use, perceived peer sexual behavior, and covariates. Chi-square analyses were performed to assess subgroup differences among these variables. Logistic regression was conducted to examine the relationship between hours spent listening to rap music per day at baseline and any engagement in sexual activity at 18-month follow-up. The primary independent variable of interest was the number of hours spent listening to rap music per day. All data were analyzed using PASW Statistics 18 (IBM Corp., Armonk, NY). Steps outlined by Baron and Kenny [29e31] were used to test the mediational relationship between rap music use, perceived peer sexual behavior, and sexual initiation. The conceptual model of the mediation is presented in Figure 1. First, a regression analysis was conducted to determine if rap music use was a predictor of perceived peer sexual behavior (pathway a in Figure 1).
K.A. Johnson-Baker et al. / Journal of Adolescent Health 58 (2016) 317e322
Figure 1. Representation of the mediation model.
Second, a regression analysis was conducted to determine the effect of perceived peer sexual behavior on sexual initiation (pathway b in Figure 1), while controlling for rap music use. Third, a regression analysis was conducted to determine if rap music use was a significant predictor of sexual initiation, while controlling for perceived peer sexual behavior (pathway c in Figure 1). Significance testing to determine partial mediation was completed using the Sobel test [32]. Students who reported any sexual behavior at baseline, and those with missing data on priority variables, were excluded from the analyses, resulting in an analytic sample of 445 students. Results Baseline characteristics for the sample are presented in Table 1. The sample had a mean age of 13 years (standard deviation ¼ .60), was mostly female (56%), and was predominantly ethnic minority (42% Hispanic and 40% black). Most students reported rap music use; of these, 69% listened to 3 or more hours per day (high use), 17% listened to
