Social Cognitive Theory as a Theoretical Framework to Predict Sexual Risk Behaviors among Older Adults

ABSTRACT

Objectives

Older adults vary in their safe and unsafe sexual behaviors. While researchers are beginning to understand more about the sexual and intimate expression of older adults, only recently are they beginning to understand how older adults make decisions about sexual risk. Bandura’s social cognitive theory offers a frame for understanding how self-efficacy, environmental factors, and goal motivation are related to sexual risk behaviors for older adults, including the interplay between these variables.

Methods

Using a diverse sample of older adults (n = 720) age 50+ years, social cognitive theory was modeled to determine the relationship between environment variables (age, gender, and sexual health conversations with practitioners), behavioral variables (self-efficacy), and cognitive variables (importance of sexual wellness goals) with the outcome variable of sexual risk behaviors.

Results

Self-efficacy had an indirect effect on sexual risk via sexual wellness goal motivation. Healthcare provider conversations had both direct and indirect effects on older adults’ sexual risk through sexual wellness goal motivation. Models were similarly predictive for older men and women.

Conclusions

Sexual risk behaviors among older adults are more influenced by environmental factors in their healthcare settings and their perception and prioritization of sexual wellness goals.

Clinical implications

Providers play a key role in initiating and maintaining sexual health discussions with older patients, potentially mitigating sexual risk and bolstering self-efficacy.

KEYWORDS:

• Sex risk
• older adults
• self-efficacy
• goal motivation
• social cognitive theory

Clinical implications

• Open and supportive communication between OA patients and their healthcare providers is pivotal in supporting OAs’ sexual health and wellness goals.

• As the relationship between sexual risk and sexual goals is nuanced, providers need to help OAs clearly articulate their sexual wellness goals and clarify how those relate to actual and perceived sexual risk among their older patients, encouraging accuracies and action when necessary.

• Self-efficacy may operate indirectly on sexual risk through other variables, such as speaking with a healthcare provider who can play an important role in enhancing self-efficacy among OAs by creating opportunities to practice sexual-wellness and experience mastery.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Kansas State University [Small Research Grant].