This study conducted a psychometric evaluation of the construct validity of the Health Self-Determinism Index-Sexual (HSDI-S). The instrument was modified to measure motivation related to sexual health rather than motivation of general health in the Health Self-Determinism Index (HSDI). The HSDI-S was completed by 260 conveniently selected women (between the ages of 18 and 44) attending primary-care clinics in the southeastern United States. Confirmatory factor analysis using LISREL did not validate the four subscales of the original HSDI. Subsequent exploratory and confirmatory factor analysis isolated a single-factor model composed of eight items: four judgment items and four external/internal cues items. This finding is suggestive that changes in wording appear to have shifted the responses from motivation for sexual health to that of women's perception of their role in intimate relationships. The eight extrinsically worded items isolate a single-factor model of social and cultural influences of childbearing-age women's intimate relationships.
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